26QE011_ATTCH5_PrivacyChecklist.pdf

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AMD 1 Grades 6-12 Suicide Prevention Instructional Resources and Screeners
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HE125426QE011
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DoDEA PRIVACY CHECKLIST, DECEMBER 2022

DEPARTMENT OF DEFENSE EDUCATION ACTIVITY (DODEA)

Privacy Checklist INSTRUCTIONS: DoDEA has a continuing affirmative responsibility to safeguard PII and to prevent its loss, theft or compromise. All DoDEA affiliated personnel, including support Contractors/Companies/Entities must ensure their actions do not contribute to, or result in, a compromise or breach of PII. This checklist is completed by an authorized representative of a digital resource that maintains, processes, stores, disseminates, discloses, or otherwise “handles” members of the public, i.e. Student or Sponsors, PII on DoDEA's behalf. The authorized representative MUST carefully read/review and check each box of the Acknowledgments section and complete/sign the certification block. Please return the checklist to the DoDEA representative, i.e. Action Officer or Contracting Officer.

ACKNOWLEDGMENTS

CERTIFICATION

By my signature below, I acknowledge that I have read and fully understand the information contained in the Acknowledgments section of this Checklist.

Authorized Representative Legal Name Authorized Representative Signature and Date

11.0.0.20130303.1.892433.887364 December 16, 2022 DoDEA This checklist is completed by an entity who is required to maintain PII on DoDEA's behalf.

Sam Gotti DoDEA Privacy Checklist

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