ContractorsEmployeeComplianceAgreement.pdf

Contractor’s Employee Compliance Agreement

Rev. 3/11

Massachusetts

Department of

Revenue

A. Confidentiality Policy I, ________________________________________, a full or part-time employee, volunteer, trainee, intern, member, director, officer, prin-cipal, partner or agent (“Employee”) of ________________________________________ (the “Contractor”), hereby acknowledge that, in connection with my performance of services for the Contractor under a contract or agreement (the “Contract”) with the Massachusetts De-partment of Revenue (“DOR”), I may acquire or have access to confidential information from DOR. This information includes, but is not lim-ited to, state and federal tax information, health insurance coverage information, wage reporting information, financial institution match information, 14-day new hire information and child support information, as well as “personal data” as defined in G.L. c. 66A and “personal information” as defined in G.L. c. 93H (collectively, the “DOR Information”).

I will at all times maintain the confidentiality of the DOR Information. I will not “browse” (defined as an unauthorized willful inspection) the DOR Information for any purpose not outlined in the Contract. I will not access, or attempt to access, request, use, or modify my own DOR Information for any purpose. I will not access, or attempt to access, request, use, or modify any DOR Information relating to any individual or entity with whom I have a personal or financial relationship, for any reason. This includes, without limitation, family members, neighbors, relatives, friends, ex-spouses, acquaintances, and their employers. I will not, either directly or indirectly, disclose or otherwise make the DOR Information available to any unauthorized person (defined as a person who does not have a legitimate business reason to view, access or use the DOR Information) at any time, either during or after my employment with the Contractor.

I understand that, pursuant to G.L. c. 93H, DOR must provide notification to the Attorney General, the Director of Consumer Affairs and Busi-ness Regulation, the Information Technology Division, the Public Records Division and the affected individual when an Employee engages in any unauthorized access or use of an individual’s personal information.

I also understand that failure to comply with the confidentiality statutes summarized below may be grounds for prohibiting me from working on the Contract, as well as cause for terminating the Contract and for prohibiting the Contractor from entering into a future contract with the Commonwealth.

B. State and Federal Statutes Relating to Confidentiality of DOR Information I agree to comply with all laws relating to confidentiality of the DOR Information, including but not limited to, the following:

1. Fair Information Practices Act (“FIPA”), G.L. c. 66A: Prohibits the unauthorized disclosure of “personal data,” as defined in G.L. c. 66A.

General Laws chapter 214, section 3B provides for injunctive and other nonmonetary relief for a violation of the statute.

2. G.L. c. 62C, § 21: Prohibits unauthorized disclosure of tax information or returns as defined in 830 CMR 62C.21.1. The word “return” is defined very broadly in 830 CMR 62C.21.1 and includes information developed by DOR. A violation of this statute is punishable by a fine of not more than $1,000 and/or by imprisonment for not more than six months, and by disqualification from holding office in the Commonwealth for a period not exceeding three years.

3. G.L. c. 62C, § 21B: Prohibits unauthorized willful inspection of tax information or returns as defined in 830 CMR 62C.21.1. The word “return” is defined very broadly in 830 CMR 62C.21.1 and includes information developed by DOR. A violation of this statute is punishable by a fine of not more than $1,000 per return, document or taxpayer and/or by imprisonment for not more than one year, and by disqualification from holding office in the Commonwealth for a period not exceeding three years. This section also provides that browsing by an Employee is grounds for prohibiting the Employee from working on the Contract, as well as cause for terminating the Contract and for prohibiting the Contractor from entering into a future contract with the Commonwealth.

4. G.L. c. 62E, § 8: Prohibits unauthorized disclosure of information obtained from the wage reporting and financial institution match system.

A violation of this statute is punishable by a fine of $100 per offense.

5. G.L. c. 119A, § 5A: Prohibits unauthorized willful inspection or unauthorized disclosure of child support personal data, including data stored in a computer system or computer files. Any such inspection or disclosure is punishable by a fine of not more than $1,000 with re-spect to each person concerning whom information has been disclosed or inspected and/or by imprisonment for not more than one year, and by disqualification from holding office in the Commonwealth for a period not exceeding three years. This section provides that unautho-rized disclosure or browsing of child support data by an Employee is grounds for prohibiting the Employee from working on the Contract, as well as cause for terminating the Contract and for prohibiting the Contractor from entering into a future contract with the Commonwealth.

This law also places additional restrictions on the disclosure of location information about a parent or child when the agency is provided with reasonable evidence of a risk of harm.

6. 18 U.S.C. § 2721 et seq.: The Federal Driver Privacy Protection Act (“DPPA”), prohibits the disclosure of “personal information,” in any form, obtained from a record of the Registry of Motor Vehicles, unless otherwise exempted by law. It is unlawful for any person knowingly to obtain or disclose, or use personal information from a motor vehicle record for any purpose not permitted under section 2721(b) of that title.

A person who violates this statute shall be liable to the individual to whom the information pertains for a minimum of $2,500 and may also be subject to criminal prosecution.

7. I.R.C. § 6103: Prohibits unauthorized disclosure of federal tax returns or return information by Employees and former Employees of con-tractors of state tax and child support agencies. Additionally, I.R.C. § 7213 makes any unauthorized disclosure of federal tax returns or return information a felony punishable by a fine of up to $5,000 and/or imprisonment for not more than five years, together with the costs of prosecu-tion. I.R.C. § 7431 also permits a taxpayer to bring a civil action for damages in a federal district court against a person who violated § 6103.

8. I.R.C. § 7213A: Prohibits the unauthorized willful inspection of federal tax returns or return information and makes such inspection pun-ishable by a fine of up to $1,000 and/or imprisonment for not more than one year, together with the costs of prosecution. I.R.C. § 7431 also permits a taxpayer to bring a civil action for damages in a federal district court against a person who violated § 6103.

9. Privacy Act of 1974, 5 U.S.C. § 552a: Provides that a person who has access to records that contain individually identifiable information, the disclosure of which is prohibited by the Privacy Act, and who willfully discloses the material to anyone not entitled to receive it, is guilty of a misdemeanor and may be fined not more than $5,000.

C. Child Support Self-Identification If I have access to child support information in the connection with my performance of services for DOR, I agree to self-identify to DOR’s Problem Resolutions Office (617-626-4190) if I am, or any member of my immediate family is, a participant in a child support case. I also acknowledge that I will be restricted from access to my or my immediate family’s child support case for any purpose.

D. Non-Disclosure Agreement — Security Information Under the Contract, I may also be receiving or accessing information or data from DOR that is confidential, proprietary or sensitive, includ-ing, but not limited to, information relating to software, processes, data files, computer programs and materials, source code and object code, regardless of the medium, and information contained therein (hereinafter, collectively, “Security Information”). This Security Information is being provided to me solely in connection with my work under the Contract and I will use this Security Information only in connection with the performance of such work.

If I receive or have access to the Security Information, I will physically safeguard such information at all times. I understand that if I improp-erly disseminate the Security Information for purposes other than in connection with the performance of my work under the Contract, I may be subject to sanctions.

E. Reporting of Disclosure Related Issues I will immediately notify DOR’s Inspectional Services Division (“ISD”) at 617-626-2130 if any DOR or Security Information in my possession is improperly used or accessed, or if I discover any possible disclosure, unauthorized access, inspection or browsing of the DOR or Security Information, or unauthorized use of the DOR or Security Information. In addition to notifying ISD, I will also notify my immediate supervisor and/or manager.

In addition to contacting ISD, I understand that if I discover any incident involving the possible improper browsing or disclosure of federal tax information, I must immediately call the Special Agent-in-Charge, Treasury Inspector General for Tax Administration at 917-408-5641 or 800-366-4484.

F. Questions If I have any questions regarding any of the above, I will contact my immediate supervisor, manager and/or DOR’s Office of Internal Affairs at 617-626-2130.

Signature of contractor’s employee Date

/ASCII85EncodePages false /AllowTransparency false /AutoPositionEPSFiles true /AutoRotatePages /All /Binding /Left /CalGrayProfile (Dot Gain 20%) /CalRGBProfile (sRGB IEC61966-2.1) /CalCMYKProfile (U.S. Web Coated \050SWOP\051 v2) /sRGBProfile (sRGB IEC61966-2.1) /CannotEmbedFontPolicy /Error /CompatibilityLevel 1.4 /CompressObjects /Tags /CompressPages true /ConvertImagesToIndexed true /PassThroughJPEGImages true /CreateJDFFile false /CreateJobTicket false /DefaultRenderingIntent /Default /DetectBlends true /DetectCurves 0.0000 /ColorConversionStrategy /LeaveColorUnchanged /DoThumbnails false /EmbedAllFonts true /EmbedOpenType false /ParseICCProfilesInComments true /EmbedJobOptions true /DSCReportingLevel 0 /EmitDSCWarnings false /EndPage -1 /ImageMemory 1048576 /LockDistillerParams false /MaxSubsetPct 100 /Optimize true

/OPM 1

/ParseDSCComments true /ParseDSCCommentsForDocInfo true /PreserveCopyPage true /PreserveDICMYKValues true /PreserveEPSInfo true /PreserveFlatness true /PreserveHalftoneInfo false /PreserveOPIComments true /PreserveOverprintSettings true /StartPage 1 /SubsetFonts true /TransferFunctionInfo /Apply /UCRandBGInfo /Preserve /UsePrologue false /ColorSettingsFile (None) /AlwaysEmbed [ true /GillSans-Italic /Helvetica-Condensed /Helvetica-Condensed-Black /Helvetica-Condensed-BlackObl /Helvetica-Condensed-Bold /Helvetica-Condensed-BoldObl /Helvetica-Condensed-Light /Helvetica-Condensed-LightObl /Helvetica-Condensed-Oblique /ZapfDingbats /Zeal /NeverEmbed [ true /AntiAliasColorImages false /CropColorImages true /ColorImageMinResolution 300 /ColorImageMinResolutionPolicy /OK /DownsampleColorImages false /ColorImageDownsampleType /Average /ColorImageResolution 300 /ColorImageDepth -1 /ColorImageMinDownsampleDepth 1 /ColorImageDownsampleThreshold 1.50000 /EncodeColorImages true /ColorImageFilter /DCTEncode /AutoFilterColorImages true /ColorImageAutoFilterStrategy /JPEG /ColorACSImageDict << /QFactor 0.15 /HSamples [1 1 1 1] /VSamples [1 1 1 1] /ColorImageDict << /QFactor 0.15 /HSamples [1 1 1 1] /VSamples [1 1 1 1] /JPEG2000ColorACSImageDict << /TileWidth 256 /TileHeight 256 /Quality 30 /JPEG2000ColorImageDict << /TileWidth 256 /TileHeight 256 /Quality 30 /AntiAliasGrayImages false /CropGrayImages true /GrayImageMinResolution 300 /GrayImageMinResolutionPolicy /OK /DownsampleGrayImages false /GrayImageDownsampleType /Average /GrayImageResolution 300 /GrayImageDepth -1 /GrayImageMinDownsampleDepth 2 /GrayImageDownsampleThreshold 1.50000 /EncodeGrayImages true /GrayImageFilter /DCTEncode /AutoFilterGrayImages true /GrayImageAutoFilterStrategy /JPEG /GrayACSImageDict << /QFactor 0.15 /HSamples [1 1 1 1] /VSamples [1 1 1 1] /GrayImageDict << /QFactor 0.15 /HSamples [1 1 1 1] /VSamples [1 1 1 1] /JPEG2000GrayACSImageDict << /TileWidth 256 /TileHeight 256 /Quality 30 /JPEG2000GrayImageDict << /TileWidth 256 /TileHeight 256 /Quality 30 /AntiAliasMonoImages false /CropMonoImages true /MonoImageMinResolution 1200 /MonoImageMinResolutionPolicy /OK /DownsampleMonoImages false /MonoImageDownsampleType /Average /MonoImageResolution 1200 /MonoImageDepth -1 /MonoImageDownsampleThreshold 1.50000 /EncodeMonoImages true /MonoImageFilter /CCITTFaxEncode /MonoImageDict << /K -1 /AllowPSXObjects false /CheckCompliance [ /None /PDFX1aCheck false /PDFX3Check false /PDFXCompliantPDFOnly false /PDFXNoTrimBoxError true /PDFXTrimBoxToMediaBoxOffset [ 0.00000 0.00000 0.00000 0.00000 /PDFXSetBleedBoxToMediaBox true /PDFXBleedBoxToTrimBoxOffset [ 0.00000 0.00000 0.00000 0.00000 /PDFXOutputIntentProfile (None) /PDFXOutputConditionIdentifier () /PDFXOutputCondition () /PDFXRegistryName () /PDFXTrapped /False

/Description << /CHS <FEFF4f7f75288fd94e9b8bbe5b9a521b5efa7684002000500044004600206587686353ef901a8fc7684c976262535370673a548c002000700072006f006f00660065007200208fdb884c9ad88d2891cf62535370300260a853ef4ee54f7f75280020004100630072006f0062006100740020548c002000410064006f00620065002000520065006100640065007200200035002e003000204ee553ca66f49ad87248672c676562535f00521b5efa768400200050004400460020658768633002> /CHT <FEFF4f7f752890194e9b8a2d7f6e5efa7acb7684002000410064006f006200650020005000440046002065874ef653ef5728684c9762537088686a5f548c002000700072006f006f00660065007200204e0a73725f979ad854c18cea7684521753706548679c300260a853ef4ee54f7f75280020004100630072006f0062006100740020548c002000410064006f00620065002000520065006100640065007200200035002e003000204ee553ca66f49ad87248672c4f86958b555f5df25efa7acb76840020005000440046002065874ef63002> /DAN <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> /DEU <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> /ESP <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> /FRA <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> /ITA <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> /JPN <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> /KOR <FEFFc7740020c124c815c7440020c0acc6a9d558c5ec0020b370c2a4d06cd0d10020d504b9b0d1300020bc0f0020ad50c815ae30c5d0c11c0020ace0d488c9c8b85c0020c778c1c4d560002000410064006f0062006500200050004400460020bb38c11cb97c0020c791c131d569b2c8b2e4002e0020c774b807ac8c0020c791c131b41c00200050004400460020bb38c11cb2940020004100630072006f0062006100740020bc0f002000410064006f00620065002000520065006100640065007200200035002e00300020c774c0c1c5d0c11c0020c5f40020c2180020c788c2b5b2c8b2e4002e> /NLD (Gebruik deze instellingen om Adobe PDF-documenten te maken voor kwaliteitsafdrukken op desktopprinters en proofers. De gemaakte PDF-documenten kunnen worden geopend met Acrobat en Adobe Reader 5.0 en hoger.)

/NOR <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> /PTB <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> /SUO <FEFF004b00e40079007400e40020006e00e40069007400e4002000610073006500740075006b007300690061002c0020006b0075006e0020006c0075006f0074002000410064006f0062006500200050004400460020002d0064006f006b0075006d0065006e007400740065006a00610020006c0061006100640075006b006100730074006100200074007900f6007000f60079007400e400740075006c006f0073007400750073007400610020006a00610020007600650064006f007300740075007300740061002000760061007200740065006e002e00200020004c0075006f0064007500740020005000440046002d0064006f006b0075006d0065006e00740069007400200076006f0069006400610061006e0020006100760061007400610020004100630072006f0062006100740069006c006c00610020006a0061002000410064006f00620065002000520065006100640065007200200035002e0030003a006c006c00610020006a006100200075007500640065006d006d0069006c006c0061002e> /SVE <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> /ENU (Use these settings to create Adobe PDF documents for quality printing on desktop printers and proofers. Created PDF documents can be opened with Acrobat and Adobe Reader 5.0 and later.)

/Namespace [ (Adobe) (Common) (1.0) /OtherNamespaces [ /AsReaderSpreads false /CropImagesToFrames true /ErrorControl /WarnAndContinue /FlattenerIgnoreSpreadOverrides false /IncludeGuidesGrids false /IncludeNonPrinting false /IncludeSlug false /Namespace [ (Adobe) (InDesign) (4.0) /OmitPlacedBitmaps false /OmitPlacedEPS false /OmitPlacedPDF false /SimulateOverprint /Legacy /AddBleedMarks false /AddColorBars false /AddCropMarks false /AddPageInfo false /AddRegMarks false /ConvertColors /NoConversion /DestinationProfileName () /DestinationProfileSelector /NA /Downsample16BitImages true /FlattenerPreset << /PresetSelector /MediumResolution /FormElements false /GenerateStructure true /IncludeBookmarks false /IncludeHyperlinks false /IncludeInteractive false /IncludeLayers false /IncludeProfiles true /MultimediaHandling /UseObjectSettings /Namespace [ (Adobe) (CreativeSuite) (2.0) /PDFXOutputIntentProfileSelector /NA /PreserveEditing true /UntaggedCMYKHandling /LeaveUntagged /UntaggedRGBHandling /LeaveUntagged /UseDocumentBleed false >> setdistillerparams /HWResolution [1200 1200] /PageSize [612.000 792.000] >> setpagedevice