1625-0031 Privacy Threshold Analysis (PTA)

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

PRIVACY THRESHOLD ANALYSIS (PTA)
This form serves as the official determination by the DHS Privacy Office to
identify the privacy compliance requirements for all Departmental uses of
personally identifiable information (PII).
A Privacy Threshold Analysis (PTA) serves as the document used to identify
information technology (IT) systems, information collections/forms, technologies,
rulemakings, programs, information sharing arrangements, or pilot projects that involve
PII and other activities that otherwise impact the privacy of individuals as determined by
the Chief Privacy Officer, pursuant to Section 222 of the Homeland Security Act, and to
assess whether there is a need for additional Privacy Compliance Documentation. A PTA
includes a general description of the IT system, information collection, form, technology,
rulemaking, program, pilot project, information sharing arrangement, or other Department
activity and describes what PII is collected (and from whom) and how that information is
used and managed.
Please complete the attached Privacy Threshold Analysis and submit it to your
component Privacy Office. After review by your component Privacy Officer the PTA is sent
to the Department’s Senior Director for Privacy Compliance for action. If you do not have a
component Privacy Office, please send the PTA to the DHS Privacy Office:
Senior Director, Privacy Compliance
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
Tel: 202-343-1717
PIA@hq.dhs.gov

Upon receipt from your component Privacy Office, the DHS Privacy Office will review this
form and assess whether any privacy compliance documentation is required. If compliance
documentation is required – such as Privacy Impact Assessment (PIA), System of Records
Notice (SORN), Privacy Act Statement, or Computer Matching Agreement (CMA) – the DHS
Privacy Office or component Privacy Office will send you a copy of the relevant compliance
template to complete and return.
Privacy Threshold Analysis – IC/Form

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Privacy Threshold Analysis (PTA)

Specialized Template for
Information Collections (IC) and Forms
The Forms-PTA is a specialized template for Information Collections and Forms. This
specialized PTA must accompany all Information Collections submitted as part of the
Paperwork Reduction Act process (any instrument for collection (form, survey,
questionnaire, etc.) from ten or more members of the public). Components may use this PTA
to assess internal, component-specific forms as well.
Form Number:
Form Title:
Component:

N/A
N/A

U.S. Coast Guard (USCG)

Office:

CG-REG

IF COVERED BY THE PAPERWORK REDUCTION ACT:
Collection Title:
Plan Approval and Records for Electrical Engineering Regulations -Title 46 CFR Subchapter J
OMB Control
1625-0031
OMB Expiration
September 30,
Number:
Date:
2024
Collection status:
Extension
Date of last PTA (if
October 19, 2017
applicable):
Name:
Office:
Phone:
Name:
Office:
Phone:

PROJECT OR PROGRAM MANAGER
Mr. David Du Pont
CG-REG
Title:
Reg Dev Mgr
202-372-1497
Email:
David.A.DuPont@uscg.mil

COMPONENT INFORMATION COLLECTION/FORMS CONTACT
A.L. Craig
CG-6P
Title:
PRA Coordinator
202-475-3528
Email:
Albert.L.Craig@uscg.mil

Privacy Threshold Analysis – IC/Form

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

SPECIFIC IC/Forms PTA QUESTIONS
1. Purpose of the Information Collection or Form
a. Describe the purpose of the information collection or form. Please provide a
general description of the project and its purpose, including how it supports the DHS
mission, in a way a non-technical person could understand (you may use
information from the Supporting Statement).
If this is an updated PTA, please specifically describe what changes or upgrades are
triggering the update to this PTA.
The U.S. Coast Guard (USCG) is renewing the Information Collection Request (ICR) titled,
1625-0031: “Plan Approval and Records for Electrical Engineering Regulations -- Title 46
CFR Subchapter J.” There has not been any substantive changes or updates to this
collection since the last submission.
The purpose of the information collection is to aid the Coast Guard in determining if a
vessel complies with certain safety and environmental protection standards. Plans and
records for construction or modification of U.S. vessels submitted and maintained on
board are required for compliance with these standards.
There is no form associated with this collection.

Plan Approval and Records for Electrical Engineering Regulations -- Title 46 CFR
Subchapter J records includes vessel specific information and contains the following
personally identifiable information (PII):
Name and address of the vessel owner/operator, if owned/operated by an individual.
b. List the DHS (or Component) authorities to collect, store, and use this
information. If this information will be stored and used by a specific DHS
component, list the component-specific authorities.
46 U.S. Code 3306 and 3703 is the authority for this collection.
2. Describe the IC/Form

Privacy Threshold Analysis – IC/Form

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

a. Does this form collect any
Personally Identifiable
Information” (PII 1)?

b. From which type(s) of
individuals does this form
collect information?
(Check all that apply.)

c. Who will complete and
submit this form? (Check
all that apply.)

d. How do individuals
complete the form? Check
all that apply.

☒ Yes
☐ No

☒ Members of the public
☒ U.S. citizens or lawful permanent
residents
☒ Non-U.S. Persons
☐ DHS Employees/Contractors (list
Components)
☐ Other federal employees or contractors

☒ The record subject of the form (e.g., the
individual applicant).
☐ Legal Representative (preparer, attorney,
etc.).
☒ Business entity.
If a business entity, is the only
information collected business contact
information?
☒ Yes
☐ No
☐ Law enforcement.
☐ DHS employee/contractor.
☐ Other individual/entity/organization that is
NOT the record subject. Please describe.
Click here to enter text.

☒ Paper.
☒ Electronic. (ex: fillable PDF)
☐ Online web form. (available and submitted via
the internet)
Provide link:

e. What information will DHS collect on the form?

1
Personally identifiable information means any information that permits the identity of an individual to be directly or indirectly inferred, including
any other information which is linked or linkable to that individual regardless of whether the individual is a U.S. citizen, lawful permanent resident,
visitor to the U.S., or employee or contractor to the Department.

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Plan Approval and Records for Electrical Engineering Regulations -- Title 46 CFR
Subchapter J records includes vessel specific information and contains the following PII:
Name and address of the vessel owner/operator, if owned/operated by an individual.

f. Does this form collect Social Security number (SSN) or other element that is
stand-alone Sensitive Personally Identifiable Information (SPII)? No.
☐ Social Security number
☐ DHS Electronic Data Interchange
Personal Identifier (EDIPI)
☐ Alien Number (A-Number)
☐ Social Media Handle/ID
☐ Tax Identification Number
☐ Known Traveler Number
☐ Visa Number
☐ Trusted Traveler Number (Global
☐ Passport Number
Entry, Pre-Check, etc.)
☐ Bank Account, Credit Card, or other
☐ Driver’s License Number
financial account number
☐ Biometrics
☐ Other. Please list:

g. List the specific authority to collect SSN or these other SPII elements.
N/A

h. How will the SSN and SPII information be used? What is the purpose of the
collection?
N/A
i.

N/A

j.

Is SSN necessary to carry out the functions of this form and/or fulfill
requirements of the information collection? Note: even if you are properly
authorized to collect SSNs, you are required to use an alternative identifier. If
there are technological, legal, or regulatory limitations to eliminating the SSN,
privacy-enhancing alternatives should be taken, such as truncating the SSN.
Are individuals
provided notice at the
time of collection by
DHS (Does the records
subject have notice of
the collection or is

Privacy Threshold Analysis – IC/Form

☐ Yes. Please describe how notice is provided.
Click here to enter text.
☒ No.
There is no CG-Form associated with this collection.

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

form filled out by
third party)?

3. How will DHS store the IC/form responses?
a. How will DHS store
☐ Paper. Please describe.
the original,
Click here to enter text.
completed IC/forms?
☐ Electronic. Please describe the IT system that will

b. If electronic, how
does DHS input the
responses into the IT
system?
c. How would a user
search the
information
submitted on the
forms, i.e., how is the
information
retrieved?

2

d. What is the records
retention
schedule(s)? Include

store the data from the form.
Click here to enter text.
☒ Scanned forms (completed forms are scanned into
an electronic repository). Please describe the
electronic repository.
The records that the Coast Guard receives are
maintained in Marine Information for Safety and Law
Enforcement (MISLE) database.

☒ Manually (data elements manually entered). Please
describe.
A scanned record is uploaded to the vesselspecific file in MISLE.
☐ Automatically. Please describe.
Click here to enter text.

☐ By a unique identifier. 2 Please describe. If
information is retrieved by personal identifier, please
submit a Privacy Act Statement with this PTA.
Click here to enter text.
☒ By a non-personal identifier. Please describe.
A search can be done using vessel-specific
information.
A record is retained for the life of the vessel; NARA
retention schedule number N1-026-05-015.

Generally, a unique identifier is considered any type of “personally identifiable information,” meaning any information that permits the identity
of an individual to be directly or indirectly inferred, including any other information which is linked or linkable to that individual regardless of
whether the individual is a U.S. citizen, lawful permanent resident, visitor to the U.S., or employee or contractor to the Department.

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

the records schedule
number.
e. How do you ensure
As records are maintained in the MISLE database,
that records are
disposal/deletion is in accordance with the business
disposed of or deleted
rules for the database.
in accordance with
the retention
schedule?
f. Is any of this information shared outside of the original program/office? If yes,
describe where (other offices or DHS components or external entities) and why.
What are the authorities of the receiving party?
☐ Yes, information is shared with other DHS components or offices. Please describe.
Click here to enter text.
☐ Yes, information is shared external to DHS with other federal agencies, state/local
partners, international partners, or non-governmental entities. Please describe.
Click here to enter text.

☒ No. Information on this form is not shared outside of the collecting office.

Please include a copy of the referenced form and Privacy Act Statement (if
applicable) with this PTA upon submission.

Privacy Threshold Analysis – IC/Form

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

PRIVACY THRESHOLD REVIEW
(TO BE COMPLETED BY COMPONENT PRIVACY OFFICE)
Component Privacy Office Reviewer:

Date submitted to Component Privacy
Office:
Concurrence from other Components
involved (if applicable):
Date submitted to DHS Privacy Office:
Have you approved a Privacy Act
Statement for this form? (Only
applicable if you have received a
waiver from the DHS Chief Privacy
Officer to approve component Privacy
Act Statements.)

A.L. Craig

September 22, 2023
N/A

September 26, 2023

☐ Yes. Please include it with this PTA
submission.
☒ No. Please describe why not.
There is no CG-Form associated with this
collection.

Component Privacy Office Recommendation:
Please include recommendation below, including what existing privacy compliance
documentation is available or new privacy compliance documentation is needed.
The U.S. Coast Guard (USCG) is renewing the Information Collection Request (ICR) titled,
1625-0031: “Plan Approval and Records for Electrical Engineering Regulations -- Title 46
CFR Subchapter J.” There has not been any substantive changes or updates to this collection
since the last submission.
The purpose of the information collection is to aid the Coast Guard in determining if a
vessel complies with certain safety and environmental protection standards. Plans and
records for construction or modification of U.S. vessels submitted and maintained on board
are required for compliance with these standards.
There is no form associated with this collection.

Plan Approval and Records for Electrical Engineering Regulations -- Title 46 CFR
Subchapter J records includes vessel specific information and contains the following PII:
Privacy Threshold Analysis – IC/Form

Page 8 of 11

Version number: 06-2023

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

Name and address of the vessel owner/operator, if owned/operated by an individual.

Records are maintained in accordance with NARA’s retention schedule number N1-026-05015 and are uploaded to the facility-specific file in the Marine Information for Safety and
Law Enforcement (MISLE) system.
Plan Approval and Records for Electrical Engineering Regulations -- Title 46 CFR
Subchapter J is privacy sensitive – coverage is provided by DHS/USCG/PIA-008, Marine
Information for Safety and Law Enforcement (MISLE).

Privacy Threshold Analysis – IC/Form

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Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

PRIVACY THRESHOLD ADJUDICATION
(TO BE COMPLETED BY THE DHS PRIVACY OFFICE)
DHS Privacy Office Reviewer:

Brian Pochatila

PCTS Workflow Number:
Date approved by DHS Privacy Office:
PTA Expiration Date
DHS Privacy Office Approver (if
applicable):

0015488
September 27, 2023
September 27, 2026
Riley Dean

DESIGNATION

Privacy Sensitive IC or
Form:
Determination:

Privacy Act
Statement:
System PTA:
PIA:

SORN:

Yes If “no” PTA adjudication is complete.
☐ PTA sufficient at this time.
☐ Privacy compliance documentation determination in
progress.
☐ New information sharing arrangement is required.
☐ DHS Policy for Computer-Readable Extracts Containing SPII
applies.
☐ Privacy Act Statement required.
☒ Privacy Impact Assessment (PIA) required.
☐ System of Records Notice (SORN) required.
☐ Specialized training required.
☐ Other. Click here to enter text.

Choose an item.
Click here to enter text.
Choose an item.
Click here to enter text.
System covered by existing PIA
If covered by existing PIA, please list: HS/USCG/PIA-008 Marine
Information for Safety and Law Enforcement (MISLE)
If a PIA update is required, please list: Click here to enter text.
Choose an item.
If covered by existing SORN, please list: Click here to enter text.

Privacy Threshold Analysis – IC/Form

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Version number: 06-2023

Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
202-343-1717, pia@hq.dhs.gov
www.dhs.gov/privacy

If a SORN update is required, please list: Click here to enter text.
DHS Privacy Office Comments:
Please describe rationale for privacy compliance determination above.

USCG is renewing the Information Collection Request (ICR) titled, 1625-0031: “Plan
Approval and Records for Electrical Engineering Regulations -- Title 46 CFR Subchapter J.”
There has not been any substantive changes or updates to this collection since the last
submission.

The purpose of the information collection is to aid the Coast Guard in determining if a
vessel complies with certain safety and environmental protection standards. Plans and
records for construction or modification of U.S. vessels submitted and maintained on board
are required for compliance with these standards. There is no form associated with this
collection.
Plan Approval and Records for Electrical Engineering Regulations -- Title 46 CFR
Subchapter J records includes vessel specific information and contains the following PII:
name and address of the vessel owner/operator, if owned/operated by an individual.

The DHS Privacy Office concurs that the Plan Approval and Records for Electrical
Engineering Regulations - Title 46 CFR Subchapter J is privacy sensitive requiring PIA
coverage. PIA coverage is provided by DHS/USCG/PIA-008 Marine Information for Safety
and Law Enforcement (MISLE), which captures information required to support the Coast
Guard's marine safety, security, environmental protection and law enforcement programs.
SORN coverage is not required because information is not retrieved by unique identifiers.

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