Att_E_Certificate of Data Destruction.pdf

Certificate of Data Return and Destruction

Upon receipt of a request from the OCC, all copies of the data and any derivative files provided to the Data Recipient by the OCC must be returned to the OCC, as specified in the request. Data must be destroyed using procedures that are compliant with the latest version of NIST SP 800-88, Guidelines for Media Sanitization. No data files, or parts of files, are to be retained when the files are returned or destroyed, unless expressly authorized in writing by the data provider.

I _____________________________________ an authorized representative of

(Company name)

(Name of the Data Custodian) hereby certify that the following data files from the OCC, in their entirety, have been submitted for destruction. In addition, all electronic files have been deleted from the Contractor’s systems: All back-up tapes will automatically rewrite in _____ (number of) days and all copies of the files will cease to exist in any production or non-production environment.

Data File Description Years between Created and

Last Modified or Accessed

(Signature of the Data Custodian) (Date)

(Project Title) (Data Custodian Name)

I certify that the data described above have been returned or deleted from

_________________________ (company name) systems in compliance with _____________.

(Signature of IT Representative) (Date)

Attachment C