Attachment 4 - DHS- Form 11000-6 Non-Disclosure Agreement - 70Z03826QJ0000269.pdf

This document is a Department of Homeland Security (DHS) Non-Disclosure Agreement (Form 11000-6) that establishes the terms and conditions for individuals granted conditional access to sensitive government information. The agreement covers three primary categories of protected information: Protected Critical Infrastructure Information (PCII) under the Critical Infrastructure Information Act of 2002; Sensitive Security Information (SSI) governed by 49 CFR Part 1520; and Other Sensitive but Unclassified (SBU) information that could adversely affect national interests, federal programs, or individual privacy rights if disclosed. Signatories must acknowledge receipt of security indoctrination and understand procedures for determining who may access the information.

The signatory assumes responsibility for protecting information from unauthorized disclosure and agrees to specific handling requirements for each information category. Key obligations include: not disclosing information without proper authority; surrendering all materials upon engagement completion; not altering or removing markings without authorization; promptly reporting losses, thefts, or security violations; and assigning all royalties and emoluments from unauthorized disclosures to the U.S. Government. The agreement specifies that violations may result in cancellation of conditional access and potential administrative, disciplinary, civil, or criminal action. The signatory affirms understanding of dissemination restrictions, compliance with applicable laws and regulations, and that the U.S. Government may conduct inspections at any time to ensure compliance. This agreement remains binding until officially released in writing by an authorized DHS representative.