Privacy Act Memo

Attachment 3 - Privacy Act Memo- signed.pdf

Data Use Certification for the Adolescent Brain Cognitive Development Study (NIDA)

Privacy Act Memo

OMB: 0925-0780

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Updated 12/2012

Acquisition Plan Attachment
PRIVACY ACT MEMO

FROM :

Elizabeth Hoffman
________________________________________,
Project Officer

SUBJECT:

Privacy Act Applicability to Contract

NIH Brain Development Cohorts Data Sharing Platform
Project Title: _______________________________________________________________
NIDA Reference Number: ____________________

Josh Lazarus
________________________________________,
Contracting Officer

TO:

This memorandum certifies that I have reviewed the above referenced document and find that the work to be
performed by the contractor:
(✔)

is subject to the Privacy Act and HHSAR Clause 352.224-70 Confidentiality of Information will
be inserted in the contract.

( )

is not subject to the Privacy Act because:
( )

a.

No information on individuals is to be maintained under the contract. The contract
provides for ________________________________________________ and no
work under the contract will involve the collection or use of information about
individuals.

( )

b.

The gathering of data on individuals is incidental to performance of the contract;
however no information on individuals will be maintained by or retrieved by personal
identifier. The Confidentiality of Information clause prescribed by HHSAR 324.70 ( )
is, ( ) not required to be inserted in the contract.

( )

c.

The contract provides for the performance of work which will require the contractor to
collect, maintain or use information on individuals. However, for the following
reason(s) the records do not constitute a system of records subject to the Privacy
Act.
Inclusion of the confidentiality of Information clause
prescribed by HHSAR 324.70 will provide sufficient protection of privacy interests.

Elizabeth A.
Hoffman -S

Digitally signed by
Elizabeth A. Hoffman -S
Date: 2023.05.30
11:09:09 -04'00'

________________

Project Officer

Date

( ) Contracting Officer concurs that Privacy Act is not applicable _________ (CO initials)
If subject to the Priviacy Act, the Privacy Act Coordinator must complete the following:
signed by
Christopher Digitally
Christopher R. Squiers -S
2023.06.29 13:37:33
R. Squiers -S Date:
-04'00'

Privacy Act Coordinator

( ) concur
✔
( ) non-concur

09-25-0200

Applicable System of Records Number _____________

________________
Date


File Typeapplication/pdf
File TitleMicrosoft Word - AP Privacy Act Memo
Authorlazarusjt
File Modified2023-06-29
File Created2018-10-01

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