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Supplemental Agreement With Research Staff

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

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