NRFU Field Interview Incentive Reciept_ENG

FIELD INTERVIEW INCENTIVE RECEIPT FORM

Thank you for your taking part in this interview to determine if anyone in your household is eligible to join the Ask U.S. Panel pilot. To thank you for your time, we are offering you a $____ cash incentive.

___________________________________ _________ __ __ __ __ __ __ __ __

Interviewer Date Case ID

□ Accepted Cash Incentive □ Declined Cash Incentive

Disposition: Send original to supervisor; retain yellow copy; pink copy to respondent.