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Census Form 2020 PDF

The document contains two annex forms related to conducting the 2020 Census of Population and Housing (CPH) questionnaire via Computer-Assisted Web-based Interviewing (CAWI) technique in the Philippines. Annex 1 is a consent form that obtains agreement to terms of collecting, processing, using and storing information for legitimate purposes. Annex 2 collects personnel information of the interviewer such as name, position, contact details and attestation for conducting the CAWI.

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375 views2 pages

Census Form 2020 PDF

The document contains two annex forms related to conducting the 2020 Census of Population and Housing (CPH) questionnaire via Computer-Assisted Web-based Interviewing (CAWI) technique in the Philippines. Annex 1 is a consent form that obtains agreement to terms of collecting, processing, using and storing information for legitimate purposes. Annex 2 collects personnel information of the interviewer such as name, position, contact details and attestation for conducting the CAWI.

Uploaded by

Baems Ambor
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Republic of the Philippines Annex 1 – Consent Form

Philippine Statistics Authority

Accomplishment of the
2020 Census of Population and Housing (CPH) Questionnaire via
Computer-Assisted Web-based Interviewing (CAWI) Technique

CONSENT FORM

TERMS AND AGREEMENT


 You give consent to the Philippine Statistics Authority (PSA) to collect, process, use and
store all information provided for any legitimate purposes pursuant to Republic Act No.
10625 (Philippine Statistical Act of 2013), and Republic Act No. 10173 (Data Privacy Act of
2012) and other statutory acts that may apply;

 You agree that PSA cannot utilize any information as evidence in any legal proceeding;

Kindly put a check mark ( ) below and affix your signature if you agree to all above-stated terms and
agreements;

/ I agree to all above-stated terms and agreements.

I do not agree to all above-stated terms and agreements.

Attested by:

SEPTEMBER 11, 2020


Signature Date

AGUAM, JANISAH MBHTE-BARMM


Surname, First Name Agency

Please return the accomplished form by email [email protected]/ or


[email protected]. For inquiries, our staff, Melanie S. Mohammad, CPH focal person can
be reached at 0975-928030-73 or 552-32-06.
Republic of the Philippines Annex 2 – Personnel Information for CAWI
Philippine Statistics Authority

Accomplishment of the
2020 Census of Population and Housing (CPH) Questionnaire via
Computer-Assisted Web-based Interviewing (CAWI) Technique

PERSONNEL INFORMATION FOR CAWI

Last Name: AGUAM


First Name: JANISAH
Middle Name: MAMA
Position/ Official Designation: SST-I
Name of Agency: MINISTRY OF BASIC, HIGHER, AND TECHNICAL
EDUCATION
PSA Board or
Name of Inter-agency
Committee on Statistics N/A
(e.g. Inter-Agency Committee on
Population and Housing Statistics)
Residential Address:
ILIAN, MARANTAO LANAO DEL SUR

Permanent Address:
ILIAN, MARANTAO LANAO DEL SUR

Telephone Number/s: N/A


Mobile Number/s: 0930-590-5409 /0977-6177-570
Email Address/es: ILIAN, MARANTAO LANAO DEL SUR

Attested by:

AGUAM, JANISAH
Surname, First Name
(Signature over printed name)

SEPTEMBER 11, 2020


Date

Please return the accomplished form by email [email protected]/ or


[email protected]. For inquiries, our staff, Melanie S. Mohammad, CPH focal person can
be reached at 0975-928030-73 or 552-32-06.

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