Appendix G-2_Disclaimer_Pretest 2

Appendix G-2: Disclaimer for Pretest 2

(To be given to respondents before interview)

The Economic Research Service (ERS) of the U.S. Department of Agriculture and Westat are conducting a study to understand food or drinks people buy or obtain for free. The results of the study will help to advance our understanding of what food or drinks people buy or obtain for free and whether families in US can get what they need.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0536-0073 (expires 01/31/2019). This information collection asks people to report food or drinks they buy or obtain for seven days, to report meals and snacks taken over the course of seven days and to complete an income worksheet online. In addition, one of the household members will be asked participate in three in-person surveys and to complete a respondent feedback form. The average time that is required for each member in your household to complete this survey is estimated to average 5 hours, including the time for reviewing instructions, getting trained to report food or drinks obtained, reporting food or drinks obtained, reporting meals and snacks taken, completing an income worksheet, and completing two in-person interviews. This information collection is not mandatory and your participation is voluntary.

This study does not require the study coordinators to access any of your personal information. You do not have to provide any personal or sensitive information (e.g., relating to illegal behaviors, alcohol or drug use, sexual attitudes, mental health, etc.). Information provided to this study does not have the potential to damage your financial standing, employability or reputation, or place you at risk of criminal or civil liability. ID numbers will be handled separately from names. Efforts will be made to keep your study-related information confidential. Your responses are covered by the Confidential Information Protection and Statistical Efficiency Act of 2002 (PL-107-347).

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