Attachment C - DHS Form 11000-6 NDA and NDA Pre-Brief.pdf

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DEPARTMENT OF HOMELAND SECURITY

NON-DISCLOSURE AGREEMENT

Protected Critical Infrastructure Information (PCII)

DHS Form 11000-6 (08-04)

Agreement in consideration of my being granted conditional access to certain information, specified below, that is owned by, produced by, or in the possession of the United States Government.

(Signer will acknowledge the category or categories of information that he or she may have access to, and the signer's willingness to comply with the standards for protection by placing his or her initials in front of the applicable category or categories.)

Initials:

I attest that I am familiar with, and I will comply with all requirements of the PCII program set out in the Critical Infrastructure Information Act of 2002 (CII Act) (Title II, Subtitle B, of the Homeland Security Act of 2002, Public Law 107-296, 196 Stat. 2135, 6 USC 101 et seq.), as amended, the implementing regulations thereto (6 CFR Part 29), as amended, and the applicable PCII Procedures Manual, as amended, and with any such requirements that may be officially communicated to me by the PCII Program Manager or the PCII Program Manager's designee.

Sensitive Security Information (SSI)Initials:

I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of SSI information as cited in this Agreement and in accordance with 49 CFR Part 1520, "Protection of Sensitive Security Information," "Policies and Procedures for Safeguarding and Control of SSI," as amended, and any supplementary guidance issued by an authorized official of the Department of Homeland Security.

Other Sensitive but Unclassified (SBU)Initials:

As used in this Agreement, sensitive but unclassified information is an over-arching term that covers any information, not otherwise indicated above, which the loss of, misuse of, or unauthorized access to or modification of could adversely affect the national interest or the conduct of Federal programs, or the privacy to which individuals are entitled under Section 552a of Title 5, as amended, but which has not been specifically authorized under criteria established by an Executive Order or an Act of Congress to be kept secret in the interest of national defense or foreign policy. This includes information categorized by DHS or other government agencies as: For Official Use Only (FOUO); Official Use Only (OUO); Sensitive Homeland Security Information (SHSI); Limited Official Use (LOU); Law Enforcement Sensitive (LES);

Safeguarding Information (SGI); Unclassified Controlled Nuclear Information (UCNI); and any other identifier used by other government agencies to categorize information as sensitive but unclassified.

I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of the information to which I am granted access as cited in this Agreement and in accordance with the guidance provided to me relative to the specific category of information.

I understand and agree to the following terms and conditions of my access to the information indicated above:

3. I attest that I understand my responsibilities and that I am familiar with and will comply with the standards for protecting such information that I may have access to in accordance with the terms of this Agreement and the laws, regulations, and/or directives applicable to the specific categories of information to which I am granted access. I understand that the United States Government may conduct inspections, at any time or place, for the purpose of ensuring compliance with the conditions for access, dissemination, handling and safeguarding information under this Agreement.

I, , an individual official, employee, consultant, or subcontractor of or to (the Authorized Entity), intending to be legally bound, hereby consent to the terms in this

1. I hereby acknowledge that I have received a security indoctrination concerning the nature and protection of information to which I have been provided conditional access, including the procedures to be followed in ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures.

2. By being granted conditional access to the information indicated above, the United States Government has placed special confidence and trust in me and I am obligated to protect this information from unauthorized disclosure, in accordance with the terms of this Agreement and the laws, regulations, and directives applicable to the specific categories of information to which I am granted access.

8. If I violate the terms and conditions of this Agreement, such violation may result in the cancellation of my conditional access to the information covered by this Agreement. This may serve as a basis for denying me conditional access to other types of information, to include classified national security information.

4. I will not disclose or release any information provided to me pursuant to this Agreement without proper authority or authorization. Should situations arise that warrant the disclosure or release of such information I will do so only under approved circumstances and in accordance with the laws, regulations, or directives applicable to the specific categories of information. I will honor and comply with any and all dissemination restrictions cited or verbally relayed to me by the proper authority.

5. (a) For PCII - (1) Upon the completion of my engagement as an employee, consultant, or subcontractor under the contract, or the completion of my work on the PCII Program, whichever occurs first, I will surrender promptly to the PCII Program Manager or his designee, or to the appropriate PCII officer, PCII of any type whatsoever that is in my possession.

(2) If the Authorized Entity is a United States Government contractor performing services in support of the PCII Program, I will not request, obtain, maintain, or use PCII unless the PCII Program Manager or Program Manager's designee has first made in writing, with respect to the contractor, the certification as provided for in Section 29.8(c) of the implementing regulations to the CII Act, as amended.

(b) For SSI and SBU - I hereby agree that material which I have in my possession and containing information covered by this Agreement, will be handled and safeguarded in a manner that affords sufficient protection to prevent the unauthorized disclosure of or inadvertent access to such information, consistent with the laws, regulations, or directives applicable to the specific categories of information. I agree that I shall return all information to which I have had access or which is in my possession 1) upon demand by an authorized individual; and/or 2) upon the conclusion of my duties, association, or support to DHS; and/or 3) upon the determination that my official duties do not require further access to such information.

6. I hereby agree that I will not alter or remove markings, which indicate a category of information or require specific handling instructions, from any material I may come in contact with, in the case of SSI or SBU, unless such alteration or removal is consistent with the requirements set forth in the laws, regulations, or directives applicable to the specific category of information or, in the case of PCII, unless such alteration or removal is authorized by the PCII Program Manager or the PCII Program Manager's designee. I agree that if I use information from a sensitive document or other medium, I will carry forward any markings or other required restrictions to derivative products, and will protect them in the same matter as the original.

7. I hereby agree that I shall promptly report to the appropriate official, in accordance with the guidance issued for the applicable category of information, any loss, theft, misuse, misplacement, unauthorized disclosure, or other security violation, I have knowledge of and whether or not I am personally involved. I also understand that my anonymity will be kept to the extent possible when reporting security violations.

9. (a) With respect to SSI and SBU, I hereby assign to the United States Government all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of the information not consistent with the terms of this Agreement.

(b) With respect to PCII I hereby assign to the entity owning the PCII and the United States Government, all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of PCII not consistent with the terms of this Agreement.

10. This Agreement is made and intended for the benefit of the United States Government and may be enforced by the United States Government or the Authorized Entity. By granting me conditional access to information in this context, the United States Government and, with respect to PCII, the Authorized Entity, may seek any remedy available to it to enforce this Agreement including, but not limited to, application for a court order prohibiting disclosure of information in breach of this Agreement. I understand that if I violate the terms and conditions of this Agreement, I could be subjected to administrative, disciplinary, civil, or criminal action, as appropriate, under the laws, regulations, or directives applicable to the category of information involved and neither the United States Government nor the Authorized Entity have waived any statutory or common law evidentiary privileges or protections that they may assert in any administrative or court proceeding to protect any sensitive information to which I have been given conditional access under the terms of this Agreement.

DHS Form 11000-6 (08-04) Page 2

11. Unless and until I am released in writing by an authorized representative of the Department of Homeland Security (if permissible for the particular category of information), I understand that all conditions and obligations imposed upon me by this Agreement apply during the time that I am granted conditional access, and at all times thereafter.

12. Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions shall remain in full force and effect.

13. My execution of this Agreement shall not nullify or affect in any manner any other secrecy or non-disclosure Agreement which I have executed or may execute with the United States Government or any of its departments or agencies.

14. These restrictions are consistent with and do not supersede, conflict with, or otherwise alter the employee obligations, rights, or liabilities created by Executive Order No. 12958, as amended; Section 7211 of Title 5, United States Code (governing disclosures to Congress); Section 1034 of Title 10, United States Code, as amended by the Military Whistleblower Protection Act (governing disclosure to Congress by members of the military); Section 2302(b)(8) of Title 5, United States Code, as amended by the Whistleblower Protection Act (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities Protection Act of 1982 (50 USC 421 et seq.) (governing disclosures that could expose confidential Government agents); and the statutes which protect against disclosure that may compromise the national security, including Sections 641, 793, 794, 798, and 952 of Title 18, United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 USC 783(b)). The definitions, requirements, obligations, rights, sanctions, and liabilities created by said Executive Order and listed statutes are incorporated into this agreement and are controlling.

15. Signing this Agreement does not bar disclosures to Congress or to an authorized official of an executive agency or the Department of Justice that are essential to reporting a substantial violation of law.

16. I represent and warrant that I have the authority to enter into this Agreement.

17. I have read this Agreement carefully and my questions, if any, have been answered. I acknowledge that the briefing officer has made available to me any laws, regulations, or directives referenced in this document so that I may read them at this time, if I so choose.

DHS Form 11000-6 (08-04)

DEPARTMENT OF HOMELAND SECURITY

NON-DISCLOSURE AGREEMENT

Acknowledgement Typed/Printed Name: Government/Department/Agency/Business Address Telephone Number:

I make this Agreement in good faith, without mental reservation or purpose of evasion.

Signature:

Typed/Printed Name: Government/Department/Agency/Business Address Telephone Number:

Signature:

WITNESS:

This form is not subject to the requirements of P.L. 104-13, "Paperwork Reduction Act of 1995" 44 USC, Chapter 35.

Date:

Date:

DHS- 11000- 14

PAM WASHINGTON

IDENTIFICATION ACCESS CONTROL CARD REQUEST DOCUMENT

D:20050825155718- 04'00'

D:20050825155718- 04'00'

DEPARTMENT OF HOMELAND SECURITY

NON-DISCLOSURE AGREEMENT

NON DISCLOSURE AGREEMENT

Protected Critical Infrastructure Information (PCII)

Protected Critical Infrastructure Information (PCI I)

DHS Form 11000-6 (08-04)

D H S Form 1 1 0 0 0-6 (08-04)

Agreement in consideration of my being granted conditional access to certain information, specified below, that is owned by, produced by, or in the possession of the United States Government.

(Signer will acknowledge the category or categories of information that he or she may have access to, and the signer's willingness to comply with the standards for protection by placing his or her initials in front of the applicable category or categories.)

Initials:

I attest that I am familiar with, and I will comply with all requirements of the PCII program set out in the Critical Infrastructure Information Act of 2002 (CII Act) (Title II, Subtitle B, of the Homeland Security Act of 2002, Public Law 107-296, 196 Stat. 2135, 6 USC 101 et seq.), as amended, the implementing regulations thereto (6 CFR Part 29), as amended, and the applicable PCII Procedures Manual, as amended, and with any such requirements that may be officially communicated to me by the PCII Program Manager or the PCII Program Manager's designee.

I attest that I am familiar with, and I will comply with all requirements of the P C I I program set out in the Critical Infrastructure Information Act of 2002 (C I I Act) (Title 2, Subtitle B, of the Homeland Security Act of 2002, Public Law 1 0 7-2 9 6, 1 9 6 Statute 2 1 3 5, 6 U S C 1 0 1 et sequens.), as amended, the implementing regulations thereto (6 CFR Part 29), as amended, and the applicable PCI I Procedures Manual, as amended, and with any such requirements that may be officially communicated to me by the PCI I Program Manager or the PCI I Program Manager's designee.

Sensitive Security Information (SSI)

Sensitive Security Information (SS I)

Initials:

I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of SSI information as cited in this Agreement and in accordance with 49 CFR Part 1520, "Protection of Sensitive Security Information," "Policies and Procedures for Safeguarding and Control of SSI," as amended, and any supplementary guidance issued by an authorized official of the Department of Homeland Security.

I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of SS I information as cited in this Agreement and in accordance with 49 C F R Part 1 5 2 0, "Protection of Sensitive Security Information," "Policies and Procedures for Safeguarding and Control of SS I," as amended, and any supplementary guidance issued by an authorized official of the Department of Homeland Security.

Other Sensitive but Unclassified (SBU)

Other Sensitive but Unclassified (SB U)

Initials:

As used in this Agreement, sensitive but unclassified information is an over-arching term that covers any information, not otherwise indicated above, which the loss of, misuse of, or unauthorized access to or modification of could adversely affect the national interest or the conduct of Federal programs, or the privacy to which individuals are entitled under Section 552a of Title 5, as amended, but which has not been specifically authorized under criteria established by an Executive Order or an Act of Congress to be kept secret in the interest of national defense or foreign policy. This includes information categorized by DHS or other government agencies as: For Official Use Only (FOUO); Official Use Only (OUO); Sensitive Homeland Security Information (SHSI); Limited Official Use (LOU); Law Enforcement Sensitive (LES); Safeguarding Information (SGI); Unclassified Controlled Nuclear Information (UCNI); and any other identifier used by other government agencies to categorize information as sensitive but unclassified.

As used in this Agreement, sensitive but unclassified information is an over arching term that covers any information, not otherwise indicated above, which the loss of, misuse of, or unauthorized access to or modification of could adversely affect the national interest or the conduct of Federal programs, or the privacy to which individuals are entitled under Section 5 5 2. A. of Title 5, as amended, but which has not been specifically authorized under criteria established by an Executive Order or an Act of Congress to be kept secret in the interest of national defense or foreign policy. This includes information categorized by DHS or other government agencies as: For Official Use Only (F O U O); Official Use Only (O U O); Sensitive Homeland Security Information (SHS I); Limited Official Use (L O U); Law Enforcement Sensitive (L E S); Safeguarding Information (SG I); Unclassified Controlled Nuclear Information (UCN I); and any other identifier used by other government agencies to categorize information as sensitive but unclassified.

I attest that I am familiar with, and I will comply with the standards for access, dissemination, handling, and safeguarding of the information to which I am granted access as cited in this Agreement and in accordance with the guidance provided to me relative to the specific category of information.

I understand and agree to the following terms and conditions of my access to the information indicated above:

3. I attest that I understand my responsibilities and that I am familiar with and will comply with the standards for protecting such information that I may have access to in accordance with the terms of this Agreement and the laws, regulations, and/or directives applicable to the specific categories of information to which I am granted access. I understand that the United States Government may conduct inspections, at any time or place, for the purpose of ensuring compliance with the conditions for access, dissemination, handling and safeguarding information under this Agreement.

I, , an individual official, employee, consultant, or subcontractor of or to

(the Authorized Entity), intending to be legally bound, hereby consent to the terms in this

1. I hereby acknowledge that I have received a security indoctrination concerning the nature and protection of information to which I have been provided conditional access, including the procedures to be followed in ascertaining whether other persons to whom I contemplate disclosing this information have been approved for access to it, and that I understand these procedures.

2. By being granted conditional access to the information indicated above, the United States Government has placed special confidence and trust in me and I am obligated to protect this information from unauthorized disclosure, in accordance with the terms of this Agreement and the laws, regulations, and directives applicable to the specific categories of information to which I am granted access.

8. If I violate the terms and conditions of this Agreement, such violation may result in the cancellation of my conditional access to the information covered by this Agreement. This may serve as a basis for denying me conditional access to other types of information, to include classified national security information.

4. I will not disclose or release any information provided to me pursuant to this Agreement without proper authority or authorization. Should situations arise that warrant the disclosure or release of such information I will do so only under approved circumstances and in accordance with the laws, regulations, or directives applicable to the specific categories of information. I will honor and comply with any and all dissemination restrictions cited or verbally relayed to me by the proper authority.

5. (a) For PCII - (1) Upon the completion of my engagement as an employee, consultant, or subcontractor under the contract, or the completion of my work on the PCII Program, whichever occurs first, I will surrender promptly to the PCII Program Manager or his designee, or to the appropriate PCII officer, PCII of any type whatsoever that is in my possession.

5. (A. ) For PC I I - (1) Upon the completion of my engagement as an employee, consultant, or subcontractor under the contract, or the completion of my work on the PC I I Program, whichever occurs first, I will surrender promptly to the PCI I Program Manager or his designee, or to the appropriate PCI I officer, PCI I of any type whatsoever that is in my possession.

(2) If the Authorized Entity is a United States Government contractor performing services in support of the PCII Program, I will not request, obtain, maintain, or use PCII unless the PCII Program Manager or Program Manager's designee has first made in writing, with respect to the contractor, the certification as provided for in Section 29.8(c) of the implementing regulations to the CII Act, as amended.

(2) If the Authorized Entity is a United States Government contractor performing services in support of the PCI I Program, I will not request, obtain, maintain, or use PCI I unless the PCI I Program Manager or Program Manager's designee has first made in writing, with respect to the contractor, the certification as provided for in Section 29.8(c) of the implementing regulations to the CI I Act, as amended.

(b) For SSI and SBU - I hereby agree that material which I have in my possession and containing information covered by this Agreement, will be handled and safeguarded in a manner that affords sufficient protection to prevent the unauthorized disclosure of or inadvertent access to such information, consistent with the laws, regulations, or directives applicable to the specific categories of information. I agree that I shall return all information to which I have had access or which is in my possession 1) upon demand by an authorized individual; and/or 2) upon the conclusion of my duties, association, or support to DHS; and/or 3) upon the determination that my official duties do not require further access to such information.

(b) For SS I and SB U - I hereby agree that material which I have in my possession and containing information covered by this Agreement, will be handled and safeguarded in a manner that affords sufficient protection to prevent the unauthorized disclosure of or inadvertent access to such information, consistent with the laws, regulations, or directives applicable to the specific categories of information. I agree that I shall return all information to which I have had access or which is in my possession 1) upon demand by an authorized individual; and/or 2) upon the conclusion of my duties, association, or support to DHS; and/or 3) upon the determination that my official duties do not require further access to such information.

6. I hereby agree that I will not alter or remove markings, which indicate a category of information or require specific handling instructions, from any material I may come in contact with, in the case of SSI or SBU, unless such alteration or removal is consistent with the requirements set forth in the laws, regulations, or directives applicable to the specific category of information or, in the case of PCII, unless such alteration or removal is authorized by the PCII Program Manager or the PCII Program Manager's designee. I agree that if I use information from a sensitive document or other medium, I will carry forward any markings or other required restrictions to derivative products, and will protect them in the same matter as the original.

6. I hereby agree that I will not alter or remove markings, which indicate a category of information or require specific handling instructions, from any material I may come in contact with, in the case of SS I or SB U, unless such alteration or removal is consistent with the requirements set forth in the laws, regulations, or directives applicable to the specific category of information or, in the case of PCI I, unless such alteration or removal is authorized by the PCI I Program Manager or the PCI I Program Manager's designee. I agree that if I use information from a sensitive document or other medium, I will carry forward any markings or other required restrictions to derivative products, and will protect them in the same matter as the original.

7. I hereby agree that I shall promptly report to the appropriate official, in accordance with the guidance issued for the applicable category of information, any loss, theft, misuse, misplacement, unauthorized disclosure, or other security violation, I have knowledge of and whether or not I am personally involved. I also understand that my anonymity will be kept to the extent possible when reporting security violations.

9. (a) With respect to SSI and SBU, I hereby assign to the United States Government all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of the information not consistent with the terms of this Agreement.

9. (A. ) With respect to SS I and SB U, I hereby assign to the United States Government all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of the information not consistent with the terms of this Agreement.

(b) With respect to PCII I hereby assign to the entity owning the PCII and the United States Government, all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of PCII not consistent with the terms of this Agreement.

(b) With respect to PCI I I hereby assign to the entity owning the PCI I and the United States Government, all royalties, remunerations, and emoluments that have resulted, will result, or may result from any disclosure, publication, or revelation of PCI I not consistent with the terms of this Agreement.

10. This Agreement is made and intended for the benefit of the United States Government and may be enforced by the United States Government or the Authorized Entity. By granting me conditional access to information in this context, the United States Government and, with respect to PCII, the Authorized Entity, may seek any remedy available to it to enforce this Agreement including, but not limited to, application for a court order prohibiting disclosure of information in breach of this Agreement. I understand that if I violate the terms and conditions of this Agreement, I could be subjected to administrative, disciplinary, civil, or criminal action, as appropriate, under the laws, regulations, or directives applicable to the category of information involved and neither the United States Government nor the Authorized Entity have waived any statutory or common law evidentiary privileges or protections that they may assert in any administrative or court proceeding to protect any sensitive information to which I have been given conditional access under the terms of this Agreement.

10. This Agreement is made and intended for the benefit of the United States Government and may be enforced by the United States Government or the Authorized Entity. By granting me conditional access to information in this context, the United States Government and, with respect to PCI I, the Authorized Entity, may seek any remedy available to it to enforce this Agreement including, but not limited to, application for a court order prohibiting disclosure of information in breach of this Agreement. I understand that if I violate the terms and conditions of this Agreement, I could be subjected to administrative, disciplinary, civil, or criminal action, as appropriate, under the laws, regulations, or directives applicable to the category of information involved and neither the United States Government nor the Authorized Entity have waived any statutory or common law evidentiary privileges or protections that they may assert in any administrative or court proceeding to protect any sensitive information to which I have been given conditional access under the terms of this Agreement.

DHS Form 11000-6 (08-04)

DHS Form 1 1 0 0 0-6 (08-04)

11. Unless and until I am released in writing by an authorized representative of the Department of Homeland Security (if permissible for the particular category of information), I understand that all conditions and obligations imposed upon me by this Agreement apply during the time that I am granted conditional access, and at all times thereafter.

12. Each provision of this Agreement is severable. If a court should find any provision of this Agreement to be unenforceable, all other provisions shall remain in full force and effect.

13. My execution of this Agreement shall not nullify or affect in any manner any other secrecy or non-disclosure Agreement which I have executed or may execute with the United States Government or any of its departments or agencies.

14. These restrictions are consistent with and do not supersede, conflict with, or otherwise alter the employee obligations, rights, or liabilities created by Executive Order No. 12958, as amended; Section 7211 of Title 5, United States Code (governing disclosures to Congress); Section 1034 of Title 10, United States Code, as amended by the Military Whistleblower Protection Act (governing disclosure to Congress by members of the military); Section 2302(b)(8) of Title 5, United States Code, as amended by the Whistleblower Protection Act (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities Protection Act of 1982 (50 USC 421 et seq.) (governing disclosures that could expose confidential Government agents); and the statutes which protect against disclosure that may compromise the national security, including Sections 641, 793, 794, 798, and 952 of Title 18, United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 USC 783(b)). The definitions, requirements, obligations, rights, sanctions, and liabilities created by said Executive Order and listed statutes are incorporated into this agreement and are controlling.

14. These restrictions are consistent with and do not supersede, conflict with, or otherwise alter the employee obligations, rights, or liabilities created by Executive Order Number 1 2 9 5 8, as amended; Section 7 2 1 1 of Title 5, United States Code (governing disclosures to Congress); Section 1 0 3 4 of Title 10, United States Code, as amended by the Military Whistleblower Protection Act (governing disclosure to Congress by members of the military); Section 2 3 0 2(b)(8) of Title 5, United States Code, as amended by the Whistleblower Protection Act (governing disclosures of illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities Protection Act of 1982 (50 U S C 421 et sequens) (governing disclosures that could expose confidential Government agents); and the statutes which protect against disclosure that may compromise the national security, including Sections 6 4 1, 7 9 3, 7 9 4, 7 9 8, and 9 5 2 of Title 18, United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 U S C 7 8 3(b)). The definitions, requirements, obligations, rights, sanctions, and liabilities created by said Executive Order and listed statutes are incorporated into this agreement and are controlling.

15. Signing this Agreement does not bar disclosures to Congress or to an authorized official of an executive agency or the Department of Justice that are essential to reporting a substantial violation of law.

16. I represent and warrant that I have the authority to enter into this Agreement.

17. I have read this Agreement carefully and my questions, if any, have been answered. I acknowledge that the briefing officer has made available to me any laws, regulations, or directives referenced in this document so that I may read them at this time, if I so choose.

DHS Form 11000-6 (08-04)

DHS Form 1 1 0 0 0-6 (08-04)

DEPARTMENT OF HOMELAND SECURITY

NON-DISCLOSURE AGREEMENT

NON DISCLOSURE AGREEMENT

Acknowledgement

Typed/Printed Name:

Government/Department/Agency/Business Address

Telephone Number:

I make this Agreement in good faith, without mental reservation or purpose of evasion.

Signature:

Typed/Printed Name:

Government/Department/Agency/Business Address

Telephone Number:

Signature:

WITNESS:

This form is not subject to the requirements of P.L. 104-13, "Paperwork Reduction Act of 1995" 44 USC, Chapter 35.

This form is not subject to the requirements of P L 1 0 4-13, "Paperwork Reduction Act of 1995" 44 U S C, Chapter 35.

Date:

Date:

Name1:

AuthorizedEntity:

Initials1:

Initials2:

Initials3:

Name2:

Address:

Signature:

WitnessName:

WitnessAddress:

WitnessSignature:

WitnessPhone:

Telephone:

Signature Date. Enter 2 digit month, 2 digit day and 4 digit year.:

Signature Date. Enter 2 digit month, 2 digit day and 4 digit year.:

Department of Homeland Security (DHS) Non-Disclosure Agreement (NDA) Pre-Briefing Sensitive But Unclassified Information (SBU)

Instructions

The Department of Homeland Security (DHS) Non-Disclosure Agreement (NDA) Pre- Briefing Materials for Sensitive But Unclassified Information (SBU) outlines the basic security procedures for handling Other Sensitive But Unclassified Information.

DHS Contractor Employees are encouraged to read the enclosed pre-briefing materials before initialing the Other Sensitive but Unclassified (SBU) section and signing DHS Form 11000.6, DHS Non-Disclosure Agreement. Initials are not required for the Protected Critical Infrastructure Information (PCII) or the Sensitive Security Information (SSI) section of the NDA. These sections will be addressed at a later date if required.

Contractor employees may not commence work on a DHS contract until the DHS Office of Security has received a signed NDA. Once work begins on the contract, contractor employees will have up to 30 days to attend DHS “Security Tuesday” where an in depth briefing on the rules and responsibilities for handling and protecting SBU is provided.

Reference

(1) DHS MD 11042.1, Safeguarding Sensitive But Unclassified (For Official Use Only) Information.

(2) DHS MD 11053, Security Education, Training, and Awareness Program Directive.

(3) Department of Homeland Security, “Safeguarding Classified & Sensitive Unclassified Information, Reference Pamphlet,” updated March 2007

(4) DHS Form 11000.6, DHS Non-Disclosure Agreement (NDA).

NDA Pre-Brief Source

The DHS Non-Disclosure Agreement pre-briefing contents are excerpted from:

Reference #3, “DHS Safeguarding Classified & Sensitive Unclassified Information, Reference Pamphlet, updated, March 2007”.

SENSITIVE BUT UNCLASSIFIED INFORMATION

For Official Use Only (FOUO)

FOUO is the designator used within DHS to identify Sensitive but Unclassified information within the DHS community that is not otherwise specifically described and governed by statute or regulation and the unauthorized disclosure of which could adversely impact a person’s privacy or welfare, the conduct of Federal programs, or other programs or operations essential to the national interest. For example, information designated as Protected Critical Infrastructure Information (PCII) and Sensitive Security Information (SSI) is governed by separate guidance issued by the responsible program office.

For additional guidance on FOUO refer to DHS Management Directive (MD) 11042.1, “Sensitive but Unclassified (For Official Use Only) Information.” For guidance on SSI refer to DHS MD 11056, “Sensitive Security Information,” or, 49 CFR Part 1520. For guidance on PCII refer to 6 CFR Part 29.

Other government agencies and international organizations may use different terminology to identify sensitive information such as “Limited Official User (LOU), “Official Use Only (OUO)” and “Law Enforcement Sensitive (LES).” In most instances the safeguarding requirements for these types of information are equivalent to FOUO.

However, these other agencies may have additional requirements concerning safeguarding of sensitive information. When available, follow the safeguarding guidance provided by the other agency or organization. Should there be no such guidance, the information will be safeguarded in accordance with the requirements for FOUO as provided in DHS MD 11042.1.

Any DHS Employee, Detailee, or Contractor can designate information as FOUO provided it meets the sensitivity threshold represented by the FOUO definition cited above and it falls within one of the categories of information listed in MD 11042.1 as FOUO. Officials occupying supervisory or managerial positions are authorized to designate other information not listed in the MD and originating under their jurisdiction, as FOUO.

The FOUO designation shall NOT be applied to any information in order to conceal government negligence, ineptitude, or other disreputable circumstances embarrassing to the government agency.

Marking

Information designated as FOUO will be sufficiently marked so that persons having access to it are aware of its sensitivity and protection requirements. At a minimum, prominently mark on the bottom of each page “FOR OFFICIAL USE ONLY.” Materials containing specific types of FOUO information may be further marked with an applicable caveat, e.g., “LAW ENFORCEMENT SENSITIVE,” in order to alert the reader of the type of information conveyed. Additional access and dissemination restrictions may also be cited as the situation warrants.

Access and Dissemination

A security clearance is not required for access to FOUO information.

Access to FOUO information is based on “need-to-know” as determined by the holder of the information. Where there is uncertainty as to a person’s need-to-know, the holder of the information will request dissemination instructions from their next-level supervisor or the information’s originator.

FOUO information may be shared with other agencies, Federal, state, tribal, or local government and law enforcement officials, provided a need-to-know has been established and the information is shared in the furtherance of a coordinated and official government activity, to include homeland defense.

When discussing FOUO information over a telephone, the Security Telephone Unit (STU-III) or Secure Telephone Equipment (STE) is encouraged, but not required.

FOUO information may be transmitted via non-secure fax machine, although the use of a secure fax is encouraged. Where a non-secure fax machine is used ensure that the materials faxed will not be left unattended or subject to unauthorized disclosure on the receiving end.

FOUO information may be transmitted over regular email channels. However, it shall not be sent to personal email accounts. For added security when transmitting FOUO information by email, password protected attachments may be used with the password transmitted or otherwise communicated separately.

FOUO information shall not be entered or posted on any public website.

FOUO information may be mailed by regular US Postal Service first class mail or any commercial mailing service.

Storage

When unattended, FOUO information will be stored in a locked filing cabinet, locked desk drawer, a locked overhead storage compartment such as systems furniture credenza, or a similar locked compartment. Information can also be stored in a room or area that has sufficient physical access control measures to afford adequate protection and prevent unauthorized access by members of the public, visitors, or other persons without the need-to-know, such as a locked room or an area where access is controlled by a guard, cipher lock, or card reader.

Destruction

• Hard copy FOUO materials will be destroyed by shredding, burning, pulping, or pulverizing, sufficient to assure destruction beyond recognition and reconstruction.

• After destruction, materials may be disposed of with normal waste.

• Electronic storage media shall be sanitized appropriately by overwriting or degaussing.

• Paper products or electronic media containing FOUO information will not be disposed of in regular trash or recycling receptacles unless the materials have been destroyed as specified above.

Incident Reporting

• Incidents involving FOUO material on DHS information systems will be reported to the organizational element’s computer security incident response center

(CSIRC).

• Suspicious or inappropriate requests for information shall be immediately reported to the DHS Office of Security.

• At the request of the originator, an inquiry will be conducted by the local Security Official or other designee to determine the cause and effect of the incident, and the appropriateness of administrative and disciplinary action against the offender.

Questions or concerns relative to any security issue may be addressed to the DHS Office of Security, Customer Service Center:

(202) 447-5010