Privacy and Civil Liberty Impact Assessment

1557-0316 Supplier-Vendor Registration Portal.docx

OCC Supplier Registration Form

Privacy and Civil Liberty Impact Assessment

OMB: 1557-0316

Document [docx]
Download: docx | pdf

Shape1



Privacy & Civil Liberties Impact Assessment (PCLIA)

Office of Minority and Women Inclusion (OWMI) Supplier Registration Application


May 25, 2016



Reviewing Official


<<Privacy Program Manager>>


Bureau Certifying Official


<< Privacy Program Specialist>>



Version: 1.1

March 2016



Prepared by:


Privacy Program Office (PPO)






PCLIA

Record of Changes

Version No.

Date Released

Description of Change

Pages Affected

Changes Made By

1.0

1/6/16

Updated Template

all

V.Curtis/L.Mitchell,R. Shelden

1.1

3/5/16

Formatting and updates

all

V.Curtis/L.Mitchell,R. Shelden


















Section 1: Introduction


It is the policy of the OCC to conduct a Privacy and Civil Liberties Impact Assessment (“PCLIA”) when personally identifiable information (“PII”) is maintained in a system or IT project. PCLIAs are required for all systems and projects that collect, maintain, or disseminate PII, regardless of the manner in which the information is retrieved.


This assessment is being completed pursuant to Section 208 of the E-Government Act of 2002 (“E-Gov Act”), 44 U.S.C. § 3501, and Office of the Management and Budget (“OMB”) Memorandum 03-22, “OMB Guidance for Implementing the Privacy Provisions of the E-Government Act of 2002,” which requires OCC to conduct a PCLIA before:


  1. developing or procuring information technology (“IT”) systems or projects that collect, maintain or disseminate PII from or about members of the public, or


  1. initiating a new collection of information that: a) will be collected, maintained, or disseminated using IT; and b) includes any PII permitting the physical or online contacting of a specific individual, if identical questions have been posed to, or identical reporting requirements imposed on, 10 or more persons. Agencies, instrumentalities, or employees of the federal government are not included.


This PCLIA provides the following information regarding the system or project:


  1. an overview of its purpose and functions;

  2. a description of the information collected;

  3. a description of the how information is maintained, used, and shared;

  4. an assessment of whether the system or project is in compliance with federal requirements that support information privacy; and

  5. an overview of the redress/complaint procedures available to individuals who may be affected by the use or sharing of information by the system or project.


[Explain here whether a PCLIA is being conducted for this system/project for the first time or whether this PCLIA supersedes or supplements a preexisting PCLIA.]


Section 2: Definitions


Agency – means any entity that falls within the definition of the term “executive agency”' as defined in 31 U.S.C. § 102.


Certifying Official – The Bureau official who certify that all requirements have been completed so a PCLIA can be reviewed and approved by the Reviewing Official.


Collect (including “collection”) – means the retrieval, receipt, gathering, or acquisition of any PII and its storage or presence in a OCC system. This term should be given its broadest possible meaning.


Contractors and service providers – are private companies that provide goods or services under a contract with the OCC. This includes, but is not limited to, information providers, information processors, and other organizations providing information system development, information technology services, and other outsourced applications.


Data mining – means a program involving pattern-based queries, searches, or other analyses of 1 or more electronic databases, where (a) a department or agency of the federal government, or a non-federal entity acting on behalf of the federal government, is conducting the queries, searches, or other analyses to discover or locate a predictive pattern or anomaly indicative of terrorist or criminal activity on the part of any individual or individuals; (b) the queries, searches, or other analyses are not subject-based and do not use personal identifiers of a specific individual, or inputs associated with a specific individual or group of individuals, to retrieve information from the database or databases; and (c) the purpose of the queries, searches, or other analyses is not solely (i) the detection of fraud, waste, or abuse in a government agency or program; or (ii) the security of a government computer system.


DisclosureWhen it is clear from its usage that the term “disclosure” refers to records provided to the public in response to a request under the Freedom of Information Act (5 U.S.C. § 552, “FOIA”) or the Privacy Act (5 U.S.C. § 552a), its application should be limited in that manner. Otherwise, the term should be interpreted as synonymous with the terms “sharing” and “dissemination” as defined in this manual.


Dissemination – as used in this manual, is synonymous with the terms “sharing” and “disclosure” (unless it is clear from the context that the use of the term “disclosure” refers to a FOIA/Privacy Act disclosure).


E-Government – means the use of digital technologies to transform government operations to improve effectiveness, efficiency, and service delivery.


Federal information system – means a discrete set of information resources organized for the collection, processing, maintenance, transmission, and dissemination of information owned or under the control of a federal agency, whether automated or manual.


Final Rule – After the NPRM comment period closes, the agency reviews and analyzes the comments received (if any). The agency has the option to proceed with the rulemaking as proposed, issue a new or modified proposal, or withdraw the proposal before reaching its final decision. The agency can also revise the supporting analyses contained in the NPRM (e.g., to address a concern raised by a member of the public in response to the NPRM).


Government information – means information created, collected, used, maintained, processed, disseminated, or disposed of by or for the federal government.


Individual – means a citizen of the United States or an alien lawfully admitted for permanent residence. If a question does not specifically inquire about or an issue does not clearly involve a Privacy Act system of records, the term should be given its common, everyday meaning. In certain contexts, the term individual may also include citizens of other countries who are covered by the terms of an international or other agreement that involves information stored in the system or used by the project.


Information – means any representation of knowledge such as facts, data, or opinions in any medium or form, regardless of its physical form or characteristics. This term should be given the broadest possible meaning. This term includes, but is not limit to, information contained in a Privacy Act system of records.


Information technology (IT) means any equipment or interconnected system or subsystem of equipment, used in the automatic acquisition, storage, analysis, evaluation, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of data or information by the executive agency, if the equipment is used by the executive agency directly or is used by a contractor under a contract with the executive agency that requires the use: (i) of that equipment; or (ii) of that equipment to a significant extent in the performance of a service or the furnishing of a product. It includes computers, ancillary equipment (including imaging peripherals, input, output, and storage devices necessary for security and surveillance), peripheral equipment designed to be controlled by the central processing unit of a computer, software, firmware and similar procedures, services (including support services), and related resources; but does not include any equipment acquired by a federal contractor incidental to a federal contract. Clinger-Cohen Act of 1996, 40 U.S.C. § 11101(6).


Major Information system embraces “large” and “sensitive” information systems and means “a system or project that requires special management attention because of its importance to an agency mission; its high development, operating, or maintenance costs; or its significant role in the administration of agency programs, finances, property, or other resources.” OMB Circular A-130, § 6.u. This definition includes all systems that contain PII and are rated as “MODERATE or HIGH impact” under Federal Information Processing Standard 199.


National Security systems a telecommunications or information system operated by the federal government, the function, operation or use of which involves: (1) intelligence activities, (2) cryptologic activities related to national security, (3) command and control of military forces, (4) equipment that is an integral part of a weapon or weapons systems, or (5) systems critical to the direct fulfillment of military or intelligence missions, but does not include systems used for routine administrative and business applications, such as payroll, finance, logistics, and personnel management. Clinger-Cohen Act of 1996, 40 U.S.C. § 11103.


Notice of Proposed Rule Making (NPRM) – the Privacy Act (Section (J) and (k)) allow agencies to use the rulemaking process to exempt particular systems of records from some of the requirements in the Act. This process is often referred to as “notice-and-comment rulemaking.” The agency publishes an NPRM to notify the public that the agency is proposing a rule and provides an opportunity for the public to comment on the proposal before the agency can issue a final rule.


Personally Identifiable Information (PII)any information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other personal or identifying information that is linked or linkable to a specific individual.


Privacy and Civil Liberties Impact Assessment (PCLIA) – a PCLIA is:


  1. a process conducted to: (a) identify privacy and civil liberties risks in systems, programs, and other activities that maintain PII; (b) ensure that information systems, programs, and other activities comply with legal, regulatory, and policy requirements; (c) analyze the privacy and civil liberties risks identified; (d) identify remedies, protections, and alternative or additional privacy controls necessary to mitigate those risks; and (e) provide notice to the public of privacy and civil liberties protection practices.

  2. a document that catalogues the outcome of that privacy and civil liberties risk assessment process.


Protected Information – as the term is used in this PCLIA, has the same definition given to that term in TD 25-10, Section 4.


Privacy Act Recordany item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, the individual’s education, financial transactions, medical history, and criminal or employment history and that contains the individual’s name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a finger or voice print or a photograph. 5 U.S.C. § 552a (a)(4).


Reviewing Official The OCC Privacy Program Manager approves all PCLIAs as part of her/his duties..


Routine Use – with respect to the disclosure of a record outside of OCC (i.e., external sharing), the sharing of such record for a purpose which is compatible with the purpose for which it was collected 5 U.S.C. § 552a(a)(7).


Sharing – any OCC initiated distribution of information to government employees or agency contractors or grantees, including intra- or inter-agency transfers or exchanges of OCC information, regardless of whether it is covered by the Privacy Act. It does not include responses to requests for agency records under FOIA or the Privacy Act. It is synonymous with the term “dissemination” as used in this assessment. It is also synonymous with the term “disclosure” as used in this assessment unless it is clear from the context in which the term is used that it refers to disclosure to the public in response to a request for agency records under FOIA or the Privacy Act.


Systemas the term used in this manual, includes both federal information systems and information technology.


System of Recordsa group of any records under the control of OCC from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual. 5 U.S.C. § 552a (a)(5).


System of Records Notice – Each agency that maintains a system of records shall publish in the Federal Register upon establishment or revision a notice of the existence and character of the system of records, which notice shall include: (A) the name and location of the system; (B) the categories of individuals on whom records are maintained in the system; (C) the categories of records maintained in the system; (D) each routine use of the records contained in the system, including the categories of users and the purpose of such use; (E) the policies and practices of the agency regarding storage, retrievability, access controls, retention, and disposal of the records; (F) the title and business address of the agency official who is responsible for the system of records; (G) the agency procedures whereby an individual can be notified at her/his request if the system of records contains a record pertaining to him; (H) the agency procedures whereby an individual can be notified at her/his request how she/he can gain access to any record pertaining to him contained in the system of records, and how she/he can contest its content; and (I) the categories of sources of records in the system. 5 U.S.C. § 552a (e)(4).


System Owner Official responsible for the overall procurement, development, integration, modification, or operation and maintenance of a system


Section 3: System Overview


Section 3.1: System/Project Description and Purpose


The purpose of the OMWI Supplier Registration Application is to collect information from potential OCC customer companies. PII is used to contact the company representative for purposes of providing OCC contract work. It supports the mission of the Department by satisfying a Dodd/Frank requirement.


Estimated Number of Individuals Whose Personally Identifiable Information is Maintained in the System or by the Project

0 – 999

1000 – 9,999

10,000 – 99,999

100,000 – 499,999

500,000 – 999,999

1,000,000+



Section 3.2: Authority to Collect


The authorities for operating this system or performing this project are:

Dodd/Frank act.

Please provide citation to and discuss specific or general mission-related statutory or regulatory authorities that allow the Department, office, or bureau to operate this system or perform this project.





Authority

Description


Section 4: Information Collection


Section 4.1: Relevant and Necessary


The Privacy Act requires “each agency that maintains a system of records [to] maintain in its records only such information about an individual as is relevant and necessary to accomplish a purpose of the agency required to be fulfilled by statute or by executive order of the President.” 5 U.S.C. § 552a (e)(1). It allows federal agencies to exempt records from certain requirements (including the relevant and necessary requirement) under certain conditions5 U.S.C. §552a (k). The proposed exemption must be described in a Notice of Proposed Rulemaking (“NPRM”). In the context of the Privacy Act, the purpose of the NPRM is to give the public notice of a Privacy Act exemption claimed for a system of records and solicit public opinion on the proposed exemption. After addressing any public concerns raised in response to the NPRM, the agency must issue a Final Rule. It is possible for some, but not all, of the records maintained in the system or by the project to be exempted from the Privacy Act through the NPRM/Final Rule process.


Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.

Section 4.1(a) Please check all of the following that are true:


        1. None of the PII maintained in the system or by the project is part of a Privacy Act system of records;

        2. All of the PII maintained in the system or by the project is part of a system of records and none of it is exempt from the Privacy Act relevant and necessary requirement;

        3. All of the PII maintained in the system or by the project is part of a system of records and all of it is exempt from the Privacy Act relevant and necessary requirement;

        4. Some, but not all, of the PII maintained in the system or by the project is part of a system of records and the records to which the Privacy Act applies are exempt from the relevant and necessary requirement; and

        5. Some, but not all, of the PII maintained in the system or by the project is part of a system of records and none of the records to which the Privacy Act applies are exempt from the relevant and necessary requirement.

If you selected Options 3 or 4, please cite (in the space provided below) the relevant NPRM or Final Rule and provide the justification for claiming this exemption in the space provided at the end of this section.

If you selected Option 3, please check “N/A” for Sections 4.1(b) through 4.1(d).

If you selected Options 1, 2, 4, or 5, please proceed to Section 4.1(b).



Section 4.1(b) Yes No N/A With respect to PII maintained in the system or by the project that is subject to the Privacy Act’s relevant and necessary requirement, was an assessment conducted prior to collection (e.g., during Paperwork Reduction Act analysis) to determine which PII types (see Section 4.2 below) were relevant and necessary to meet the system’s or project’s mission requirements? If yes, please discuss the outcome of that assessment in the space provided at the end of this section. If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section. If yes or no please proceed to Section 4.1(c).


Section 4.1(c) Yes No N/A With respect to PII currently maintained in the system or by the project that is subject to the Privacy Act’s relevant and necessary requirement, is the PII limited to only that which is relevant and necessary to meet the system’s or project’s mission requirements?

If yes, please provide support for that conclusion in the space provided at the end of this section.

If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section. If yes or no please proceed to Section 4.1(d).


Section 4.1(d) Yes No With respect to PII maintained in the system or by the project that is subject to the Privacy Act’s relevant and necessary requirement, is there a process to continuously reevaluate and ensure that the PII remains relevant and necessary?

If yes, please describe that process in the space provided at the end of this section.

If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section Space for Narrative Explanation of Answers to Sections 4.1(a) through 4.1(d): Summary of privacy and/or civil liberties risks presented and mitigation efforts.


Space for Narrative Explanation of Answers to Sections 4.1(a) through 4.1(d): Summary of privacy and/or civil liberties risks presented and mitigation.




Section 4.2: PII and/or information types or groupings


To perform their various missions, federal agencies must necessarily collect various types of information. The checked boxes below represent the types of information maintained in the system or by the project. Information identified below is used by the system or project to fulfill the purpose stated in Section 3.3 – Authority to Collect.

Please select the appropriate boxes below to identify the types or groupings of information collected by the system or project. If the system or project uses groupings or information that are not listed below, please add them using the additional spaces provided.


Biographical/General Information

Name

Gender

Group/Organization Membership

Date of Birth

Race

Military Service Information

Home Physical/Postal Mailing Address

Ethnicity

Personal Home Phone or Fax Number

Zip Code

Personal Cell Number

Alias (including nickname)

Business Physical/Postal Mailing Address

Business Cell Number

Business Phone or Fax Number

Personal e-mail address

Nationality

Mother’s Maiden Name

Business e-mail address

Country of Birth

Spouse Information

Personal Financial Information (including loan information)

City or County of Birth

Children Information

Business Financial Information (including loan information)

Immigration Status

Information about other relatives.

Marital Status

Citizenship

Professional/personal references or other information about an individual’s friends, associates or acquaintances.

Religion/Religious Preference

Device settings or preferences (e.g., security level, sharing options, ringtones).

Global Positioning System (GPS)/Location Data

Sexual Orientation

User names, avatars etc.

Secure Digital (SD) Card or Other Data stored on a card or other technology

Cell tower records (e.g., logs. user location, time etc.)

Network communications data

Cubical or office number

Contact lists and directories (known to contain personal information)

Contact lists and directories (unknown whether it contains personal information)

Contact lists and directories (known to contain only business information)

Education Information

Resume or curriculum vitae

Other (please describe):

Other (please describe):

Other (please describe): ______________________

Other (please describe):

______________________


Identifying Numbers

Full Social Security number

Health Plan Beneficiary Number

Truncated/Partial Social Security number (e.g., last 4 digits)

Alien Registration Number

Personal Taxpayer Identification Number

Business Taxpayer Identification Number (If known: sole proprietor; non-sole proprietor)

Personal Credit Card Number

Business Credit Card Number (If known: sole proprietor; non-sole proprietor)

Personal Vehicle Identification Number

Business Vehicle Identification Number (If known: sole proprietor; non-sole proprietor)

Personal License Plate Number

Business License Plate Number (If known: sole proprietor; non-sole proprietor)

File/Case ID Number (individual)

File/Case ID Number (business) (If known: sole proprietor; non-sole proprietor)

Personal Professional License Number

Business Professional License Number (If known: sole proprietor; non-sole proprietor)

Employee Identification Number

Patient ID Number

Business Bank Account Number

Personal Bank Account Number

Commercially obtained internet navigation/purchasing habits of individuals

Government obtained internet navigation/purchasing habits of individuals

Passport Number and Passport information (including full name, passport number, DOB, POB, sex, nationality, issuing country photograph and signature) (use “Other” if some but not all elements are collected)

Driver’s License Number

Personal device identifiers or serial numbers

Other Identifying Numbers (please describe):____________________________

Other Identifying Numbers (please describe):____________________________

Other Identifying Numbers (please describe):____________________________


Medical/Emergency Information Regarding Individuals

Medical/Health Information

Worker’s Compensation Act Information

Patient ID Number

Mental Health Information

Disability Information

Emergency Contact Information (e.g., a third party to contact in case of emergency)

Other (please describe): ____________________________________________________


Biometrics/Distinguishing Features/Characteristics of Individuals

Physical description/

characteristics (e.g., hair, eye color, weight, height, sex, gender etc.)

Signatures

Vascular scans

Fingerprints

Photos

Retina/Iris Scans

Palm prints

Video

Dental Profile

Voice audio recording

Scars, marks, tattoos

DNA Sample or Profile

Other (please describe): ______________________

Other (please describe): _______________________

Other (please describe): _______________________


Specific Information/File Types

Taxpayer Information/Tax Return Information

Law Enforcement Information

Security Clearance/Background Check Information

Civil/Criminal History Information/Police Records (government source)

Credit History Information (government source)

Bank Secrecy Act Information

Civil/Criminal History Information/Police Records (commercial source)

Credit History Information (commercial source)

National Security/Classified Information

Protected Information (as defined in Treasury Directive 25-10)

Case files

Personnel Files

Information provided under a confidentiality agreement

Information subject to the terms of an international or other agreement

Other (please describe): ______________________


Audit Log and Security Monitoring Information

User ID assigned to or generated by a user of Treasury IT

Date and time an individual accesses a facility, system, or other IT

Files accessed by a user of Treasury IT (e.g., web navigation habits)

Passwords generated by or assigned to a user of Treasury IT

Internet or other queries run by a user of Treasury IT

Contents of files accessed by a user of Treasury IT

Biometric information used to access Treasury facilities or IT

Video of individuals derived from security cameras

Public Key Information (PKI).

Information revealing an individual’s presence in a particular location as derived from security token/key fob, employee identification card scanners or other IT or devices

Still photos of individuals derived from security cameras.

Internet Protocol (IP) Address

Other (please describe):

Other (please describe):

Other (please describe):

_____________________


Other

Other (please describe: ______________

Other (please describe: _______________

Other (please describe: ______________

Other (please describe: _______________


Section 4.3: Sources of information and the method and manner of collection

In the boxes provided below, please list the sources for each personal identifier or grouping identified in Section 4.2 above. One chart must be filled out for each source. Please add columns as necessary.

Individual

<<Source name>>

<<Source name>>

Specific PII identified in Section 4.2 that was acquired from this source:_Name, Phone Number, E-mail Address.

Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).

Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).

Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).


Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).

all).

Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).

Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).


Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).


Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).

Specific PII identified in Section 4.2 that was acquired from this source:__________ (identify all).


Manner in which information is acquired from source by the Treasury project/system: (select all that apply):

Manner in which information is acquired from source by the Treasury project/system: (select all that apply):

Manner in which information is acquired from source by the Treasury project/system: (select all that apply):

From a paper or electronic form provided to individuals, the public or members of a particular group



From a paper or electronic form provided to individuals, the public or members of a particular group



From a paper or electronic form provided to individuals, the public or members of a particular group



Please identify the form name (or description) and/or number (e.g., OMB Control Number): _________________

Please identify the form name (or description) and/or number (e.g., OMB Control Number): _________________

Please identify the form name (or description) and/or number (e.g., OMB Control Number): _________________

Received in paper format other than a form.

Received in paper format other than a form.

Received in paper format other than a form.

Delivered to the project on disk or other portable device and uploaded to the system.

Delivered to the project on disk or other portable device and uploaded to the system.

Delivered to the project on disk or other portable device and uploaded to the system.

Accessed and downloaded or otherwise acquired via the internet

Accessed and downloaded or otherwise acquired via the internet

Accessed and downloaded or otherwise acquired via the internet

Email

Email

Email

Scanned documents uploaded to the system.

Scanned documents uploaded to the system.

Scanned documents uploaded to the system.

Bulk transfer

Bulk transfer

Bulk transfer

Extracted from particular technology (e.g., radio frequency identification data (RFID) devices, video or photographic cameras, biometric collection devices).

Extracted from particular technology (e.g., radio frequency identification data (RFID) devices, video or photographic cameras, biometric collection devices).

Extracted from particular technology (e.g., radio frequency identification data (RFID) devices, video or photographic cameras, biometric collection devices).

Fax

Fax

Fax

Extracted from notes of a phone interview or face to face contact

Extracted from notes of a phone interview or face to face contact

Extracted from notes of a phone interview or face to face contact

Other: Please describe:

_________________

Other: Please describe:

_________________

Other: Please describe:

_________________

Other: Please describe:

_________________

Other: Please describe:

_________________

Other: Please describe:

_________________



Section 4.4: Privacy and/or civil liberties risks related to collection


Notice of Authority, Principal Uses, Routine Uses, and Effect of not Providing Information


When Federal agencies use a form to obtain information from an individual that will be maintained in a system of records, they must inform the individual of the following: “(A) the authority (whether granted by statute, or by executive order of the President) which authorizes the solicitation of the information and whether disclosure of such information is mandatory or voluntary; (B) the principal purpose or purposes for which the information is intended to be used; (C) the routine uses which may be made of the information as published pursuant to paragraph (4)(D) of this subsection; and (D) the effects on her/him, if any, of not providing all or any part of the requested information.” 5 U.S.C § 522a(e)(3).



Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.

Section 4.4(a) Yes No Does OCC collect any of the PII maintained in the system or by the project directly from an individual?

If no, please select “N/A” for Sections 4.4(b) and 4.4(c) and discuss the factors considered in deciding to collect PII from third party sources (open the link for this section to view guidance for responding). Also, discuss the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.

If yes please proceed to Section 4.4(b):


Section 4.4(b) Yes No N/A Was the information collected from the individual using a form (paper or electronic)? If yes or no, please proceed to Section 4.4(c).


Section 4.4(c) Yes No N/A If the answer to Section 4.4(b) was “yes,” was the individual notified (on the form in which the PII was collected or on a separate form that can be retained by the individual) about the following at the point where the information was collected (e.g., in a form; on a website). Please check all boxes next to information that was provided to the individual.


The authority (whether granted by statute, or by Executive order of the President) which authorizes the solicitation of the information.

Whether disclosure of such information is mandatory or voluntary.

The principal purpose or purposes for which the information is intended to be used.

The individuals or organizations outside of Treasury with whom the information may be/ will be shared.

The effects on the individual, if any, if they decide not to provide all or any part of the requested information.

If you answered Yes in response to question 4.4(c) and did not check all 5 boxes, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.


If you answered Yes and did check all of the boxes in question 4.4(c), please state in the space provided at the end of this section that “No privacy and civil liberties risks were identified.”

If you answered N/A in response to question 4.4(c), please state in the space provided at the end of this section that “No privacy and civil liberties risks were identified.”

If you answered No in response to question 4.4(c), please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.





Use of Social Security Numbers


Social Security numbers (“SSN”) are commonly used by identity thieves to commit fraudulent acts against individuals. The SSN is one data element that has the ability to harm the individual and requires more protection when used. Therefore, and in an effort to reduce risk to individuals and federal agencies, OMB Memorandum M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information, (May 22, 2007) required agencies to reduce the use of SSNs in agency systems and programs and to identify instances in which the collection is superfluous. In addition, OMB mandated agencies to explore alternatives to agency use of SSNs as personal identifiers for Federal employees and members of the public.


In addition, the Privacy Act provides that: “It shall be unlawful for any Federal, State or local government agency to deny to any individual any right, benefit, or privilege provided by law because of such individual’s refusal to disclose his social security account number.” Pub. L. No. 93–579, § 7. This provision does not apply to: (1) any disclosure which is required by federal statute; or (2) any disclosure of an SSN to any federal, state, or local agency maintaining a system of records in existence and operating before January 1, 1975, if such disclosure was required under statute or regulation adopted prior to such date to verify the identity of an individual. Id. at § 7(a)(2)(A)-(B).


Section 4.4(d) Yes No N/A Does the system or project maintain SSNs?

If no, please select N/A for Sections 4.4(e) and (f) and state in the space provided at the end of this section that “No privacy and civil liberties risks were identified.” If yes, please proceed to Section 4.4(e).


Section 4.4(e) Yes No N/A Is it possible to use an alternative to the SSN as a personal identifier in the system or project?


If no, please explain in the space below why an alternative was not possible (e.g., cite the statute requiring use of the SSN).

answer Section 4.4(f) below.


Section 4.4(f) Yes No N/A Will individuals be denied any right, benefit, or privilege provided by law because they refused to disclose their SSN? If yes, please check the applicable box::


If yes, is there a statutory exception that would allow collection of the SSN (check all that apply):

SSN disclosure is required by Federal statute or Executive Order. If checked, please provide in the space provided below the legal citation to the applicable Federal statute or Executive Order; or

the SSN is disclosed to any Federal, state, or local agency maintaining a system of records in existence and operating before January 1, 1975, and disclosure was required under statute or regulation adopted prior to such date to verify the identity of an individual. If checked, please provide the name of the system of records in the space provided below.;


Section 4.4 (g) Yes No N/A When the SSN is collected, are individuals given notice whether disclosure is mandatory or voluntary, the legal authority such number is solicited, and what uses will be made of it?


If yes, please provide in the space below the content of that notice and explain how the notice is provided to the individual.


If no, please analyze the privacy and/or civil liberties risks presented (i.e., violation of the statute) and mitigation efforts in the space provided at the end of this section.



First Amendment Activities


The Privacy Act provides that Federal agencies “maintain no record describing how any individual exercises rights guaranteed by the First Amendment unless expressly authorized by statute or by the individual about whom the record is maintained or unless pertinent to and within the scope of an authorized law enforcement activity.” 5 U.S.C. § 552a(e)(7).


Section 4.4(h) Yes No Does the system or project maintain any information describing how an individual exercises their rights guaranteed by the First Amendment?

If no, please check N/A in Section 4.4(h) below and state in the space provided at the end of this section that “The system [or project] does not maintain any information describing how any individual exercises their rights guaranteed by the First Amendment Therefore, no privacy and civil liberties risks were identified,” and proceed to Section 5.0.

If yes, please proceed to Section 4.4(g).


Section 4.4(h)

If the system or project maintains information describing how an individual exercises their rights guaranteed by the First Amendment, do any of the following exceptions apply (the information may be maintained if any of the exceptions apply)?


N/A, the system or project does not maintain any information describing how any individual exercises their rights guaranteed by the First Amendment.


Exceptions:


The individual about whom the information was collected or maintained expressly authorizes its collection/maintenance.

The information maintained is pertinent to and within the scope of an authorized law enforcement activity.

There is a statute that expressly authorizes its collection.


If you checked one or more of the three boxes in Section 4.4(h) other than N/A, please state in the space provided below that “The system/project does maintain information describing how any individual exercises their rights guaranteed by the First Amendment, but maintenance of this information is authorized because . . . [discuss the applicable exception].” Also, where applicable, please explain how express consent was acquired, how the information is pertinent to an authorized law enforcement activity, and/or the name and citation to the statute that expressly authorized its collection.

If you did not check “N/A” and did not check one or more of the other three boxes/exceptions in Section 4.4(h), please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.




Section 5: Maintenance, use, and sharing of the information


The following sections require a clear description of the system’s or project’s use of information.


Section 5.1: Describe how and why the system or project uses the information it collects and maintains


Please describe all of the uses of the information types and groupings collected and maintained by the system or project (see Section 4.2), including a discussion of why the information is used for this purpose and how it relates to the mission of the bureau or office that owns the system.

(This is merely a more detailed discussion of the business purpose (Section 3.1 above) and will include a more granular discussion of the uses of different types of information checked in Section 4.2.)


The purpose of the OMWI Supplier Registration Application is to collect information from potential OCC customer companies. PII is used to contact the company representative for purposes of providing OCC contract work. It supports the mission of the Department by satisfying a Dodd/Frank requirement.




Collecting Information Directly from the Individual When Using it to Make Adverse Determinations About Them


The Privacy Act requires that Federal agencies “collect information to the greatest extent practicable directly from the subject individual when the information may result in adverse determinations about an individual’s rights, benefits, and privileges under Federal programs.” 5 U.S.C. § 552a(e)(2).


Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.

Section 5.1(a) Yes No Is it possible that the information maintained in the system or by the project may be used by OCC to make an adverse determination about an individual’s rights, benefits, and privileges under federal programs (e.g., decisions about whether the individual will receive a financial benefit, get a clearance or access to a Treasury facility, obtain employment with Treasury)?

If yes or no, proceed to Section 5.1(b).

Section 5.1(b) Yes No Is it possible that OCC will share information maintained in the system or by the project with a third party external to OCC that will use the information to make an adverse determination about an individual’s rights, benefits, and privileges under federal programs?

If you selected no for this section and Section 5.1(a), choose “N/A” for Section 5.1(c) and enter the following in the space provided below: “No Privacy risks were identified because the information cannot be used to make adverse decisions about individuals and is not shared with any external parties who might use it to make an adverse determination about an individual’s rights, benefits, and privileges under Federal programs.”

If you answered yes to either (or both) Section 5.1(a) and/or 5.1(b), please proceed to Section 5.1(c).

Section 5.1(c) Yes No N/A If information could potentially be used to make an adverse determination about an individual’s rights, benefits, and privileges under federal programs, does the system or project collect information (to the greatest extent practicable) directly from the individual?

If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below, including a discussion of what is done to ensure the system contains information that is of a quality that will not result in unfair determinations being made about individuals. Note: Your response to this question must be consistent with your response in Section 4.4(a).

If yes, proceed to Section 5.1(d).



Data Mining


As required by Section 804 of the Implementing the 9/11 Commission Recommendations Act of 2007 (“9-11 Commission Act”), OCC reports annually to Congress on its data mining activities.


Section 5.1(d) Yes No Is information maintained in the system or by the project used to conduct “data-mining” activities as that term is defined in the Implementing the 9-11 Commission Act?

If yes, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below and provide a citation and/or link to the most recent Treasury data-mining report to Congress in which your system was discussed (if applicable). If no, please state in the space provided below that “No privacy and civil liberties risks were identified.”

If this system is already reporting under the Federal Agency Data Mining Reporting Act of 2007, provide a brief summary here and a link to where all Treasury data-mining reports can be found.


Section 5.2: Ensuring accuracy, completeness, and timeliness of information collected, maintained, and shared

Exemption from Accuracy, Relevance, Timeliness, and Completeness Requirements


The Privacy Act requires that Federal agencies “maintain all records which are used by the agency in making any determination about any individual with such accuracy, relevance, timeliness, and completeness as is reasonably necessary to assure fairness to the individual in the determination.” 5 U.S.C § 552a(e)(5). If a particular system of records meets certain requirements (including the NPRM process defined in Section 2 above), an agency may exempt the system of records (or a portion of the records) from this requirement.


Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.

Section 5.2(a) Yes No Is all or any portion of the information maintained in the system or by the project: (a) part of a system of records and (b) exempt from the accuracy, relevance, timeliness, and completeness requirements in sections (e)(5) of the Privacy Act?


If yes, please cite the NPRM or Final Rule below, explain the justification for claiming any exemptions from this requirement, discuss any information that is not subject to the exemption and discuss the privacy and/or civil liberties risks presented and mitigation efforts below.

If no, please state in the space provided at the end of this section that “No exemptions are claimed from the accuracy, relevance, timeliness, and completeness requirements. Therefore, no privacy or civil liberties issues were identified with respect to this section.” Then, please proceed to section 5.2(b).




Computer Matching


The Computer Matching and Privacy Protection Act of 1988 amended the Privacy Act imposing additional requirements when Privacy Act systems of records are used in computer matching programs.


Pursuant to the Privacy Act, as amended, there are two distinct types of matching programs. The first type of matching program involves the computerized comparison of two or more automated federal personnel or payroll systems of records or a system of federal personnel or payroll records with non-federal records. This type of matching program may be conducted for any purpose. The second type of matching program involves the computerized comparison of two or more automated systems of records or a system of records with non-federal records. The purpose of this type of matching program must be for the purpose of eligibility determinations or compliance requirements for applicants, recipients, beneficiaries, participants, or providers of services for payments or in-kind assistance under federal benefit programs, or recouping payments or delinquent debts under such federal benefit programs. See 5 U.S.C. § 522a(a)(8).


Matching programs must be conducted pursuant to a matching agreement between the source and recipient agencies. The matching agreement describes the purpose and procedures of the matching and establishes protections for matching records.

Section 5.2(b) Yes No Is any of the information maintained in the system or by the project (a) part of a system of records and (b) used as part of a matching program?


If no, please respond “N/A” to Sections 5.2(c), (d), and (e) below, proceed to Section 5.2(f) and state in the space provided at the end of this section that “The information maintained in the system (or used by the project) is not used as part of a matching program. Therefore, no privacy and civil liberties risks were identified in response to this section.”

If yes, proceed to Section 5.2(c).

Section 5.2(c) Yes No N/A Is there a matching agreement in place that contains the information required by Section (o) of the Privacy Act?


If yes, please provide a citation to the agreement in the space provided at the end of this section and proceed to Section 5.2(d). If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section and proceed to Section 5.2(d).

Section 5.2(d) Yes No N/A Are assessments made regarding the accuracy of the records that will be used in the matching program?


See 5 U.S.C § 552a.(o)(J) for additional information. If yes, please explain in the space provided at the end of this section the procedures used to conduct this assessment. If no, please answer the next question and analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.

Section 5.2(e) Yes No N/A Does the bureau or office that owns the system or project independently verify the information, provide the individual notice and an opportunity to contest the findings, or obtain Data Integrity Board approval in accordance with Section (p) of the Privacy Act before taking adverse action against the individual?

If yes, please provide a citation in the space provided at the end of this section to the procedures used to ensure compliance with Section (p) of the Privacy Act and generally discuss those procedures. If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.



Ensuring Fairness in Making Adverse Determinations About Individuals


Federal agencies are required to “maintain all records which are used by the agency in making any determination about any individual with such accuracy, relevance, timeliness, and completeness as is reasonably necessary to assure fairness to the individual in the determination.” 5 U.S.C. § 552a(e)(5). This requirement also applies when merging records from two or more sources where the merged records are used by the agency to make any determination about any individual.


Section 5.2(f) Yes No With respect to the information maintained in the system or by the project, are steps taken to ensure all information used to make a determination about an individual is maintained with such accuracy, relevance, timeliness, and completeness as is reasonably necessary to assure fairness to the individual in the determination?If yes, please describe in the space provided below the process by which the information is maintained in an accurate, relevant, complete and timely manner.


If you responded “no” a


If you selected “N/A” because all of the information in the system or project was exempted from the accuracy etc. requirements through the NPRM/Final Rule process, please state in the space provided at the end of this section the steps taken to maintain accurate etc. information (in spite of claiming the exemption) and why maintenance of information that does not meet these requirements is necessary to the success of the system or project.





Merging Information About Individuals


Section 5.2(g) Yes No Is PII maintained related to a particular individual in the system or by the project merged with information from other Treasury or external sources (e.g., other files or systems) to create a single file about that individual from those sources? If no, please respond “N/A” to Sections 5.2(g) through 5.2(j) and state in the space provided at the end of this section that “No privacy and civil liberties risks were identified.”


If you answered “yes” to Section 5.2(a) above and exempted all of the merged information from the accuracy etc. requirements through the NPRM/Final Rule process, please respond “N/A” to Sections 5.2(g) through 5.2(k) and state in the space provided at the end of this section that “All of the information that the program merges is contained in a system of records that was exempted through the NPRM/Final Rule process. The NPRM and Final Rule can be found at: [provide link].”


If yes and all of the information maintained by the system or program was not exempted from the accuracy etc. requirements, proceed to Section 5.2(h).


Section 5.2(h) Yes No N/A Once merged into a file related to the individual, is the information used to make determinations about the individual (e.g., decisions about whether the individual will receive a financial benefit or payment, get a clearance or access to a an OCC facility, obtain employment with OCC, etc.)?

If no, please check N/A for Section 5.2(i) thru (k) below and state in the space provided below that “No privacy and civil liberties risks were identified because the merged information is not used to make determinations about individuals.”

If yes, proceed to Section 5.2(i).


Section 5.2(i) Yes No N/A Are there documented policies or procedures that determine how PII related to individuals is merged from multiple sources?

For example, when two records are compared for possible merger, are there certain attributes (e.g., name, fingerprint-based corrections number, date of birth, etc.) that must match, or are there a minimum number of attributes (e.g., two out of five) that must match to link the two records as relating to the same person?

Section 5.2(j) Yes No N/A Do the documented policies or procedures address how to proceed when partial matches (where some, but not all of the information being merged matches a particular individual) are made after the information is merged?

If yes, please describe those procedures below.


Section 5.2(k) Yes No N/A If information maintained in the system or by the project is used to make a determination about an individual, are steps taken to ensure the accuracy, relevance, timeliness, and completeness of the information as is reasonably necessary to assure fairness to the individual?

If yes, please describe that process below.


If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below.





Policies and Standard Operating Procedures or Technical Solutions Designed to Ensure Information Accuracy, Completeness, and Timeliness


Section 5.2(l) Yes No N/A If information maintained in the system or by the project is used to make any determination about an individual (even if it is an exempt system of records), are there documented policies or standard operating procedures for the system or project that address the accuracy, completeness, and timeliness of the information?

If no, please discuss the privacy and/or civil liberties risks presented and mitigation efforts below.

If yes, please describe these policies and procedures below.

If yes or no, proceed to section 5.2(m).


Section 5.2(m) Yes No Does the system or project use any software or other technical solutions designed to improve the accuracy, completeness, and timeliness of the information used to make an adverse determination about an individual's rights, benefits, and/or privileges (regardless of whether the system of records is exempt from the Privacy Act)?

If no, please discuss the privacy and/or civil liberties risks presented and mitigation efforts in the space below.


If yes, please describe these software or other technical solutions in the space below.





Accuracy, Completeness, and Timeliness of Information Received from the Source


Section 5.2(n) Yes No Did OCC receive any guarantee, assurance, or other information from any information source(s) regarding the accuracy, timeliness and completeness of the information maintained in the system or by the project?


If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below.


If yes, please identify the source and content of those guarantees or assurances or other relevant information below, including any privacy and/or civil liberties risks and mitigation efforts.






Disseminating Notice of Corrections of or Amendments to PII


Section 5.2(o) Yes No Where feasible and appropriate, is there a process in place for disseminating corrections of or amendments to the PII maintained in the system or by the project to all internal and external information-sharing partners?

If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below, including why it is not feasible or appropriate to disseminate corrections or amendments made to the PII maintained by the system or project?.


If yes, please identify and generally discuss the policy, and provide a public link or citation if it is publicly posted.

If N/A, please state in the space provided that: “No privacy or civil liberties risks were identified because the system or project does not share information internally or externally. If N/A, also check N/A for the section immediately below.


Section 5.2(p) Yes No N/A Where feasible and appropriate, does the process for disseminating corrections or amendments include notifying the individual whose information is corrected or amended?

If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below.


If yes, please identify and generally discuss the policy, and provide a link or citation if it is publicly posted.


If N/A, please state in the space provided that: “No privacy or civil liberties risks were identified because the system or project does not share information internally or externally.”




Section 5.3: Information sharing within the OCC

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.


Internal Information Sharing


Section 5.3(a) Yes No Is PII maintained in the system or by the project shared with other Treasury bureaus?

If no, please check N/A isection 5.3(b) and state in the space provided that “No privacy and civil liberties risks were identified because PII maintained in the system or by the project is shared with other Treasury bureaus or offices.”


If yes, please proceed to Section 5.3(b).

Section 5.3(b) Yes No N/A Does the Treasury bureau or office that receives the PII limit access to only those Treasury officers and employees who have a need for the PII in the performance of their official duties (i.e., those who have a “need to know”)?

If yes, please explain how the PII shared is limited to Treasury personnel who have a need to know.


If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below.





Memorandum of Understanding/Other Agreements Limiting Treasury’s Internal Use/Disclosure of PII


Section 5.3(c) Yes No N/A Is any of the PII maintained in the system or by the project subject to the requirements of a Memorandum of Understanding or other agreement (e.g., agreement with another federal or state agency that provided the information to the Treasury or subject to an international agreement or treaty) that limits or places conditions on Treasury’s internal use, maintenance, handling, or disclosure of the PII?

If yes, please provide a copy of the agreement(s) when the PCLIA is presented for review and provide a public link in the space below if available. Also, provide in the space below a general description of the agreement and any privacy and civil liberties limitations (e.g., disclosure)




Internal Information Sharing Chart

Please complete the chart below for each internal Treasury bureau or office with which PII from the system or project is shared (add additional columns as needed). Discuss privacy risks and mitigation in the space provided below the chart.

Internal Recipient’s Name (e.g., bureau or office)





Purpose of the Sharing





PII Shared





Applicable Statutory or Regulatory or Restrictions on Information Shared





Applicable Restrictions Imposed by Agreement on Information Shared (e.g., by OCC agreement with the party that provided the information to OCC)





Name and Description of MOU or Other Agreement Restricting Treasury’s Internal Use, Maintenance, Handling, or Sharing of PII Received





Method of PII Transfer (e.g., paper/oral disclosures/magnetic disk/portable device/email/fax/other (please describe if other)





Used throughout OCC.


Section 5.4: Information sharing with external (i.e., outside OCC) organizations and individuals

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.



External Information Sharing

Section 5.4(a) Yes No Is PII maintained in the system or by the project shared with agencies, organizations, or individuals external to OCC?


If no, please respond “N/A” i Sections 5.4(b) through 5.4(k)), state in the space provided below that: “No privacy and civil liberties risks were identified because PII maintained [in the system/by the project] is not shared with agencies, organizations, or individuals external to Treasury” and go to Section 6.0. If yes, please respond to Sections 5.4(b) through 5.4(k).




Accounting of Disclosures

Section 5.4(b) Yes No N/A With respect to records maintained in the system or by the project that are subject to the Privacy Act, do you maintain a paper or electronic log or other record of the date, nature, and purpose of each disclosure (not including intra-agency disclosures and FOIA disclosures) of a record to any person or to another agency (outside of OCC) and the name and address of the person or agency to whom the disclosure is made? See 5 U.S.C § 552a(c).

If yes, respond “N/A” to Section 5.4(c) and proceed to Section 5.4(d).


If external disclosures are made, but no running tabulation is maintained in paper or electronic log, please answer “No” and proceed to question 5.4(c).


Section 5.4(c) Yes No N/A If you do not keep a running tabulation of every disclosure at the time it is made, are you able to reconstruct an accurate and complete accounting of disclosures so as to be able to respond to Privacy Act requests in a timely fashion?

Select N/A if you maintain a running tabulation in paper or electronic f (or other record) and proceed to Section 5.4(d).


If yes, describe the process by which you reconstruct an accurate and complete accounting of disclosures in a timely fashion and proceed to Section 5.4(d).


Section 5.4(d) Yes No N/A With respect to records maintained in the system or by the project that are subject to the Privacy Act, do you retain the log or other record of the date, nature, and purpose of each disclosure, for at least five years or the life of the record, whichever is longer, after the disclosure for which the accounting is made?

If “N/A” or “Yes,” please proceed to Section 5.4(e).


If no, analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided below.

Section 5.4(e) Yes No N/A With respect to records maintained in the system or by the project that are subject to the Privacy Act, does your bureau or office exempt the system of records (as allowed by the Privacy Act in certain circumstances) from the requirement to make the accounting available to the individual named in the record?

If yes, please cite the relevant NPRM or Final Rule below, explain the justification for claiming this exemption, and state in the space provided below: “No privacy and civil liberties risks were identified because the system was exempted from the requirement to disclose the accounting to the individual as allowed by the Privacy Act and in accordance with Treasury regulations.”


If no, please proceed to Section 5.4(f).


Section 5.4(f) Yes No N/A With respect to records maintained in the system or by the project that are subject to the Privacy Act, does your bureau or office exempt the system of records (as allowed by the Privacy Act in certain circumstances) from the requirement to inform any person or other agency about any correction or notation of dispute made by the agency of any record that has been disclosed to the person or agency if an accounting of disclosures was made?

If yes, please cite the relevant NPRM or Final Rule below and explain the justification for claiming this exemption.






Statutory or Regulatory Restrictions on Disclosure

Section 5.4(g) Yes No In addition to the Privacy Act, are there any other statutory or regulatory restrictions on the sharing of any of the PII maintained in the system or by the project (e.g., 26 U.S.C § 6103 for tax returns and return information)? If yes, please provide a citation in the space provided below to all applicable statutory or regulatory restrictions and a general discussion of the scope of the limitations on use and how compliance with the requirement is achieved (e.g., training, marking the information).


If no, please state in the space provided below: here are no statutory or regulatory restrictions on the PII in the system. Therefore, no privacy or civil liberties risks were identified.




Memorandum of Understanding Related to External Sharing

Section 5.4(h) Yes No N/A Did OCC execute a Memorandum of Understanding, or entered into any other type of agreement, with any external agencies, organizations, or individuals with which/whom it shares PII maintained in the system or by the project?


If no, analyze the privacy and/or civil liberties risks presented (if any) and mitigation efforts below or explain why an agreement is unnecessary.

If yes, provide a copy of the MOU or other agreement(s) when the PCLIA is presented for review and generally describe the agreement below (i.e., name of the agreement, the parties, PII shared pursuant to the agreement, any privacy, civil liberties or confidentiality protections, and any limitations on sharing) and how compliance with the MOUs requirements is achieved with respect to PII (e.g., training, marking the information).





Memorandum of Understanding Limiting Treasury’s Use or Disclosure of PII

Section 5.4(i) Yes No Is any of the PII maintained in the system or by the project subject to the requirements of a Memorandum of Understanding or other agreement (e.g., agreement with another federal or state agency, an international agreement or treaty, or contract with private company that provided the information to OCC or one of its bureaus) that limits or places conditions on OCC’s internal use or external (i.e., outside OCC) sharing of the PII?

privacy and civil liberties issues were identified.”


<< Space for Narrative Explanation of the Answer to Section 5.4(i): Privacy and/or civil liberties risks presented and mitigation efforts>>


Memorandum of Understanding Limiting External Party’s Use or Disclosure of PII

Section 5.4(j) Yes No Is any of the PII maintained in the system or by the project subject to the requirements of a Memorandum of Understanding or other agreement in which OCC limits or places conditions on an external party’s use, maintenance, handling, or disclosure of PII shared by OCC?

privacy and civil liberties issues were identified.”

<< Space for Narrative Explanation of the Answer to Section 5.4(j): Privacy and/or civil liberties risks presented and mitigation efforts>>



External Information Sharing Chart

Section 5.4(k) Yes No Is information from the system or project shared externally?

External Recipient’s Name




Purpose of the Sharing

PII Shared




Content of Applicable Routine Use/Citation to the SORN




Applicable Statutory or Regulatory or Restrictions on Information Shared




Name and Description of Relevant MOUs or Other Agreements Containing Sharing Restrictions Imposed on Treasury by an External Source or Source/Originating Agency (including description of restrictions imposed on use, maintenance, and disclosure of PII)




Name and Description of Relevant MOUs or Other Agreements Containing Restrictions Imposed by Treasury on External Sharing Partner (including description of restrictions imposed on use, maintenance, and disclosure of PII)




Method(s) Used to Transfer PII (e.g., paper/ oral disclosures/magnetic disk/portable device/email fax/other (please describe if other)







Obtaining Consent Prior to New Disclosures Not Included in the SORN or Authorized by the Privacy Act

Section 5.4(l) Yes No X N/A Is the individual’s consent obtained by the OCC, where feasible and appropriate, prior to any new disclosures of previously collected records in a system of records (those not expressly authorized by the Privacy Act or contained in the “routine use” published in the SORN)? If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below.


If yes, please state “No privacy and civil liberties risks were identified” in the space provided below.


If N/A, please explain in the space provided below.

<< Space for Narrative Explanation of the Answer to Section 5.4(l): Privacy and/or civil liberties risks presented and mitigation efforts >>



Section 6: Compliance with federal information management requirements


Responses to the questions below address the practical, policy, and legal consequences of failing to comply with one or more of the following federal information management requirements (to the extent required) and how those risks were or are being mitigated: (1) the Privacy Act System of Records Notice Requirement; (2) the Paperwork Reduction Act; (3) the Federal Records Act; (4) the E-Gov Act security requirements; and (5) Section 508 of the Rehabilitation Act of 1973.


Section 6.1: Privacy Act System of Records Notice (SORN)


For collections of PII that meet certain requirements, the Privacy Act requires that the agency publish a SORN in the Federal Register.

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.


System of Records

Section 6.1(a) Yes No Does the system or project retrieve records about an individual using an identifying number, symbol, or other identifying particular assigned to the individual? (see items selected in Section 4.2 above)

If no, select N/A in response to section 6.1(b) below. If yes:


Section 6.1(b) Yes No N/A Was a SORN published in the Federal Register for this system of records?

If yes, please include below a citation to each SORN covering information used by the system or project (there can be more than one). If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts below.

<< Space for Narrative Explanation of the Answers to Sections 6.1(a) and 6.1(b): Privacy and legal risks presented and mitigation efforts >>



Section 6.2: The Paperwork Reduction Act


The PRA requires OMB approval before a Federal agency may collect standardized data from 10 or more respondents within a 12 month period. OMB requires agencies to conduct a PIA (a Treasury PCLIA) when initiating, consistent with the PRA, a new electronic collection of PII for 10 or more persons (excluding agencies, instrumentalities, or employees of the federal government).

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each Section. All narrative responses should be included in the space provided at the end of each section.


Paperwork Reduction Act Compliance

Section 6.2(a) Yes No Does the system or project maintain information obtained from individuals and organizations who are not federal personnel or an agency of the federal government? If no, please select “N/A” for the two (2) sections immediately below. If yes:


Section 6.2(b) Yes No N/A Does the project or system involve a new collection of information in identifiable form for 10 or more persons from outside the federal government? If no, please select “N/A” for the next section.


Section 6.2(c) Yes No N/A Did the project or system complete an Information Collection Request (“ICR”) and receive OMB approval?

If yes, please submit a copy of the ICR supporting statement with your PCLIA for review and provide the OMB Control Number: <OMB Control Number> (If multiple forms, please provide a list as an appendix).

If no, please analyze the PRA, privacy and/or civil liberties risks presented and mitigation efforts below.



Section 6.3: Records Management - NARA/Federal Records Act Requirements


Records retention schedules determine the maximum amount of time necessary to retain information in order to meet the needs of the project or system. Information is generally either disposed of or sent to the NARA for permanent retention upon expiration of this period.

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.


NARA Records Retention Requirements

Section 6.3(a) Yes No Are the records used in the system or by the project covered by a NARA’s General Records Schedule(s) (“GRS”) or a Treasury/bureau Specific Records Schedule (SRS)?


If yes, please include the general retention schedule(s) for the information maintained by the project or system and select N/A for Sections 6.3(b) thru (d).


If no, please proceed to Section 6.3(b).

Section 6.3(b) Yes No Did NARA approved a retention schedule for the records maintained in the system or by the project?

If no, proceed to Section 6.3(c).


If yes, please provide the retention period(s) for the information maintained by the project or system.


Section 6.3(c) Yes No N/A If NARA did not approve a retention schedule for the records maintained in the system or by the project and the records are not covered by NARA’s GRS or OCC SRS, has a draft retention schedule (approved by all applicable OCC officials) been developed for the records used in this project or system?

If no, please provide an expected date for when the applicable .proposed records retention schedule will be approved and analyze the privacy and/or civil liberties risks presented and mitigation efforts below.




Section 6.4: E-Government Act/NIST Compliance


The completion of Federal Information Security Management Act (“FISMA”) Security Assessment & Authorization (SA&A) process is required before a federal information system may receive Authority to Operate (“ATO”). Different security requirements apply to National Security Systems.

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.


Federal Information System Subject to FISMA Security Assessment and Authorization

Section 6.4(a) Yes No N/A Is the system a federal information system subject to FISMA requirements? If no, please check “N/A” in response to Section 6.4(b) and discuss in the space provided at the end of this section the security protocols in place to protect any PII on the system and analyze the privacy and/or civil liberties risks presented and any mitigation efforts. If yes, please proceed to Section 6.4(b).


Section 6.4(b) Yes No N/A Has the system or project undergone a SA&A and received ATO?


If yes, please analyze any privacy and/or civil liberties risks presented, mitigation efforts and provide the date the assessment was completed (or the date you expect it to be completed) as well as a point of contact. If completion of this process is required, but was not completed, please provide an explanation for why an SA&A and ATO processes were not/have not yet been completed. If completion of these processes is not required, please check “not applicable” and explain below why these processes do not apply to this system or project.

<<Space for Narrative Explanation of the Answers to Sections 6.4(a) and 6.4(b)>>

<<Privacy and/or civil liberties risks presented and mitigation efforts>>

<<Date SA&A received>>

<<SA&A Contact>>


Access Controls and Security Requirements

Section 6.4(c) Yes No Does the system or project include access controls to ensure limited access to information maintained by the system or project?

If yes, g describe these controls in the space provided at the end of this section.


If no, analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.

Logical access control is in place using PIV cards and application owner approval.


Security Risks in Manner of Collection

Section 6.4(d) Yes No In Section 4.3 above, you identified the sources for information used in the system or project and the method and manner of collection. Were any security, privacy, or civil liberties risks identified with respect to the manner in which the information is collected by Treasury from the source(s) (e.g., who bears the risk of costs associated with notifying potentially affected individuals and providing remediation [e.g., credit reporting or other remedies] caused by a breach during transport or transmission of the PII from Treasury to the internal or external recipient)?




Security Controls When Sharing Internally or Externally

Section 6.4(e) Yes No N/A Are all OCC security requirements met and are risks (e.g., risks associated with a breach during transmission) appropriately distributed between OCC and the recipient before transmitting or transporting information (e.g., bulk transfer, direct access by recipient, portable disk, paper) from the OCC project or system to internal or external parties?


If yes, please describe in the space provided at the end of this section the applicable protections implemented, including who bears the risk of costs associated with notifying potentially affected individuals and providing remediation (e.g., credit reporting or other remedies) caused by a breach during transport or transmission of the PII from Treasury to the internal or external recipient.


If no, please analyze the security, privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.




Monitoring of Individuals

Section 6.4(f) Yes No Will this system or project have the capability to identify, locate, and monitor individuals or groups of people? If yes, please describe in the space provided at the end of this section the type of information derived from these efforts and the technical (e.g., audit trails) or other processes used to limit unauthorized monitoring.


If no, please analyze the privacy and/or civil liberties risks presented (if any) and mitigation efforts below (e.g., if monitoring is not used, but could protect privacy and/or civil liberties if it was used – see the TDP for an explanation).




Audit Trails

Section 6.4(g) Yes No Are audit trails regularly reviewed for appropriate use, handling, and disclosure of PII maintained in the system or by the project inside or outside of the OCC?If yes, please describe in the space provided at the end of this section how audit trails are used to ensure appropriate use, handling and disclosure.


If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section (e.g., if monitoring is not used, but could protect privacy and/or civil liberties if it was used – see the TDP for an explanation).




Section 6.5: Section 508 of the Rehabilitation Act of 1973


When Federal agencies develop, procure, maintain, or use Electronic and Information Technology (“EIT”), Section 508 of the Rehabilitation Act of 1973 (as amended in 1998) requires that individuals with disabilities (including federal employees) must have access and use (including privacy policies and directives as well as redress opportunities) that is comparable to that which is available to individuals who do not have disabilities.

Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.


Applicability of and Compliance With the Rehabilitation Act

Section 6.5(a) Yes No Will the project or system involve the development, procurement, maintenance or use of EIT as that term is defined in Section 508 of the Rehabilitation Act of 1973 (as amended in 1998)? If no, please check N/A in response to Section 6.5(b and state the following in the space provided: “The Rehabilitation Act is not applicable.” If yes:



Section 6.5(b) Yes No N/A Does the system or project comply with all Section 508 requirements, thus ensuring that individuals with disabilities (including federal employees) have access and use (including access to privacy and civil liberties policies) that is comparable to that which is available to individuals who do not have disabilities?

If yes, please provide the completed Voluntary Product Accessibility Template (VPAT) or other 508 compliance documentation relevant to this system and describe in the space provided below what the project or system has done to comply with Section 508.


If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in the space provided at the end of this section.





Section 7: Redress


Please check the appropriate responses below and provide narrative responses as directed in the italicized guidance provided after each section. All narrative responses should be included in the space provided at the end of each section.

Access Under the Freedom of Information Act and Privacy Act

Section 7.0(a) Yes No Does the agency have a published process in place by which individuals may seek records under the Freedom of Information Act and Privacy Act? This response will be the same for all PCLIAs. Therefore, no additional response is required (unless there is something additional that needs to be included that is unique to the system)

The Treasury/bureaus FOIA and PA disclosure regulations can be found at 31 C.F.R. Part 1, Subtitle A, Subparts A and C.





Privacy Act Access Exemption

Section 7.0(b) Yes No Was any of the information that is maintained in system of records and used in the system or project exempted from the access provisions of the Privacy Act? If yes, please explain below the basis for the exemption, cite the applicable NPRM or Final Rule and analyze the privacy and/or civil liberties risks presented and mitigation efforts. If only a portion of the information in the system is exempt, please identify what records are non-exempt in the space provided at the end of this section.

<<< Space for Narrative Explanation of the Answer to Section 7.0(b): Basis for the exemption, citation to the NPRM or Final Rule and privacy and/or civil liberties risks presented and mitigation efforts >>



Additional Redress Mechanisms

Section 7.0(c) Yes No With respect to information maintained by the project or system (whether or not it is covered by the Privacy Act), does the bureau or office that owns the project or system have any additional mechanisms other than Privacy Act and FOIA remedies (e.g., a customer satisfaction unit; a complaint process) by which an individual may request access to and/or amendment of their information and/or contest adverse determinations about denial of their rights, benefits, and privileges under federal programs (e.g., decisions about whether the individual will receive a financial benefit, get a clearance or access to a OCC facility, obtain employment with OCC)?

If yes, please provide a citation to and general overview of that process in the space provided at the end of this section.


If no, please analyze the privacy and/or civil liberties risks presented and mitigation efforts in in the space provided at the end of this section.

<<Space for Narrative Explanation of the Answer to Section 7.0(c): Privacy and/or civil liberties risks presented and mitigation efforts >>



Appendix D: Glossary


Contractors and Service Providers - include, but are not limited to, information providers, information processors, and other organizations providing information system development, information technology services, and other outsourced applications.


Data Mining - a program involving pattern-based queries, searches, or other analyses of one or more electronic databases, where-- (A) a department or agency of the federal government, or a non-federal entity acting on behalf of the federal government, is conducting the queries, searches, or other analyses to discover or locate a predictive pattern or anomaly indicative of terrorist or criminal activity on the part of any individual or individuals; (B) the queries, searches, or other analyses are not subject-based and do not use personal identifiers of a specific individual, or inputs associated with a specific individual or group of individuals, to retrieve information from the database or databases; and (C) the purpose of the queries, searches, or other analyses is not solely-- (i) the detection of fraud, waste, or abuse in a government agency or program; or (ii) the security of a government computer system.


Final Rule – After the NPRM comment period closes, the agency reviews and analyzes the comments received (if any). The agency has the option-to proceed with the rulemaking as proposed, issue a new or modified proposal or withdraw the proposal before reaching its final decision. The agency can also revise the supporting analyses contained in the NPRM (e.g., to address a concern raised by a member of the public in response to the NPRM).


Information System Life Cycle - the phases, through which an information system passes, typically characterized as initiation, development, operation, and termination.


Information System - a discrete set of information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of information. Derived from 44 U.S.C § 3502(8).


Information Technology (“IT”) – any equipment or interconnected system or subsystem of equipment, used in the automatic acquisition, storage, analysis, evaluation, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of data or information by the executive agency, if the equipment is used by the executive agency directly or is used by a contractor under a contract with the executive agency that requires the use: (i) of that equipment; or (ii) of that equipment to a significant extent in the performance of a service or the furnishing of a product. It includes computers, ancillary equipment (including imaging peripherals, input, output, and storage devices necessary for security and surveillance), peripheral equipment designed to be controlled by the central processing unit of a computer, software, firmware and similar procedures, services (including support services), and related resources; but does not include any equipment acquired by a federal contractor incidental to a federal contract. Derived from Clinger-Cohen Act of 1996, 40 U.S.C. § 11101(6).


Major Information System embraces “large” and “sensitive” information systems and means “a system or project that requires special management attention because of its importance to an agency mission; its high development, operating, or maintenance costs; or its significant role in the administration of agency programs, finances, property, or other resources.” OMB Circular A-130, Section 6.u. This definition includes all systems that contain PII and were rated by the Treasury as “MODERATE” or “HIGH” impact under Federal Information Processing Standard 199.


Notice of Proposed Rule Making (“NPRM”) – the Privacy Act (Section (J) and (k)) allow agencies to use the rulemaking process to exempt particular systems of records from some of the requirements in the Act. This process is often, referred to as “notice-and-comment rulemaking.” The agency publishes an NPRM to notify the public that the agency is proposing a rule and provides an opportunity for the public to comment on the proposal before the agency can issue a final rule.


Personally Identifiable Information (“PII”) – Any information that can be used to distinguish or trace an individual’s identity, either alone or when combined with other personal or identifying information that is linked or linkable to a specific individual. The definition of this term also incorporates by reference the definition of PII in M-06-191 and the definition of the term “Information in Identifiable Form” as defined in 44 U.S.C. § 208(d)2 Pub. L. No. 107-347, 116 Stat. 2899, and as further defined in M-03-22.


Privacy Act Record - Any item, collection, or grouping of information about an individual that is maintained by an agency, including, but not limited to, his education, financial transactions, medical history, and criminal or employment history and that contains his name, or the identifying number, symbol, or other identifying particular assigned to the individual, such as a finger or voice print or a photograph;


Record Series - A series is the basic unit for organizing and controlling files. It is a group of files or documents kept together (either physically or intellectually) because they relate to a particular subject or function, result from the same activity, document a specific type of transaction, take a particular physical form, or have some other relationship arising out of their creation, receipt, maintenance, or use. Record series may span across entire enterprises. For example, the General Records Schedule contains records series which span the entire federal government.

Derived from, 36 CFR 1220.14.


Reviewing Official – A position created by M-03-22, the Review Official is responsible for reviewing and approving PIAs. Pursuant to OMB’s guidance, the reviewing Official is “the agency CIO or other agency head designee, who is other than the official procuring the system or the official who conducts the PIA.” At Treasury, the DASPTR serves as the agency Reviewing Official and is responsible for reviewing and approving PCLIAs.


Routine Use – with respect to the disclosure of a record outside of the Department (i.e., external sharing), the use of such record for a purpose which is compatible with the purpose for which it was collected.


System of Records – A group of any records under the control of any agency from which information is retrieved by the name of the individual or by some identifying number, symbol, or other identifying particular assigned to the individual.


System of Records Notice – Each agency that maintains a system of records shall publish in the Federal Register upon establishment or revision a notice of the existence and character of the system of records, which notice shall include: (A) the name and location of the system; (B) the categories of individuals on whom records are maintained in the system; (C) the categories of records maintained in the system; (D) each routine use of the records contained in the system, including the categories of users and the purpose of such use; (E) the policies and practices of the agency regarding storage, retrievability, access controls, retention, and disposal of the records; (F) the title and business address of the agency official who is responsible for the system of records; (G) the agency procedures whereby an individual can be notified at his request if the system of records contains a record pertaining to him; (H) the agency procedures whereby an individual can be notified at his request how he can gain access to any record pertaining to him contained in the system of records, and how he can contest its content; and (I) the categories of sources of records in the system.


System Owner - the official in the program office who is responsible for the use of the system and who implements the legal information resources management requirements, such as the guidance contained in M-03-22. If issues arise regarding identification of the system owner, the project or program manager are the system owner for purposes of this manual.


Treasury. The United States Department of the Treasury, including but not limited to its components and bureaus.



1 M-06-19 defines PII as “any information about an individual maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and information which can be used to distinguish or trace an individual’s identity, such as their name, social security number, date and place of birth, mother’s maiden name, biometric records, etc., including any other personal information which is linked or linkable to an individual.”

2 44 U.S.C. § 208(d) defines “Information in Identifiable Form” as “any representation of information that permits the identity of an individual to whom the information applies to be reasonably inferred by either direct or indirect means.”


11


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorOPTR (C3)
File Modified0000-00-00
File Created2021-01-16

© 2025 OMB.report | Privacy Policy