C4_FDA_Form 3398_ Non Public Agreement.pdf

This is a Commitment to Protect Non-Public Information Employee Agreement form from the Department of Health and Human Services, Food and Drug Administration (FDA).

The form requires employees with access to non-public information from FDA files to sign an agreement acknowledging their obligation not to further release, publish, or disclose such information. Signatories must certify their understanding of and compliance with 21 U.S.C. 331(j), 21 U.S.C. 360(c), and 18 U.S.C. 1905, as well as other pertinent laws and regulations governing the confidentiality of non-public information. The agreement explicitly states that signatories are subject to criminal penalties prescribed by law for any violations. The form includes blank fields for the employee's signature and printed name, date of execution, contract number, and a witness signature with date. Additionally, the form provides a section for describing the specific information being released under the agreement. This is a standard federal compliance document (Form FDA 3398) designed to ensure proper handling and protection of sensitive FDA information by employees and contractors.