Name dataset    HSN Data Set -- to be specified--

The undersigned

Name:

Address:

City:

Telephone No.:

E-mail:

certifies, in respect of the above mentioned data set (hereinafter called: the database) , made available to him/her by the Historical Sample of the Population of the Netherlands (Stichting Historische Steekproef Nederlandse Bevolking; hereinafter called: HSN), that he or she:

1 will consult the data incorporated in the database solely for the purpose of scientific research or statistics, and that these data are required for specific research purposes or specific statistics

title and aim of the research (maximum 50 words):

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2 guarantees that he or she will strictly observe all the statutory regulations concerning the data contained in the database, including, in particular, the provisions contained in or based on the Personal Data Protection Act (Wet Bescherming Persoonsgegevens);

3 is acquainted with HSN's privacy regulations (deposited with the Personal Data Protection Board [College Bescherming Persoonsgegevens], under no. M1117501), and in using the database will strictly observe these regulations, in particular by warranting the anonymity of the data and guaranteeing that the results for which the data are used cannot be traced back to individual natural persons;

4 will not use the data in the database in order to search for additional information about individual persons, regardless of whether these persons are included in the database;

5 recognizes that all the intellectual or industrial property rights in the database, the software, the hardware or other (accompanying) materials remain with HSN or its licensors, and certifies that he or she will not reproduce or copy (parts of) the database, the software or other (accompanying) materials;

6 indemnifies HSN against all claims made by third parties, arising from violation by him or her of the statutory regulations concerning the data, including violation of the Personal Data Protection Act (Wet Bescherming Persoonsgegevens);

7 undertakes to keep secret the data in the database, not to divulge them to, put them at the disposal of or make them available for use by third parties, and to utilize them solely for the purpose for which HSN has provided them to him or her;

8 will not alter, add to or remove data in the database without the written consent of HSN's Board;

9 will transfer all enrichment to the dataset like coding or linking results to the IISG as soon as possible;

10 will report to HSN as soon as possible all errors, inconsistencies or ambiguities found by him or her;

11 in case of publication of the results in any form (presentations, books, articles etc.) for which he or she has used the database, he or she will credit the HSN according to the citation rules of the HSN (including to refer at first citation to the database by the title Historical Sample of the Netherlands (HSN). Data Set @@@ Release @@@, further citations as HSN Data Set @@@ Release @@@@;

12 notifying the HSN of all kind of publications (presentations, books, articles etc.) for which he or she has used the database and send a copy of each publication to HSN;

13 will pay to the HSN the amount of € nihil to compensate the costs of making the dataset available.

Date,    ..../..../….....
Place,    ............................
Signature.................................................

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