UnNumbered Participation Consent

Attachment 4 – NIBRS Participation Consent Form

Project Title: Crime Data Modernization - NIBRS Modernization Study

Informed Consent Agreement
Please read this consent agreement carefully before you decide to participate in the study.
Purpose of the modernization study: The purpose of the study is to examine the nation’s crime data
collection system as it is currently and to assess its health as changes are made to it.
What you will do in the study: We will be conducting interviews with you and potentially other
members of your agency. These interviews will be conducted by in-person interviews. The interviews
will not be taped. Your identity and the identity of any other persons will not be included in any final
reports. The interview will be informal, which means we will have a set of high-level questions which we
will ask you, but based on your responses, we may ask other questions depending on the information
you provide.
Time required: The study will require approximately one hour and a half.
Risks: There are no anticipated risks involved in this study or your participation in it.
Benefits: There are no direct benefits to you for participating in this study. The study will assist us to
understand the issues and concerns of police agencies which are reporting their crime statistics to their
state UCR program and to the FBI.
Confidentiality: The interview will not be recorded. The information you give us in the study will be
handled confidentially and kept private to the extent permitted by law. Your name and identity will not
be associated with any information which you provide to us and will only be known to the individuals
working on this project.
Voluntary participation: Your participation in the study is completely voluntary.
Right to withdraw from the study: You have the right to withdraw from the study interview at any time
without penalty. If you wish to stop the interview at any time, please inform us of your decision.
How to withdraw from the study: If you want to withdraw from the study, explain you wish to stop the
interview and leave the room.
If you have questions about the study, contact: Unit Chief, FBI Crime Data Modernization,
Amy C. Blasher at 304-625-4840.

November 4, 2016 ~ Page 1