Privacy Impact Assessment

Appendix A: DI-4001 PIA Form
Introduction
The Department of the Interior requires PIAs to be conducted and maintained on all IT systems whether
already in existence, in development or undergoing modification in order to adequately evaluate privacy
risks, ensure the protection of privacy information, and consider privacy implications throughout the
information system development life cycle. This PIA form may not be modified and must be completed
electronically; hand-written submissions will not be accepted. See the DOI PIA Guide for additional
guidance on conducting a PIA or meeting the requirements of the E-Government Act of 2002. See
Section 6.0 of the DOI PIA Guide for specific guidance on answering the questions in this form.
NOTE: See Section 7.0 of the DOI PIA Guide for guidance on using the DOI Adapted PIA template to
assess third-party websites or applications.
Name of Project: Endangered and Threatened Wildlife, Experimental Populations Information
Collection 1018-0095(50 CFR 17.84)
Date:

August 15, 2017

Bureau/Office:

DOI, FWS, Ecological Services

Bureau/Office Contact Title:

Biologist

Point of Contact
Email:
First Name:
M.I.:
Last Name:
Phone:
Address Line 1:
Address Line 2:
City:
State/Territory:
Zip:

Amy_Brisendine@fws.gov
Amy
E
Brisendine
703-358-2005
5275 Leesburg Pike
Falls Church
Virginia
22041

Section 1. General System Information
A. Is a full PIA required?
This is a threshold question. Indicate whether the system collects, maintains, uses or
disseminates information about members of the general public, Federal employees, contractors,
or volunteers. If the system does not contain any information that is identifiable to individual
(e.g., statistical, geographic, financial), complete all questions in this section and obtain
approval and required signatures in Section 5. The entire PIA must be completed for systems

Appendix A – DI-4001 PIA Form
that contain information identifiable to individuals, including employees, contractors and
volunteers.
Yes, information is collected from or maintained on
Members of the general public
Federal personnel and/or Federal contractors
Volunteers
All
No: Information is NOT collected, maintained, or used that is identifiable to the individual in
this system. Only sections 1 and 5 of this form are required to be completed.
B. What is the purpose of the system?
Describe the purpose of the system and how it relates to the program office’s and Department’s
mission. Include the context and background necessary to understand the purpose, the name of
the program office and the technology, project or collection being assessed.
We are collecting information on endangered or threatened species, as described in 50 CFR 17.84.
The administration and management of data collected for experimental populations is
accomplished by a single office or individual; FWS biologists in different field offices around
the country are responsible for ensuring proper use of the data relating to a particular
experimental population of species protected by the Endangered Species Act (ESA).

Experimental populations established under section 10(j) of the ESA, as amended, require
information collection and reporting to the U.S. Fish and Wildlife Service (Service, we). We
collect information on the experimental populations listed in 50 CFR 17.84 to help further the
recovery of the species and to assess the success of the reintroduced populations. The
respondents notify us when an incident occurs, so there is no set frequency for collecting the
information. We use the information for purposes such as:
•
•
•

Documenting the locations of reintroduced animals.
Improving management techniques for reintroduction.
Determining causes of mortality and conflict with human activities so that Service managers
can minimize conflicts with people.

Reporting parties include, but are not limited to, State/local/Tribal governments, nonprofit
organizations, individuals or households, and businesses. We collect the information by means
of telephone calls or facsimiles from the public to Service offices specified in the speciesspecific regulations. Standard information collected includes:
•
•
•
•
•
•

Name, address, and phone number of reporting party.
Species involved.
Type of incident.
Take (quantity).
Location and time of reported incident.
Description of the circumstances related to the incident.

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Records of reported incidents will be maintained in paper copies. Due to limitations in funding
and staff time, we do not have any plans to create a system for electronic submission of reports.
C. What is the legal authority?
A Federal law, Executive Order of the President (EO), or DOI requirement must authorize the
collection and maintenance of a system of records. For Privacy Act systems, the response should
reflect the information provided in the authority section of the Privacy Act system of records
notice.
• Endangered Species Act (16 U.S.C. 1531-1544)
• 50 CFR 17.84
D. Why is this PIA being completed or modified?
Indicate why the PIA is being conducted. For example, the system is being significantly modified
or two systems are being merged together.
New Information System
New Electronic Collection
Existing Information System under Periodic Review
Merging of Systems
Significantly Modified Information System
Conversion from Paper to Electronic Records
Retiring or Decommissioning a System
Other: Describe: The contact information of reporting parties is collected.
E. Is this information system registered in CSAM?
The completed PIA, associated system of records notice(s), and any other supporting artifacts
must be entered into the CSAM system for each registered system or application.
Yes: Enter the UII Code and the System Security Plan (SSP) Name
No

F. List all minor applications or subsystems that are hosted on this system and covered under
this privacy impact assessment.
Enter “None” if no subsystems or applications are hosted. For General Support Systems (GSS)
be sure to include all hosted major applications, minor applications, or other subsystems, and
describe the purposes and types of PII if any. Privacy risks must be identified and adequately
addressed for each hosted application or subsystem identified in the GSS PIA. A separate PIA
should be conducted for each hosted application or subsystem that contains PII to ensure
privacy implications are assessed. In any case, the GSS PIA must identify all hosted
applications, describe the relationship, and reference or append the PIAs conducted for the
hosted applications. The GSS PIA and associated PIAs must be reviewed and approved by all
officials as appropriate; and all related PIAs, SORNs and supporting artifacts must be entered
into CSAM.

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Appendix A – DI-4001 PIA Form
Subsystem Name

Purpose

Contains PII
(Yes/No)

Describe
If Yes, provide a
description.

None

G. Does this information system or electronic collection require a published Privacy Act
System of Records Notice (SORN)?
A Privacy Act SORN is required if the information system or electronic collection contains
information about individuals that is retrieved by name or other unique identifier. Provide the
DOI or Government-wide Privacy Act SORN identifier and ensure it is entered in CSAM for this
system. For new SORNS being developed, select "Yes" and provide a detailed explanation.
Contact your Bureau Privacy Officer for assistance identifying the appropriate Privacy Act
SORN(s).
Yes: List Privacy Act SORN Identifier(s)
No
H. Does this information system or electronic collection require an OMB Control Number?
The Paperwork Reduction Act requires an OMB Control Number for certain collections of
information from ten or more members of the public. If information is collected from members of
the public, contact your Bureau Information Collection Clearance Officer for assistance to
determine whether you need to obtain OMB approval. Please include all OMB Control Numbers
and Expiration Dates that are applicable.
Yes: Describe OMB Control Number 1018-0095
No

Section 2. Summary of System Data
A. What PII will be collected? Indicate all that apply.
Identify all the categories of PII that will be collected, stored, used, maintained or disseminated.
Describe any additional categories of PII not already indicated, as well as any new information
that is created (for example, an analysis or report), and describe how this is done and the
purpose of that information.
Name
Citizenship
Gender
Birth Date
Group Affiliation
Marital Status
Biometrics
Other Names Used
Truncated SSN
Legal Status
Place of Birth

Religious Preference
Security Clearance
Spouse Information
Financial Information
Medical Information
Disability Information
Credit Card Number
Law Enforcement
Education Information
Emergency Contact
Driver’s License

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Appendix A – DI-4001 PIA Form
Race/Ethnicity
Social Security Number (SSN)
Personal Cell Telephone Number
Tribal or Other ID Number
Personal Email Address
Mother’s Maiden Name
Other: Specify the PII collected.

Home Telephone Number
Child or Dependent Information
Employment Information
Military Status/Service
Mailing/Home Address

B. What is the source for the PII collected? Indicate all that apply.
Include all sources of PII collected. For example, information may be collected directly from an
individual through a written form, website collection, or through interviews over the phone or in
person. Information may also come from agency officials and employees, agency records, from a
computer readable extract from another system, or may be created within the system itself. If
information is being collected through an interface with other systems, commercial data
aggregators, or other agencies, list the source(s) and explain why information from sources
other than the individual is required.
Individual
Federal agency
Tribal agency
Local agency
DOI records
Third party source
State agency
Other: Describe
C. How will the information be collected? Indicate all that apply.
Indicate all the formats or methods for collecting PII that will be used. If the system receives
information from another system, such as a transfer of financial information or response to a
background check, describe the system from which the information originates, how the
information is used, and how the systems interface.
Paper Format
Email
Face-to-Face Contact
Web site
Fax
Telephone Interview
Information Shared Between Systems
Other: Describe
D. What is the intended use of the PII collected?
Describe the intended uses of the PII collected and maintained in the system and provide a
detailed explanation on how the data will be used. The intended uses must be relevant to the
purpose of the system; for Privacy Act systems, uses must be consistent with the published system
of records notice.

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Appendix A – DI-4001 PIA Form

The contact information is collected to verify or further describe the species, type of incident, the
take (quantity), location and time of incident and the circumstances related to the incident.
E. With whom will the PII be shared, both within DOI and outside DOI? Indicate all that
apply.
Indicate all the parties, both internal and external to DOI, with whom PII will be shared. Identify
other DOI offices with assigned roles and responsibilities within the system, or with whom
information is shared, and describe how and why information is shared. Also, identify other
federal, state and local government agencies, private sector entities, contractors or other
external third parties with whom information is shared; and describe any routine information
sharing conducted with these external agencies or parties, and how such external sharing is
compatible with the original purpose of the collection of the information. If sharing is pursuant
to a Computer Matching Agreement, provide an explanation. For Privacy Act systems, describe
how an accounting for the disclosure is maintained.
Within the Bureau/Office: Describe the bureau/office and how the data will be used.
Primarily, the FWS lead biologist for the experimental population in question would be
verifying the information regarding the species’ incident with the reporting party.
Verification of contact information would be done by the biologist in case they need to verify
the information about the species’ incident or if the incident includes either a potential legal
violation of the ESA or potential depredation of livestock by a member of the experimental
population. In those cases, we would provide all of the information to FWS Law
Enforcement officers or the U.S. Department of Agriculture/APHIS Division of Wildlife
Damage Management.
Verification usually requires physical examination of the site and injured animal or carcass,
which requires travel on the part of FWS personnel.
Other Bureaus/Offices: Describe the bureau/office and how the data will be used.
Other Federal Agencies: Describe the federal agency and how the data will be used.
In those cases described above, we would provide all of the information to FWS Law
Enforcement officers or the U.S. Department of Agriculture/APHIS Division of Wildlife
Damage Management.
Tribal, State or Local Agencies: Describe the Tribal, state or local agencies and how the
data will be used.
Contractor: Describe the contractor and how the data will be used.
Other Third Party Sources: Describe the third party source and how the data will be used.
F. Do individuals have the opportunity to decline to provide information or to consent to the
specific uses of their PII?

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Appendix A – DI-4001 PIA Form
If “Yes,” describe the method by which individuals can decline to provide information or how
individuals consent to specific uses. If “No,” state the reason why individuals cannot object or
why individuals cannot give or withhold their consent.
Yes: Describe the method by which individuals can decline to provide information or how
individuals consent to specific uses.
Note that the majority of the reports are provided by State or Federal Partners. It is possible
that the contact information could be declined over the phone, or the form can be submitted
via fax without the contact information.
No: State the reason why individuals cannot object or why individuals cannot give or
withhold their consent.
G. What information is provided to an individual when asked to provide PII data? Indicate
all that apply.
Describe how notice is provided to the individual about the information collected, the right to
consent to uses of the information, and the right to decline to provide information. For example,
privacy notice to individuals may include Privacy Act Statements, posted Privacy Notices,
privacy policy, and published SORNs and PIAs. Describe each format used and, if possible,
provide a copy of the Privacy Act Statement, Privacy Notice, or a link to the applicable privacy
policy, procedure, PIA or referenced SORN Federal Register citation (e.g., XX FR XXXX, Date)
for review. Also describe any Privacy Act exemptions that may apply and reference the Final
Rule published in the Code of Federal Regulations (43 CFR Part 2).
Privacy Act Statement: Describe each applicable format.
Privacy Notice: Describe each applicable format.
Other: Describe each applicable format.
SCRIPT FOR FWS EMPLOYEES TO USE FOR
COLLECTING INFORMATION ON EXPERIMENTAL POPULATIONS

(NOTE: You may not collect any information other than that approved under OMB Control Number 1018-0095.)
Thank you for contacting us. My name is ___________________________ and I am a _(position)__________ with the
U.S. Fish and Wildlife Service’s ___(office)_____________________ in ________(location)_____________________.
We have established experimental populations for some listed species as a tool for creating additional populations to
protect the species against a catastrophic loss (due to a hurricane for example). It is important that we have information on
any injuries, mortalities (including human-related), recovery of dead specimens, animal husbandry actions necessary to
manage the population, and other types of take (including harm or harassment). The Code of Federal Regulation (50 CFR
Subpart H) contains our regulations on experimental populations. In addition, you can find information governing experimental
populations at http://www.fws.gov/endangered.
We may not conduct or sponsor and you do not have to respond to a collection of information unless it displays a currently
valid Office of Management and Budget control number. The Office of Management and Budget has reviewed and approved
our request to collect information on the take of members of experimental populations. The OMB Control Number is 10180095, which expires October 31, 2017. We use this information to:
•
Document the locations of reintroduced animals.
•
Improve management techniques for reintroduction of listed species.
•
Determine causes of mortality and, where appropriate, conflict with human activities so that we can minimize
conflicts with people and their land use.
•
Assess the effectiveness of control activities to reduce problems where depredation is an issue.

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You should be aware that in some cases the information you provide may need to be referred to our law
enforcement officers for further investigation. Please tell me:
•
Your name, address, and phone number.
•
Species involved.
•
Type of incident.
•
Quantity of take (under the ESA “take’ includes harm, harass, and nonlethal activities that may harm the listed
species) involved.
•
Location and time of reported incident.
•
Description of the circumstances related to the incident. [Provide any instructions to the reporting party.]
We estimate that it will take most people no more than 30 minutes to provide this information, which includes time for
gathering and maintaining the information. You may send comments on any aspect of this information collection to the
Service Information Collection Clearance Officer, Division of Policy and Directives Management, U.S. Fish and Wildlife Service
(MS-BPHC), 5275 Leesburg Pike, Falls Church, Virginia 22041
Thank you for providing this information. If you have any questions or need more information, please contact me at
_(telephone number)_________.

None
H. How will the data be retrieved? List the identifiers that will be used to retrieve information
(e.g., name, case number, etc.).
Describe how data is retrieved from the system. For example, is data retrieved manually or via
reports generated automatically? Are specific retrieval identifiers used or does the system use
key word searches? Be sure to list the identifiers that will be used to retrieve data (e.g., name,
case number, Tribal Identification Number, subject matter, date, etc.).
Data is retrieved manually and by species. There is no electronic system for reporting incidents
on endangered or threatened species for which there are rules in 50 CFR 17.84.
I. Will reports be produced on individuals?
Indicate whether reports will be produced on individuals. Provide an explanation on the purpose
of the reports generated, how the reports will be used, what data will be included in the reports,
who the reports will be shared with, and who will have access to the reports. Many systems have
features that allow reports to be generated on data in the system or on user actions within the
system.
Yes: What will be the use of these reports? Who will have access to them?
No

Section 3. Attributes of System Data
A. How will data collected from sources other than DOI records be verified for accuracy?
Data accuracy and reliability are important requirements in implementing the Privacy Act which
requires that agencies only maintain data that is accurate, relevant, timely, and complete about
individuals. The information has to have some form of verification for accuracy due to the
Privacy Act provisions that require that only relevant and accurate records should be collected
and maintained about individuals.
No data will be collected from sources other than the individual.

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B. How will data be checked for completeness?
Describe the procedures to ensure data is checked for completeness. To the extent practical, PII
should be checked for completeness to ensure accuracy within the context of the use of the data.
Personal contact information is provided by the individual at the time of reporting and will be
verified by the FWS staff lead for each particular species in 50 CFR 17.84.
C. What procedures are taken to ensure the data is current? Identify the process or name the
document (e.g., data models).
Describe the steps or procedures taken to ensure the data is current and not out-of-date. Where
are they documented? For example, are they outlined in standard operating procedures or data
models? Data that is not current also affects the relevancy and accuracy of the data. This is
particularly true with data warehousing. A data warehouse is a repository of an organization's
electronically stored data and is designed to facilitate reporting and analysis. A data warehouse
may contain data that is not current which would cause a domino effect throughout the data
stores.
Personal contact information is provided by the individual at the time of reporting and will be
verified by the FWS staff lead for each particular species in 50 CFR 17.84.
D. What are the retention periods for data in the system? Identify the associated records
retention schedule for the records in this system.
Identify all applicable records retention schedules or explain at what development stage the
proposed records retention schedule is in. Information system owners must consult with
Bureau/Office Records Officers early in the development process to ensure that appropriate
retention and destruction schedules are identified, or to develop a records retention schedule for
the records contained in the information system. Be sure to include applicable records retention
schedules for different types of information or subsets of information and describe if subsets of
information are deleted and how they are deleted.
The data on human individuals are retained within the data on the listed animal species until (1) the
species is taken off the threatened or endangered list and (2) the data can be disposed according to
the NARA-approved FWS Records Disposition Schedule (LIST-900 Species Reference Files (N1022-05-01/57)).

E. What are the procedures for disposition of the data at the end of the retention period?
Where are the procedures documented?
Describe policies and procedures for how PII that is no longer relevant and necessary is purged.
This may be obtained from records retention schedules, the Departmental Manual, bureau/office
records management policies, or standard operating procedures.
Paper records are shredded per 204 FW 1, 1.9A – Employees must destroy PII documents by
shredding or burning them.

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F. Briefly describe privacy risks and how information handling practices at each stage of the
“information lifecycle” (i.e., collection, use, retention, processing, disclosure and
destruction) affect individual privacy.
Describe and analyze the major potential privacy risks identified and discuss the overall impact
on the privacy of employees or individuals. Include a description of how the program office has
taken steps to protect individual privacy and mitigate the privacy risks. Provide an example of
how information is handled at each stage of the information life cycle. Also discuss privacy risks
associated with the sharing of information outside of the Department and how those risks were
mitigated. Discuss whether access controls have been implemented and whether audit logs are
regularly reviewed to ensure appropriate sharing outside of the Department.
Privacy risks associated with contact information on paper files are remediated by physical and
access controls. This includes facilities that have security at the entrance, visitor logs, utilizing
PIV cards for access to the facility and storing any records in the office, in locked cabinets, and
accessible only to FWS employees with a need to know.

Section 4. PIA Risk Review
A. Is the use of the data both relevant and necessary to the purpose for which the system is
being designed?
Describe how the use of the system or information collection relates to the purpose of the
underlying mission of the organization. Is the information directly relevant and necessary to
accomplish the specific purposes of the system? For Privacy Act systems, the Privacy Act at 5
U.S.C. 552a(e)(1) requires that each agency shall maintain in its records only such information
about an individual that is relevant and necessary to accomplish an agency purpose required by
statute or by executive order of the President.
Yes: Explanation Input from the individual is helpful in assisting FWS employees by
providing information about the circumstances involving the listed species that may not
otherwise be known.
No
B. Does this system or electronic collection derive new data or create previously unavailable
data about an individual through data aggregation?
Does the technology create new data or conduct electronic searches, queries, or analysis in an
electronic database to discover or locate a predictive pattern or anomaly? Is data aggregated in
a way that will permit system users to easily draw new conclusions or inferences about an
individual? Electronic systems can sift through large amounts of information in response to user
inquiry or programmed functions, or perform complex analytical tasks resulting in other types of
data, matching, relational or pattern analysis, or reporting. Discuss the results generated by
these uses and include an explanation on how the results are generated, whether by the
information system or manually by authorized personnel. Explain the purpose and what will be
done with the newly derived data. Derived data is obtained from a source for one purpose and
then used to deduce/infer a separate and distinct bit of information to form additional
information that is usually different from the original source information. Aggregation of data is

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the taking of various data elements and turning it into a composite of all the data to form another
type of data, e.g., tables or data arrays.
Yes: Explain what risks are introduced by this data aggregation and how these risks will be
mitigated.
No
C. Will the new data be placed in the individual’s record?
Will the results or new data be placed in individuals’ records? Explain in detail the purpose of
creating the new data, how it will be used, by whom it will be used, with whom it will be shared,
and any resulting effect on individuals.
Yes: Explanation
No
D. Can the system make determinations about individuals that would not be possible without
the new data?
Will the new data be used to make determinations about individuals or will it have any other
effect on the subject individuals? Explain in detail the purpose of creating the new data, how it
will be used, by whom it will be used, with whom it will be shared, and any resulting effect on
individuals.
Yes: Explanation
No
E. How will the new data be verified for relevance and accuracy?
Explain how accuracy of the new data is ensured. Describe the process used for checking
accuracy. Also explain why the system does not check for accuracy. Describe any technical
solutions, policies, or procedures focused on improving data accuracy and integrity of the
project.
This survey does not derive new data about the individual.
F. Are the data or the processes being consolidated?
If the data is being consolidated, that is, combined or united into one system, application, or
process, then the existing controls should remain to protect the data. If needed, strengthen the
control(s) to ensure that the data is not inappropriately accessed or used by unauthorized
individuals. Minimum sets of controls are outlined in OMB Circular A-130, Appendix III. The
DOI Security Control Standards (based on NIST SP 800-53 and FedRAMP) describe the
practice of identification and authentication that is a technical measure that prevents
unauthorized people or processes from accessing data. The IT Security A&A process requires a
system security plan outlining the implementation of the technical controls associated with
identification and authentication.

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Yes, data is being consolidated. Describe the controls that are in place to protect the data
from unauthorized access or use.
Yes, processes are being consolidated. Describe the controls that are in place to protect the
data from unauthorized access or use.
No, data or processes are not being consolidated.
G. Who will have access to data in the system or electronic collection? Indicate all that apply.
Describe the process by which an individual receives access to the information within the
system. Explain what roles these individuals have and their level of access. If remote access to
the system is allowed or external storage or communication devices interact with the system,
describe any measures in place to secure the transmission and storage of data (e.g., encryption
and/or two-factor authentication). Do users have “read-only” access or are they authorized to
make changes in the system? Also consider “other” users who may not be as obvious, such as
the GAO or the Inspector General, database administrators, website administrators or system
administrators. Also include those listed in the Privacy Act system of records notice under the
“Routine Uses” section when a Privacy Act system of records notice is required.
Users
Contractors
Developers
System Administrator
Other: Describe FWS Biologists that are contacted will be able to access the individual’s
contact information and if necessary, may provide it to Law Enforcement or the U.S. Department
of Agriculture/APHIS Division of Wildlife Damage Management.
H. How is user access to data determined? Will users have access to all data or will access be
restricted?
Users are normally only given access to certain data on a “need-to-know” basis for information
that is needed to perform an official function. Care should be given to avoid “open systems”
where all information can be viewed by all users. System administrators may be afforded access
to all of the data depending upon the system or application. However, access should be
restricted when users may not need to have access to all the data. For more guidance on this,
refer to the Federal Information Processing Standards [FIPS] Publications in the authorities
section. The DOI Security Control Standards (based on NIST SP 800-53 and FedRAMP)
describe the practice of applying logical access controls, which are system-based means by
which the ability is explicitly enabled or restricted. It is the responsibility of information system
owners to ensure no unauthorized access is occurring.
User access is restricted to the FWS employees working the specific incident. Access may be
extended to FWS Law Enforcement or US Agriculture’s APHIS employees.

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I. Are contractors involved with the design and/or development of the system, or will they be
involved with the maintenance of the system?
Yes. Were Privacy Act contract clauses included in their contracts and other regulatory
measures addressed?
No
J. Is the system using technologies in ways that the DOI has not previously employed (e.g.,
monitoring software, SmartCards or Caller ID)?
Are there new technologies used to monitor activities of the individual in any way? Access logs
may already be used to track the actions of users of a system. Describe any new software being
used, such as keystroke monitoring.
Yes. Explanation
No
K. Will this system provide the capability to identify, locate and monitor individuals?
Most systems now provide the capability to identify and monitor individual’s actions in a system
(e.g., audit trail systems/ applications). For example, audit logs may record username, time and
date of logon, files accessed, or other user actions. Check system security procedures for
information to respond to this question.
Yes. Explanation
No
L. What kinds of information are collected as a function of the monitoring of individuals?
The DOI Security Control Standards (based on NIST SP 800-53 and FedRAMP) detail how audit
logs should be used for DOI systems. Provide what audit activities are maintained to record
system and user activity including invalid logon attempts and access to data. The IT Security
A&A process requires a system security plan outlining the implementation of the technical
controls associated with identification and authentication of users to the system. Examples of
information collected may include username, logon date, number of failed logon attempts, files
accessed, and other user actions on the system.
This is a paper based collection, individuals cannot be monitored.
M. What controls will be used to prevent unauthorized monitoring?
Certain laws and regulations require monitoring for authorized reasons by authorized
employees. Describe the controls in place to ensure that only authorized personnel can monitor
use of the system. For example, business rules, internal instructions, posting Privacy Act
Warning Notices address access controls, in addition to audit logs and least privileges. It is the
responsibility of information system owners and system managers to ensure no unauthorized
monitoring is occurring.

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Prevention of any unauthorized monitoring of paper files are enforced by securing paper files in
locked offices or locked file cabinets and used in either secure locations or employee offices.
N. How will the PII be secured?
Discuss how each privacy risk identified was mitigated. Specific risks may be inherent in the
sources or methods of collection, or the quality or quantity of information included. Describe
auditing features, access controls, and other possible technical and policy safeguards such as
information sharing protocols, or special access restrictions. Do the audit features include the
ability to identify specific records each user can access? How is the system audited? For
example, does the system perform self audits, or is the system subject to third party audits or
reviews by the Office of Inspector General or Government Accountability Office (GAO). Does
the IT system have automated tools to indicate when information is inappropriately accessed,
retrieved or misused? Describe what privacy and security training is provided to system users.
Examples of controls include rules of behavior, encryption, secured facilities, firewalls, etc.
(1) Physical Controls. Indicate all that apply.
Security Guards
Key Guards
Locked File Cabinets
Secured Facility
Closed Circuit Television
Cipher Locks
Identification Badges
Safes
Combination Locks
Locked Offices
Other. Describe
(2) Technical Controls. Indicate all that apply.
Password
Firewall
Encryption
User Identification
Biometrics
Intrusion Detection System (IDS)
Virtual Private Network (VPN)
Public Key Infrastructure (PKI) Certificates
Personal Identity Verification (PIV) Card
Other. Describe
(3) Administrative Controls. Indicate all that apply.
Periodic Security Audits

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Appendix A – DI-4001 PIA Form
Backups Secured Off-site
Rules of Behavior
Role-Based Training
Regular Monitoring of Users’ Security Practices
Methods to Ensure Only Authorized Personnel Have Access to PII
Encryption of Backups Containing Sensitive Data
Mandatory Security, Privacy and Records Management Training
Other. Describe
O. Who will be responsible for protecting the privacy rights of the public and employees? This
includes officials responsible for addressing Privacy Act complaints and requests for
redress or amendment of records.
Although all employees who have access to information in a Privacy Act system have
responsibility for protecting and safeguarding that information, often the information system
owner and Privacy Act system manager share the responsibility for protecting the privacy rights
of employees and the public. For Privacy Act responsibilities refer to 383 Department Manual
Chapters 1-13 and DOI Privacy Act regulations at 43 CFR Part 2. Also, describe how Privacy
Act complaints and requests for redress or amendment of records are addressed.
The FWS Privacy Officer, in conjunction with FWS biologists assigned to investigate incidents
involving endangered or threatened species, are responsible for protecting the privacy rights of
employees. The FWS Associate Privacy Officer receives complaints and requests for the
amendment of records.
P. Who is responsible for assuring proper use of the data and for reporting the loss,
compromise, unauthorized disclosure, or unauthorized access of privacy protected
information?
This may be the information system owner and Privacy Act system manager, or may be another
individual with designated responsibility, or otherwise stipulated by contract or in language
contained in an agreement (e.g., Head of the Bureau or Program Manager). There may be
multiple responsible officials. Consider a system that contains several databases from different
program offices; there may be one information system owner and several Privacy Act system
managers. Also, describe who is responsible for reporting the loss, compromise, unauthorized
disclosure, or unauthorized access of privacy protected information.
The FWS biologists assigned to investigate incidents involving endangered or threatened species
and privacy officer are responsible for assuring proper use of employee data. Loss, compromise,
unauthorized disclosure or unauthorized access of PII is considered a “security incident” that
must be reported to DOI-CIRC within one hour of discovery.

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Appendix A – DI-4001 PIA Form

Section 5. Review and Approval
PIAs for Bureau or Office level systems must be signed by the designated Information System Owner,
Information System Security Officer, and Bureau Privacy Officer, and approved by the Bureau Assistant
Director for Information Resources as the Reviewing Official. Department-wide PIAs must be signed by
the designated Information System Owner, Information System Security Officer, and Departmental
Privacy Officer, and approved by the DOI Chief Information Officer/Senior Agency Official for Privacy
as the Reviewing Official.
Information System Owner
Email: don_morgan@fws.gov
First Name: Don
M.I.: Last Name: Morgan Title: Chief, Branch of Recovery, Delisting and
State Grants
Bureau/Agency: U.S. FWS Phone: 703-358-2444
Signature:
Information System Security Officer
Email: lan_nguyen@fws.gov
First Name: Lan
M.I.: Last Name: Nguyen Title: HQ IT Security Manager
Bureau/Agency: U.S. FWS Phone: 703-358-1819
Signature:

LAN NGUYEN

Digitally signed by LAN NGUYEN
Date: 2017.08.16 15:58:01 -04'00'

Privacy Officer
Email: katherine_gonyea@fws.gov
First Name: Katherine
M.I.: E. Last Name: Gonyea Title: Acting, Associate Privacy Officer
Bureau/Agency: U.S. FWS Phone: 703-358-2244
Signature:

signed by KATHERINE GONYEA
KATHERINE GONYEA Digitally
Date: 2017.08.16 16:10:21 -04'00'

Reviewing Official
Email: kenneth_taylor@fws.gov
First Name: Kenneth M.I.: Last Name: Title: Assistant Director, Information Resources
Technology Management
Bureau/Agency: U.S. FWS Phone: 703-358-1968
Signature: KENNETH TAYLOR

Digitally signed by KENNETH
TAYLOR
Date: 2017.08.16 16:53:45 -04'00'

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