Records from this system of records may be disclosed to the national archives and records administration or to the general services administration for records management inspections conducted under 44 usc 2904 and 2906. Tournament dates month day, year b name of state park, marina, or concession i agree that the tournament may be held as scheduled at this location. The pa statement process should accomplish one goal. Do not process, store, or transmit any personally identifiable information pii, unclassifiedfouo or classified information on. Information collected will be used to expedite the selection process of recruiter applicants. Criteria, dod minimum antiterrorism standards for buildings. The data provided will be used to update your military personnel record. To grant individuals increased rights of access to agency records maintained on themselves. A record from this system of records may be disclosed, as a routine use, in the course of. Notwithstanding the above, using this is does not constitute consent to pm, le or ci investigative searching or monitoring of the content of privileged communications, or work product, related to personal representation or services by attorneys, psychotherapists, or clergy, and their assistants. Introduction to the privacy act defense privacy and civil liberties. All proceeds from the operation of this site are donated to veteran and other charities. Issued by the epa chief information officer, pursuant to delegation 119, dated 772005 procedures for preparing. Privacy act statement national oceanic and atmospheric.
Information about the privacy act statement and security. Attach copy yes no duty position yymmdd please circle. To be used on all documents containing personal information. The access right cannot be delegated below the level of executive officer and is subject to the limitations on disciplinary and administrative action contained in other parts of this statement. Secnav don cio navy pentagon washington, dc 20350. Navy website dod resource locator 45376 sponsored by the department of the navy chief information officer don cio. Regular active service member active guard active reserve air force army navy reserves national guard civilian marine corps coast guard h.
Dd form 2005, privacy act statement health care records. This statement serves to inform you of the purpose for collecting personal information required by tricare and health net federal services, llc hnfs and how it will be used. To grant individuals the right to seek amendment of agency records maintained on themselves upon a showing that the records are not accurate, relevant, timely or complete. See privacy act statement on reverse yymmdd required for asisqi producing courses military training request the proponent of this form is the directorate of plans, training, mobililization and security previous form is obsolete rankgrade profile. To provide such data as is requested by the recruiter to contact, process, and enlist prospects fro army service. Total army personnel command, reserve component counterparts, and other agencies that have an input to training missions, the vehicle to manage individuals and training course seatsquotas through the training base of officers and skill level 2. A person designated to make scaadl decisions for the service member. Providing information to the epa suspension and debarment program is voluntary. No agency shall disclose any record which is contained in a system of records by any means of communication to any person, or to another agency, except pursuant to a written request by, or with the prior written consent of, the individual to whom the record pertains, unless disclosure of the record would be. Privacy act statement and advisories allow the individual to make an informed decision about providing their data. The fipps help serve as a useful framework for the department to analyze how to handle pii, comply with its continuing responsibilities under the numerous legal obligations that apply, as well as adhere to its.
All information is provided in good faith, however, we make no representation or warranty of any kind regarding its accuracy, validity, reliability, or completeness. Do not process, store, or transmit any personally identifiable information pii, unclassifiedfouo or classified information on this system. Army regulation 190, the army physical security program. Depending on the nature of your application, supplemental authorities include federal statutes, state statutes pursuant to pub. Collection of this information is authorized by 10 usc, sections 503 and 30. The fbis acquisition, preservation, and exchange of fingerprints and associated information is generally authorized under 28 u. This data is used to provide human resource management and succession planning for the army s senior military leaders. The specific federal statute or executive order that authorizes collection of the requested information.
Unauthorized attempts to upload information andor change information on this website are strictly prohibited and are subject to prosecution under the computer fraud and abuse act of 1986 and title 18 u. To provide commanders and law enforcement officials with means by which information may be accurately identified. This must include measurable objectives, milestones and performance metrics to evaluate progress. Articles army corps launches alternate care facility construction building health care facilities isnt a new task for usace, which has years of experience designing and building hospitals and clinics for the military health system. Ssn and personal information in hisher leaders book with the understanding that this information will. The blanket routine uses set forth at the beginning of the army s compilations of system of records. Used by recruiter selection teams when interviewing recruiter applicants. S pacific fleet inspector general hotline complaint form please answer all questions below, use block 9 for additional information or additional sheets if the blocks are not large. The information provided on is for general and educational purposes only and is not a substitute for professional advice.
To restrict disclosure of personally identifiable records maintained by agencies. This statement serves to inform you of the purpose for collecting personal information required by health net federal services, llc hnfs, on behalf of the tricare program, and how it will be used. Code, section 301 and executive order 9397 of 22 nov 43, information regarding personal identification including, but not limited to, name, address, telephone number, social security number, next of kin, etc. This privacy act statement is located on the back of the fd258 fingerprint card. Army records, regardless of media, aremaintained from creation through final disposition in a manner that protects the rights and interests of individuals and the federal. Usaid privacy act section e3 statement or notice template. Total army personnel command, reserve component counterparts, and other agencies that have an input to training missions, the vehicle to manage individuals and training course seatsquotas through the training base of officers and skill level 2 and above. A record in this system of records may be disclosed to the department of justice to determine whether disclosure is required by the freedom of information act foia. Guardians agreement to care for a soldiers children in his or her absence. Collection of the information request by the recruiter and recorded on this form is authorized by title 10 u. If monitoring of this or any other dod interest computer system reveals a possible violation of criminal statutes, this evidence and any other related information, including identification information about the user, may be provided to law enforcement officials. The information may be disclosed to the agency contractors, grantees, experts, consultants, or volunteers who have been engaged by the agency to assist in the performance of a service. The purpose of collecting this information is to conduct background checks on visitors to army facilities and installations.
Dd form 2923 download printable pdf or fill online privacy. Contents shall not be disclosed, discussed, or shared with individuals unless they. Sep, 2010 secnav don cio navy pentagon washington, dc 20350. The privacy act of 1974, 5 usc 552a, provides protection to individuals by ensuring that personal information collected by federal agencies is limited to that which. Date signature of the individual social security no. The overview is not intended to provide policy guidance, as that role statutorily rests with the office of management and budget omb, 5 u. This could be a person designated by the service member, a courtappointed guardian, or a personal representative in accordance with dod 6025. To provide detailed information necessary for army officials and commanders to discharge their responsibilities for maintaining discipline, law and order through investigation of complaints and incidents and possible criminal prosecution, civil court action, or regulatory order. Army regulation 190, the army physical security program, authorizes the solicitation of personal information to check the records of the national crime information center. In the case of military personnel, the requested information is mandatory because of the need to. Tracking the provisions of the act itself, the overview provides reference to and legal analysis of court decisions interpreting the acts provisions. The army maintains records during the conduct of army business.
433 697 1250 152 1441 285 616 204 1406 49 1625 1290 250 1436 1074 1191 649 1214 637 1205 451 1028 467 1575 1399 83 1508 450 1280 141 1291 952 758 879 1184 921 1298 1468 1077