STUDY PARTICIPANT RECEIVING $40
PUBLIC VOUCHER FOR PURCHASES AND SERVICES OTHER THAN PERSONAL
The information that you provide in the spaces below will be used to release any incentive payments (cash or non-cash) to you. Census Bureau personnel will mail your incentive via USPS Priority Mail no later than five business days after completion of your interview. You will receive your incentive in about two weeks of completion of your interview, depending on mail service.
In the box below, please enter your name and the address where you want your incentive to be sent.
Name
Street Address
City
State
ZIP
We will be sending the incentive payment using USPS Priority Mail. Would you like to receive this using USPS Priority Mail?
Yes
No, I am a federal employee and cannot receive payment for my time
Finally please sign below and enter today's date.
Signature:
Type today's date below:
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Betsari Otero Class (CENSUS/CBSM FED) |
| File Modified | 0000-00-00 |
| File Created | 2025-08-12 |