Attachment-G9-ACF_System Registration_V1.0.docx

Enter System Name ACF

System Registration Test

Version 1.0 Dated: 6/26/25

Table of Contents

Part 1: Complete and Provide at the Project Initiation Review Stage Gate The following fields help to create the Enterprise Architecture record for the system. The creation of this record will assign a Unique ID (UUID) to the system.

Table 1. System Information System Information

Enter ID

Table 2. Roles Roles

ACF Chief Information Officer (CIO) Sign-Off for System Registration

Enter CIO Name Digital Signature – CIO

Privacy Review The following questions will be used to determine whether a SORN is believed to be required for the system or not. In addition, please indicate if a Privacy Threshold Analysis (PTA)/Privacy Impact Assessment (PIA) has been initiated. Draft System Registration document should be sent to the Privacy Team for review, OCIO.Privacy@acf.hhs.gov

1. Does the system contain records about individuals?

Select answer Supplemental Guidance:

A record, as defined by the Privacy Act, is any item, collection, or grouping of information (electronic or paper) about an individual that includes, but is not limited to, at least one of the following items:

· Name

· Identifying Number (e.g., SSN, Date of Birth [DOB])

· Any other identifying information assigned to the individual, such as a finger or voice print, or a photograph

Note that “PII” and “records about individuals” are not synonymous.

If yes, continue to question 2.

If no, please identify the types of records the system does contain:

Enter answer

2. Are records retrieved by a direct personal identifier?

Select answer Supplemental Guidance:

· A retrieval must occur for SORN to be required. Merely having the capacity to retrieve will not trigger the Privacy Act.

· A direct personal identifier may include Name, Email, SSN, or DOB.

If yes, a SORN is most likely required. Please go to question 3. Please contact ACF Privacy at OCIO.Privacy@acf.hhs.gov to confirm if a SORN is needed.

If no, please identify the ways that a record can be retrieved:

Enter answer

3. Are records about individuals in the public?

Select answer If no, a SORN is not needed. Skip question 4.

4. Does an existing SORN(s) cover the types of records maintained by this system?

Select answer Supplemental Guidance:

· All ACF and government wide SORNs can be readily located on the HHS Website.

· Please contact ACF Privacy at OCIO.Privacy@acf.hhs.gov for identifying applicable SORN.

If a SORN may already exist, please cite the name and number for review and confirmation: Direct personal identifiers include Name and Email. SORN is not needed, only PIA is needed.

Enter answer

5. Has a PTA/PIA been initiated for this system?

Select answer If no, please contact the privacy office to initiate and create a POAM.

Prior to submission to ACF SOP, send completed form to ACF Privacy to confirm the SORN Determination information is correct and if a new SORN is needed we will create a Plan of Action and Milestone (POAM) to track the SORN completion.

ACF Senior Official for Privacy (SOP) Sign-Off for SORN Determination

Enter SOP Name Digital Signature – SOP

Part 2: Complete and Provide at the Critical Design Review Stage Gate The following fields help to complete the Enterprise Architecture record for the system.

(number of users supported by the system per month; represents the average, not the peak or high-water mark)

☐ Government employees (federal staff or direct contractors of HHS, ACF, and/or other OpDivs

☐ Public Users (public citizens [i.e., grantees] with access to the system without needing to authenticate)

☐ Partner Organizations (other federal departments or entities or non-direct contractors that are provided access to the system)

Does the system require authentication to gain access?

(users of the IT system must have an account and must authenticate with the IT system prior to getting system access) Select an answer

If yes, specify: Enter answer

If yes, specify: Enter answer

Appendix A: Segments

dangers; education of the consumer and the general population; and facilitation of health promotion and disease and injury prevention.

minimize the potential for loss of life and property. This involves the development of emergency management programs and activities as well as staffing and equipping regional response centers, and mitigation focused construction and preparation.

notifications to internal or external stakeholders.

management, benefits management, employee performance management, employee relations, labor relations, separation management, and human resources development.

country. The outcome for the completion of this segment is a successful implementation of the segment target architecture that will support federal assistance efforts and increase collaboration among various federal human services programs.

and standards regarding information management.

using as few resources as needed, and effective in terms of meeting customer requirements.

dissemination of guidelines to assist in the interpretation and implementation of regulations.

tracking the spread of diseases and pests.

products under regulatory supervision proposed for introduction to the market.

services promotion, advocacy, education, awareness, research, or other services. It also involves the implementation, monitoring, evaluation, and corrective action associated with controlling programs or projects operated under the supervision of the organization.

Public Health Laboratory Science and Services All work pertaining to internal or external laboratory research/investigations, workforce development, support services, and partner laboratory support.

health programs and interventions to improve the environment, communities and the health and well-being of individuals.

research activities conducted by internal and external organizations.

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