INSTRUCTIONS: Please submit an original-signature copy of this agreement. (It will be countersigned and a copy returned to you.) Use additional copies of this page if necessary.
The undersigned staff, in consideration of their use of this restricted data certify the following:
That they have read the associated Restricted Data Use Agreement, and the Data Protection Plan incorporated by reference into this Agreement.
That they are "Research Staff" within the meaning of the Agreement (any research staff other than the Restricted Data Investigator).
That they will fully comply with the terms of the Agreement, including the Data Protection Plan incorporated by reference into it.
That they will not attempt to access this restricted data until approved to do so by the ICPSR.
Study Title
Signature
Date
Typed Name
Title/Formal Affiliation with Research Project
Signature
Date
Typed Name
Title/Formal Affiliation with Research Project
The above Research Staff are hereby granted approval to access this restricted data:
____________________________________________________________
Inter-university Consortium for Political and Social Research
________
Date
Careers | Contact Us | Privacy Policy | Official Representative Site | Accessibility
© 2007 Regents of the University of Michigan. ICPSR is part of the Institute for Social Research at the University of Michigan.
