Privacy Threshold Analysis (PTA)

The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, pia@dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis
Version date: June 10, 2010
Page 1 of 6
PRIVACY THRESHOLD ANALYSIS (PTA)
This form is used to determine whether
a Privacy Impact Assessment is required.

Please use the attached form to determine whether a Privacy Impact Assessment (PIA) is required under
the E-Government Act of 2002 and the Homeland Security Act of 2002.
Please complete this form and send it to your component Privacy Office. If you do not have a component
Privacy Office, please send the PTA to the DHS Privacy Office:
Rebecca J. Richards
Director of Privacy Compliance
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
Tel: 703-235-0780

PIA@dhs.gov

Upon receipt from the component Privacy Office, the DHS Privacy Office will review this form. If a PIA
is required, the DHS Privacy Office will send you a copy of the Official Privacy Impact Assessment Guide
and accompanying Template to complete and return.
A copy of the Guide and Template is available on the DHS Privacy Office website, www.dhs.gov/privacy,
on DHSConnect and directly from the DHS Privacy Office via email: pia@dhs.gov, phone: 703-235-0780.

The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, pia@dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis
Version date: June 10, 2010
Page 2 of 6
PRIVACY THRESHOLD ANALYSIS (PTA)
SUMMARY INFORMATION
Date Submitted for Review: March 30, 2011
Name of Project: FEMA Form 119-17-2 (Request for Use of NETC Facilities) and
FEMA Form 119-17-1 (Request for Housing Accommodations)
System Name in TAFISMA: N/A
Name of Component: Federal Emergency Management Agency
Name of Project Manager: Merril Sollenberger
Email for Project Manager: merril.sollenberger@dhs.gov
Phone Number for Project Manager: 301-447-1179
Type of Project:
Information Technology and/or System. ∗
A Notice of Proposed Rule Making or a Final Rule.
Form or other Information Collection.
Other:

∗

The E-Government Act of 2002 defines these terms by reference to the definition sections of Titles 40 and
44 of the United States Code. The following is a summary of those definitions:
•“Information Technology” means any equipment or interconnected system or subsystem of
equipment, used in the automatic acquisition, storage, manipulation, management, movement,
control, display, switching, interchange, transmission, or reception of data or information. See 40
U.S.C. § 11101(6).
•“Information System” means a discrete set of information resources organized for the collection,
processing, maintenance, use, sharing, dissemination, or disposition of information. See: 44. U.S.C. §
3502(8).
Note: for purposes of this form, there is no distinction made between national security systems or
technologies/systems managed by contractors. All technologies/systems should be initially reviewed for
potential privacy impact.

The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, pia@dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis
Version date: June 10, 2010
Page 3 of 6
SPECIFIC QUESTIONS
1.

Describe the project and its purpose:
The U.S. Fire Administration (USFA), Management, Operations, and Support Services Division,
prescribes FEMA Form (FF) 119-17-1 and 119-17-2 to coordinate housing requirements and
training activities at the National Emergency Training Center (NETC). These forms are part of
FEMA’s Information Collection designated OMB No. 1660-0029. The requestor must write,
email, or telephone a request to determine if housing is available. If housing is available, the
program office contact person must follow up by completing FEMA
FF 119-17-1, Request for Housing Accommodations: Some rooms on the NETC Emmitsburg, MD
campus are double occupancy, and some are handicap accessible. The FF 119-17-1 collects the
names, purchase order number, gender, and disability status so that NETC can coordinate
housing requirements and assign rooms for contract instructors and attendees of the
conference(s)/meeting(s) scheduled. The form also identifies if lodging fees need to be collected
from the conference/training attendees. The information collected on the form is entered into the
NETC Admissions database for storage and retrieval of the collected information.
FF 119-17-2, Request for Use of NETC Facilities: The policy of USFA is to also accommodate other
training activities on a space-available basis at the NETC Emmitsburg, MD campus. Special
groups must write, email, or telephone a request to determine availability of the facilities. If space
is available, the contact person for the special group must follow-up by completing FF 119-17-2.
The form provides information that enables NETC to assign classrooms, schedule equipment,
and arrange for food service.

2.

Status of Project:
This is a new development effort.
This is an existing project.
Date first developed: 4/01/1979
Date last updated: 1/2008
Updated 1/2008 due to OMB expiration date

3.

From whom do you collect, process, or retain information on: (Please check all that apply)
DHS Employees.
Contractors working on behalf of DHS.
The Public.

The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, pia@dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis
Version date: June 10, 2010
Page 4 of 6
The System does not contain any such information.
4.

Do you use or collect Social Security Numbers (SSNs)? (This includes truncated SSNs)
No.
Yes. Why does the program collect SSNs? Provide the function of the SSN and the
legal authority to do so:

5.

What information about individuals could be collected, generated or retained?
FEMA Form 119-7-1 provides the names, purchase order number, gender, and disability
status so that NETC can coordinate housing requirements and assign rooms for contract
instructors and attendees of the conference/meeting scheduled. The form also identifies if
lodging fees need to be collected from the conference/training attendees.
FEMA Form 119-17-2 provides information that enables NETC to assign classrooms, schedule
equipment, and arrange for food service.

6.

If this project is a technology/system, does it relate solely to infrastructure? [For example, is
the system a Local Area Network (LAN) or Wide Area Network (WAN)]?
No. Please continue to the next question.
Yes. Is there a log kept of communication traffic?
No. Please continue to the next question.
Yes. What type of data is recorded in the log? (Please choose all that apply.)
Header.
Payload Please describe the data that is logged.

7.

Does the system connect, receive, or share Personally Identifiable Information with any other
DHS systems 1?
No.

1

PII may be shared, received, or connected to other DHS systems directly, automatically, or by manual processes.
Often, these systems are listed as “interconnected systems” in TAFISMA.

The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, pia@dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis
Version date: June 10, 2010
Page 5 of 6
Yes.
Please list:
8.

Is there a Certification & Accreditation record within OCIO’s FISMA tracking system?
Unknown.
No.
Yes. Please indicate the determinations for each of the following:
Confidentiality:

Low

Moderate

High

Undefined

Integrity:

Low

Moderate

High

Undefined

Availability:

Low

Moderate

High

Undefined

PRIVACY THRESHOLD REVIEW
(TO BE COMPLETED BY THE DHS PRIVACY OFFICE)
Date reviewed by the DHS Privacy Office: April 4, 2011
Name of the DHS Privacy Office Reviewer: Rebecca J. Richards
DESIGNATION
This is NOT a Privacy Sensitive System – the system contains no Personally Identifiable
Information.
This IS a Privacy Sensitive System
Category of System
IT System.
National Security System.
Legacy System.
HR System.
Rule.
Other: Form
Determination

The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, pia@dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis
Version date: June 10, 2010
Page 6 of 6
PTA sufficient at this time.
Privacy compliance documentation determination in progress.
PIA is not required at this time.
PIA is required.
System covered by existing PIA:
New PIA is required.
PIA update is required.
SORN not required at this time.
SORN is required.
System covered by existing SORN: FEMA-Student Application &
Registration Records (SARR) SORN, October 5, 2004 69 FR 59609004
New SORN is required.
DHS PRIVACY OFFICE COMMENTS: FORTHCOMING PIA, STUDENT TRAINING
APPLICATION AND REGISTRATION SYSTEM (STARS) WILL COVER THESE COLLECTIONS.
COLLECTION WILL BE COVERED BY THE STUDENT BY THE SARR SORN.