SIPP 2014 Panel

2014 Survey of Income and Program Participation (SIPP) Panel

SIPP-105(L3)(2014) revised incentive statement

SIPP 2014 Panel

OMB: 0607-0977

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SIPP-105(L3)(2014)(CA)
(11-2013)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
The U.S. Census Bureau is conducting a vitally important survey called the Survey of Income and Program
Participation (SIPP), and we need your help to ensure accurate data collection. In the next several weeks,
a Census Bureau Field Representative will contact your household regarding this survey. I want you to
know that your household’s participation in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each unanswered
question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Section 182. Section 9 of
Title 13 requires that we hold all information about you and your household in strictest confidence. Every
Census Bureau employee, from the Director to every Field Representative, has taken an oath to uphold
this confidentiality. If an employee discloses any information that identifies you or your household, he or
she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
15350 SHERMAN WAY STE 400
VAN NUYS CA 91406–4203
census.gov

SIPP-105(L3)(2014)(CO)
(11-2013)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
The U.S. Census Bureau is conducting a vitally important survey called the Survey of Income and Program
Participation (SIPP), and we need your help to ensure accurate data collection. In the next several weeks,
a Census Bureau Field Representative will contact your household regarding this survey. I want you to
know that your household’s participation in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each unanswered
question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Section 182. Section 9 of
Title 13 requires that we hold all information about you and your household in strictest confidence. Every
Census Bureau employee, from the Director to every Field Representative, has taken an oath to uphold
this confidentiality. If an employee discloses any information that identifies you or your household, he or
she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
6950 W JEFFERSON AVE STE 250
DENVER CO 80235–2377
census.gov

SIPP-105(L3)(2014)(GA)
(11-2013)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
The U.S. Census Bureau is conducting a vitally important survey called the Survey of Income and Program
Participation (SIPP), and we need your help to ensure accurate data collection. In the next several weeks,
a Census Bureau Field Representative will contact your household regarding this survey. I want you to
know that your household’s participation in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each unanswered
question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Section 182. Section 9 of
Title 13 requires that we hold all information about you and your household in strictest confidence. Every
Census Bureau employee, from the Director to every Field Representative, has taken an oath to uphold
this confidentiality. If an employee discloses any information that identifies you or your household, he or
she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
101 MARIETTA ST NW STE 3200
ATLANTA GA 30303–2711
census.gov

SIPP-105(L3)(2014)(IL)
(11-2013)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
The U.S. Census Bureau is conducting a vitally important survey called the Survey of Income and Program
Participation (SIPP), and we need your help to ensure accurate data collection. In the next several weeks,
a Census Bureau Field Representative will contact your household regarding this survey. I want you to
know that your household’s participation in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each unanswered
question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Section 182. Section 9 of
Title 13 requires that we hold all information about you and your household in strictest confidence. Every
Census Bureau employee, from the Director to every Field Representative, has taken an oath to uphold
this confidentiality. If an employee discloses any information that identifies you or your household, he or
she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
1111 W 22ND ST STE 400
OAK BROOK IL 60523–1918
census.gov

SIPP-105(L3)(2014)(NY)
(11-2013)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
The U.S. Census Bureau is conducting a vitally important survey called the Survey of Income and Program
Participation (SIPP), and we need your help to ensure accurate data collection. In the next several weeks,
a Census Bureau Field Representative will contact your household regarding this survey. I want you to
know that your household’s participation in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each unanswered
question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Section 182. Section 9 of
Title 13 requires that we hold all information about you and your household in strictest confidence. Every
Census Bureau employee, from the Director to every Field Representative, has taken an oath to uphold
this confidentiality. If an employee discloses any information that identifies you or your household, he or
she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
32 OLD SLIP 9TH FLOOR
NEW YORK NY 10005–3500
census.gov

SIPP-105(L3)(2014)(PA)
(11-2013)

DC

UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration

U.S. Census Bureau
Washington, DC 20233-0001
OFFICE OF THE DIRECTOR

FROM THE DIRECTOR
U.S. CENSUS BUREAU
Dear Resident:
The U.S. Census Bureau is conducting a vitally important survey called the Survey of Income and Program
Participation (SIPP), and we need your help to ensure accurate data collection. In the next several weeks,
a Census Bureau Field Representative will contact your household regarding this survey. I want you to
know that your household’s participation in this survey is extremely valuable and greatly appreciated.
This survey produces data that helps shape government program decisions affecting millions of people in
the United States. For example, policymakers use the survey’s results to evaluate the future needs of the
Social Security system, changes to and the effectiveness of programs like the Supplemental Nutrition
Assistance Program, and the impact of changes to health insurance and the cost of medical care. In order
to provide accurate information to your elected representatives and support improving such significant
programs, the Census Bureau needs your help to collect accurate data.
Your household’s participation is essential to ensure the completeness and accuracy of this study’s data.
Your address has been specifically chosen to represent thousands of other households just like yours.
Although there are no penalties for failure to answer any question in this voluntary study, each unanswered
question substantially lessens the accuracy of the results.
We conduct this study under the authority of Title 13, United States Code, Section 182. Section 9 of
Title 13 requires that we hold all information about you and your household in strictest confidence. Every
Census Bureau employee, from the Director to every Field Representative, has taken an oath to uphold
this confidentiality. If an employee discloses any information that identifies you or your household, he or
she is subject to a prison term, a fine, or both.
As a token of our appreciation for your time and participation in this survey, the Census Bureau will send
you a $40 prepaid debit card after you have completed the interview.
Additional information is explained on the back of this letter. Learn more at our Web site:
.
Thank you for your participation. I am grateful for your help.
Sincerely,

John H. Thompson
Director
For more information, contact:
REGIONAL DIRECTOR
US CENSUS BUREAU
833 CHESTNUT ST STE 504
PHILADELPHIA PA 19107–4405
census.gov

Why does the Census Bureau collect this information?
Although we conduct a census every ten years, some information needs to be updated more often. This
survey provides current data about a variety of important issues, such as changes people have
experienced in their jobs, health insurance coverage, medical expenditures, the well-being of
children and adults, childcare and child support status, retirement and pension planning, participation in
government programs, and other information. Since the country changes rapidly, up-to-date facts are
necessary in order to create effective programs. Policymakers in government and private organizations
need current economic information to make informed decisions about programs that will affect people of
all income levels. Your voluntary participation is essential to ensure that this survey’s results are
complete and accurate.
How do I know the Census Bureau will protect my information?
The law authorizes the Census Bureau to collect information for this survey (Title 13, United States Code
(U.S.C.), Section 182). Section 9 of this law requires us to keep all information about you and your
household strictly confidential. The Census Bureau will use this information only for statistical purposes.
Everyone who has access to your responses is subject to a prison term, a fine up to $250,000, or both,
if any information is revealed that identifies you or your household.
How will the Census Bureau use the information that I provide?
Because Title 13 guarantees the confidentiality of your information, the Census Bureau will combine the
information you provide with that of others to produce statistics. To be efficient, the Census Bureau
attempts to obtain information you may have given to other agencies if you have participated in other
government programs. We do so because it helps to ensure your data are complete, and it reduces the
number of questions you are asked on this survey. The same confidentiality laws that protect your survey
answers also protect any additional information we collect (Title 13, U.S.C., Section 9). If you wish to
request that your information not be combined with information from other agencies, we ask that you
notify the field representative at the time of the interview.
How much time will the survey take?
We estimate that it will take about 60 minutes per person to collect the information. This includes time for
reviewing the instructions and completing and reviewing your answers. You may send comments regarding
time estimates or any other aspect of this data collection process, including suggestions for reducing this
burden, to Paperwork Reduction Project xxxx–xxxx, U.S. Census Bureau, 4600 Silver Hill Road, AMSD
3K138, Washington, DC 20233-1500. You may also e-mail comments to ;
use “Paperwork Project xxxx–xxxx” as the subject.
The U.S. Office of Management and Budget (OMB) approved this survey and gave it OMB approval number
xxxx–xxxx; the expiration date is xx/xx/xxxx. Displaying this number shows that the Census Bureau is
authorized to conduct this survey. Please use this number in any correspondence concerning this survey.

SIPP-105(L3)(2014)


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