Attachment 8 - Privacy Act Statement.pdf

Privacy Act v.1 02/2013

Authorization for Release of Credit Information

Privacy Act Statement

The SEC is authorized to ask for this information under 5 CFR § 731 and 736, Executive Order 13467, 15 U.S. C. § 1681, et seq. and Executive Order 12968. The principal purpose of collecting this information is to assist SEC personnel in making an informed decision regarding suitability for a security clearance and to determine fitness for federal employment. Disclosure of your personal information is voluntary.

However, failure to provide the requested information may result in an adverse suitability determination.

In addition to the disclosures generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act, the information contained herein may specifically be disclosed: (1) to a Federal, State, or local law enforcement agency if the disclosing agency becomes aware of a violation or potential violation of law or regulation; (2) to a court or party in a court or Federal administrative proceeding if the Government is a party or in order to comply with a judge-issued subpoena; (3) To a Federal, State, or local agency, in response to its requests, in connection with the hiring or retention of an employee, the issuance of a security clearance, or the conduct of a security or background investigation of an individual, to the extent that the information is relevant and necessary to the requesting agency; (4) to the National Archives and Records Administration or the General Services Administration in records management inspections; (5) To the Office of Inspector General for investigating allegations of fraud or misconduct; (6) to a Member of Congress or a congressional office in response to an inquiry made on behalf of an individual who is the subject of the record; and (7) to SEC contractors or their authorized employees, and other Federal agencies, as necessary, for the purpose of assisting the SEC in the efficient administration of its programs. These contractors will be required to maintain Privacy Act safeguards with respect to such records. Disclosures may also be made in accordance with the Office of Personnel Management published system of records notice. (See OPM/Central-9).

REQUEST FOR PERSEC DETERMINATION (Employees) REQUEST FOR PERSEC DETERMINATION (Contractors)

Privacy Act Statement

The SEC is authorized to ask for this information under 5 CFR § 731 and 736, and Executive Order 13467. The authority for soliciting and verifying your SSN is Executive Order 9397.

The principal purpose of collecting this information is to assist SEC personnel in making an informed decision regarding suitability for a security clearance and to determine fitness for federal employment.

Disclosure of your SSN is voluntary. Failure to provide your SSN may delay processing and thereby delay a determination of suitability. Disclosure of all other personal information is voluntary. However, failure to provide the requested information may result in an adverse suitability determination. In addition to the disclosures generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act, the information contained herein may specifically be disclosed: (1) to a Federal, State, or local law enforcement agency if the disclosing agency becomes aware of a violation or potential violation of law or regulation; (2) to a court or party in a court or Federal administrative proceeding if the Government is a party or in order to comply with a judge-issued subpoena; (3) To a Federal, State, or local agency, in response to its requests, in connection with the hiring or retention of an employee, the issuance of a security clearance, or the conduct of a security or background investigation of an individual, to the extent that the information is relevant and necessary to the requesting agency; (4) to the National Archives and Records Administration or the General Services Administration in records management inspections; (5) To the Office of Inspector General for investigating allegations of fraud or misconduct; (6) to a Member of Congress or a congressional office in response to an inquiry made on behalf of an individual who is the subject of the record; and (7) to SEC contractors or their authorized employees, and other Federal agencies, as necessary, for the purpose of assisting the SEC in the efficient administration of its programs. These contractors will be required to maintain Privacy Act safeguards with respect to such records. Disclosures may also be made in accordance with the Office of Personnel Management published system of records notice. (See OPM/Central-9).

Attachment 8