DD Form 2930 PIA

PRIVACY IMPACT ASSESSMENT (PIA)
PRESCRIBING AUTHORITY: DoD Instruction 5400.16, "DoD Privacy Impact Assessment (PIA) Guidance". Complete this form for Department of Defense
(DoD) information systems or electronic collections of information (referred to as an "electronic collection" for the purpose of this form) that collect, maintain, use,
and/or disseminate personally identifiable information (PII) about members of the public, Federal employees, contractors, or foreign nationals employed at U.S.
military facilities internationally. In the case where no PII is collected, the PIA will serve as a conclusive determination that privacy requirements do not apply to
system.
1. DOD INFORMATION SYSTEM/ELECTRONIC COLLECTION NAME:

Civil Aircraft Landing Permit System
3. PIA APPROVAL DATE:

2. DOD COMPONENT NAME:

United States Air Force

SECTION 1: PII DESCRIPTION SUMMARY (FOR PUBLIC RELEASE)
a. The PII is: (Check one. Note: foreign nationals are included in general public.)

✖

From members of the general public

From Federal employees and/or Federal contractors

From both members of the general public and Federal employees and/or
Federal contractors

Not Collected (if checked proceed to Section 4)

b. The PII is in a: (Check one)

✖

New DoD Information System

New Electronic Collection

Existing DoD Information System

Existing Electronic Collection

Significantly Modified DoD Information System
c. Describe the purpose of this DoD information system or electronic collection and describe the types of personal information about individuals
collected in the system.

The information is provided by civil aircraft operators in applying for landing rights and serves as the basis for approval/disapproval by the
military departments. The military departments also use the information to advise installation commanders of approved users, aircraft
registration numbers, and purpose for use.
d. Why is the PII collected and/or what is the intended use of the PII? (e.g., verification, identification, authentication, data matching, mission-related use,
administrative use)

The collection of this information is necessary to identify the aircraft operator and the aircraft to be operated; establish the purpose for use
of military airfields; and protect the US Government against litigation.
e. Do individuals have the opportunity to object to the collection of their PII?

✖

Yes

No

(1) If "Yes," describe the method by which individuals can object to the collection of PII.
(2) If "No," state the reason why individuals cannot object to the collection of PII.

PII collected is voluntary, however failure to provide this information will result in an individual or corporation being unable to operate civil
aircraft into a military airfield.
f. Do individuals have the opportunity to consent to the specific uses of their PII?

Yes

✖

No

(1) If "Yes," describe the method by which individuals can give or withhold their consent.
(2) If "No," state the reason why individuals cannot give or withhold their consent.

Specific use of PII collected is already strictly limited to those within the military department with a need to know.

g. When an individual is asked to provide PII, a Privacy Act Statement (PAS) and/or a Privacy Advisory must be provided. (Check as appropriate and
provide the actual wording.)
✖

Privacy Act Statement

Privacy Advisory

Not Applicable

AUTHORITY: 49 U.S. Code, Section 44502(d).
PRINCIPAL PURPOSE(S): When partially completed, indicates desire of an individual or corporation to operate civil aircraft into a
military airfield; when validated by a military approving authority, grants an individual or corporation permission to land civil aircraft at
a military airfield.
ROUTINE USE(S): None.

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DISCLOSURE: Voluntary; however, failure to provide this information will result in an individual or corporation being unable to
operate civil aircraft into a military airfield.
h. With whom will the PII be shared through data exchange, both within your DoD Component and outside your Component? (Check all that apply)
✖

Within the DoD Component

Specify.

Other DoD Components

Specify.

Other Federal Agencies

Specify.

State and Local Agencies

Specify.

Contractor (Name of contractor and describe the language in
the contract that safeguards PII. Include whether FAR privacy
clauses, i.e., 52.224-1, Privacy Act Notification, 52.224-2,
Privacy Act, and FAR 39.105 are included in the contract.)

Specify.

Other (e.g., commercial providers, colleges).

Specify.

Departmental Headquarters and Installation Commanders.

i. Source of the PII collected is: (Check all that apply and list all information systems if applicable)
✖

Individuals

Databases

Existing DoD Information Systems

Commercial Systems

Other Federal Information Systems

j. How will the information be collected? (Check all that apply and list all Official Form Numbers if applicable)
✖

E-mail

✖

Official Form (Enter Form Number(s) in the box below)

Face-to-Face Contact

✖

Paper

Fax

Telephone Interview

Information Sharing - System to System

Website/E-Form

Other (If Other, enter the information in the box below)

DD Form 2400, DD Form 2401, and DD Form 2402.
k. Does this DoD Information system or electronic collection require a Privacy Act System of Records Notice (SORN)?
A Privacy Act SORN is required if the information system or electronic collection contains information about U.S. citizens or lawful permanent U.S. residents that
is retrieved by name or other unique identifier. PIA and Privacy Act SORN information must be consistent.
✖ Yes

No

If "Yes," enter SORN System Identifier

F010 AFXO A

SORN Identifier, not the Federal Register (FR) Citation. Consult the DoD Component Privacy Office for additional information or http://dpcld.defense.gov/
Privacy/SORNs/
or
If a SORN has not yet been published in the Federal Register, enter date of submission for approval to Defense Privacy, Civil Liberties, and Transparency
Division (DPCLTD). Consult the DoD Component Privacy Office for this date
If "No," explain why the SORN is not required in accordance with DoD Regulation 5400.11-R: Department of Defense Privacy Program.

l. What is the National Archives and Records Administration (NARA) approved, pending or general records schedule (GRS) disposition authority
for the system or for the records maintained in the system?
(1) NARA Job Number or General Records Schedule Authority.

N1-AFU-86-50

(2) If pending, provide the date the SF-115 was submitted to NARA.

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(3) Retention Instructions.

Destroy 2 years after expiration date of form or when superseded.
m. What is the authority to collect information? A Federal law or Executive Order must authorize the collection and maintenance of a system of
records. For PII not collected or maintained in a system of records, the collection or maintenance of the PII must be necessary to discharge the
requirements of a statue or Executive Order.
(1) If this system has a Privacy Act SORN, the authorities in this PIA and the existing Privacy Act SORN should be similar.
(2) If a SORN does not apply, cite the authority for this DoD information system or electronic collection to collect, use, maintain and/or disseminate PII.
(If multiple authorities are cited, provide all that apply).
(a) Cite the specific provisions of the statute and/or EO that authorizes the operation of the system and the collection of PII.
(b) If direct statutory authority or an Executive Order does not exist, indirect statutory authority may be cited if the authority requires the
operation or administration of a program, the execution of which will require the collection and maintenance of a system of records.
(c) If direct or indirect authority does not exist, DoD Components can use their general statutory grants of authority (“internal housekeeping”) as
the primary authority. The requirement, directive, or instruction implementing the statute within the DoD Component must be identified.

49 USC, Section 44502(d)

n. Does this DoD information system or electronic collection have an active and approved Office of Management and Budget (OMB) Control
Number?
Contact the Component Information Management Control Officer or DoD Clearance Officer for this information. This number indicates OMB approval to
collect data from 10 or more members of the public in a 12-month period regardless of form or format.
✖

Yes

No

Pending

(1) If "Yes," list all applicable OMB Control Numbers, collection titles, and expiration dates.
(2) If "No," explain why OMB approval is not required in accordance with DoD Manual 8910.01, Volume 2, " DoD Information Collections Manual:
Procedures for DoD Public Information Collections.”
(3) If "Pending," provide the date for the 60 and/or 30 day notice and the Federal Register citation.

OMB 0701-0050, Civil Aircraft Landing Permit System, DD Form 2400/2401/2402

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SECTION 2: PII RISK REVIEW
a. What PII will be collected (a data element alone or in combination that can uniquely identify an individual)? (Check all that apply)
Biometrics

Birth Date

Citizenship

Disability Information

DoD ID Number

Driver's License

Education Information

Emergency Contact

Employment Information

Financial Information

Gender/Gender Identification

✖

Home/Cell Phone

Law Enforcement Information

Legal Status

✖

Mailing/Home Address

Marital Status

Military Records

Mother's Middle/Maiden Name

✖

✖

Child Information

Medical Information
✖ Name(s)

Official Duty Address

✖

Official Duty Telephone Phone

Other ID Number

Passport Information

✖

Personal E-mail Address

Photo

Place of Birth

✖

Position/Title

Protected Health Information (PHI)1
Religious Preference

Race/Ethnicity

Rank/Grade

Records

Security Information

Work E-mail Address

If Other, enter the information in the box below

Social Security Number (SSN) (Full or in any
form)

Personal contact information (only) is collected from individual applicants and duty contact information (only) is collected from
corporations that apply for landing permits.
If the SSN is collected, complete the following questions.
(DoD Instruction 1000.30 states that all DoD personnel shall reduce or eliminate the use of SSNs wherever possible. SSNs shall not be used in spreadsheets,
hard copy lists, electronic reports, or collected in surveys unless they meet one or more of the acceptable use criteria.)
(1) Is there a current (dated within two (2) years) DPCLTD approved SSN Justification on Memo in place?
Yes

No

If "Yes," provide the signatory and date approval. If “No,” explain why there is no SSN Justification Memo.

(2) Describe the approved acceptable use in accordance with DoD Instruction 1000.30 “Reduction of Social Security Number (SSN) Use within DoD”.

(3) Describe the mitigation efforts to reduce the use including visibility and printing of SSN in accordance with DoD Instructoin 1000.30, “Reduction of
Social Security Number (SSN) Use within DoD”.

(4) Has a plan to eliminate the use of the SSN or mitigate its use and or visibility been identified in the approved SSN Justification request?
If "Yes," provide the unique identifier and when can it be eliminated?
If "No," explain.
Yes

No

b. What is the PII confidentiality impact level2?

✖ Low

Moderate

High

1The definition of PHI involves evaluating conditions listed in the HIPAA. Consult with General Counsel to make this determination.
2Guidance on determining the PII confidentiality impact level, see Section 2.5 “Categorization of PII Using NIST SP 800-122.” Use the identified PII confidentiality impact level to apply the appropriate Privacy Overlay
low, moderate, or high. This activity may be conducted as part of the categorization exercise that occurs under the Risk Management Framework (RMF). Note that categorization under the RMF is typically
conducted using the information types described in NIST Special Publication (SP) 800-60, which are not as granular as the PII data elements listed in the PIA table. Determining the PII confidentiality impact level is
most effective when done in collaboration with the Information Owner, Information System Owner, Information System Security Manager, and representatives from the security and privacy organizations, such as the
Information System Security Officer (ISSO) and Senior Component Official for Privacy (SCOP) or designees.

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c. How will the PII be secured?
(1) Physical Controls. (Check all that apply)
✖

Cipher Locks

Closed Circuit TV (CCTV)
✖

Combination Locks

Identification Badges

Key Cards

Safes

Security Guards

If Other, enter the information in the box below

(2) Administrative Controls. (Check all that apply)
✖

Backups Secured Off-site

✖

Encryption of Backups

✖

Methods to Ensure Only Authorized Personnel Access to PII

✖

Periodic Security Audits

✖

Regular Monitoring of Users' Security Practices
If Other, enter the information in the box below

(3) Technical Controls. (Check all that apply)
Biometrics

✖ Common Access Card (CAC)

DoD Public Key Infrastructure Certificates

✖

Encryption of Data at Rest

Encryption of Data in Transit

External Certificate Authority Certificates

✖

Firewall

Intrusion Detection System (IDS)

Least Privilege Access

✖

Role-Based Access Controls

Used Only for Privileged (Elevated Roles)

User Identification and Password

✖

Virtual Private Network (VPN)

If Other, enter the information in the box below

d. What additional measures/safeguards have been put in place to address privacy risks for this information system or electronic collection?

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SECTION 3: RELATED COMPLIANCE INFORMATION
a. Is this DoD Information System registered in the DoD IT Portfolio Repository (DITPR) or the DoD Secret Internet Protocol Router Network
(SIPRNET) Information Technology (IT) Registry or Risk Management Framework (RMF) tool3?
Yes, DITPR

DITPR System Identification Number

Yes, SIPRNET

SIPRNET Identification Number

Yes, RMF tool

RMF tool Identification Number

No
If “No,” explain.

b. DoD information systems require assessment and authorization under the DoD Instruction 8510.01, “Risk Management Framework for DoD
Information Technology”.
Indicate the assessment and authorization status:
Authorization to Operate (ATO)

Date Granted:

ATO with Conditions

Date Granted:

Denial of Authorization to Operate (DATO)

Date Granted:

Interim Authorization to Test (IATT)

Date Granted:

(1) If an assessment and authorization is pending, indicate the type and projected date of completion.

(2) If an assessment and authorization is not using RMF, indicate the projected transition date.

c. Does this DoD information system have an IT investment Unique Investment Identifier (UII), required by Office of Management and Budget (OMB)
Circular A-11?
Yes

No

If "Yes," Enter UII

3

If unsure, consult the component IT Budget Point of Contact to obtain the UII

Guidance on Risk Management Framework (RMF) tools (i.g., eMASS, Xacta, and RSA Archer) are found on the Knowledge Service (KS) at https://rmfks.osd.mil.

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SECTION 4: REVIEW AND APPROVAL SIGNATURES
Completion of the PIA requires coordination by the program manager or designee through the information system security manager and privacy representative at
the local level. Mandatory coordinators are: Component CIO, Senior Component Official for Privacy, Component Senior Information Security Officer, and
Component Records Officer.
a. Program Manager or
Designee Name

James A. Rogers

(1) Title

Civil Aviation Analyst

(2) Organization

HQ USAF/A3OJ

(3) Work
Telephone

W: 202-404-7886
C: 443-486-8743

(4) DSN

754-7886

(5) E-mail address

james.a.rogers88.civ@mail.mil

(6) Date of Review

04/27/20

(7) Signature

Digitally signed by
ROGERS.JAMES.A.1143522977
Date: 2020.04.27 13:19:52 -04'00'

b. Other Official (to be
used at Component
discretion)

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

c. Other Official (to be
used at Component
discretion)

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

d. Component Privacy
Officer (CPO)

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

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e. Component Records
Officer

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

f. Component Senior
Information Security
Officer or Designee
Name

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review:

(7) Signature

g. Senior Component
Official for Privacy
(SCOP) or Designee
Name

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

h. Component CIO
Reviewing Official
Name

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

Publishing: Only Section 1 of this PIA will be published. Each DoD Component will maintain a central repository of PIAs on the Component's public Web site.
DoD Components will submit an electronic copy of each approved PIA to the DoD CIO at: osd.mc-alex.dod-cio.mbx.pia@mail.mill.
If the PIA document contains information that would reveal sensitive information or raise security concerns, the DoD Component may restrict the
publication of the assessment to include Section 1.

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