S000000251 Attachment 7 Confidentiality Agreement.pdf

DFA Tax and Driver Services Motor Vehicle Agreement to Safeguard

By signing below, I acknowledge that I have completed the DFA Tax and Driver Services Motor Vehicle Security Awareness Training and Federal Tax Information (FTI) Disclosure Awareness Training, and I understand the agency’s security policy and procedures for safeguarding all Tax and Driver Services Motor Vehicle program information, Personally Identifiable Information (PII), and Federal Tax Information (FTI). I acknowledge that I have access to DFA Tax and Driver Services Motor Vehicle confidential program data maintained by the State of Arkansas or contract companies both within the AIRS intranet or externally on the internet. An example of such data is listed below and is not limited to the following:

• The Arkansas Department of Finance and Administration – which includes data from the Office of Driver Services and the Office of Motor Vehicles

I agree that I will obtain, use, or disclose such data only in connection with the performance of my official duties solely for authorized purposes.

I agree that it is my responsibility to take action to safeguard all data used in the course of my work, and it is my responsibility to report any incident that may compromise such data to my supervisor immediately.

I understand that failure to safeguard DFA Tax and Driver Services Motor Vehicle confidential program data, PII, and FTI may result in any or all of the following actions:

• A fine up to $5,000 and/or imprisonment up to five years, along with the cost of prosecution for willfully disclosing or inspecting FTI. (IRC 7213 and 7213A)

• Civil damages, brought about by the taxpayer whose information has been disclosed or inspected, of $1,000 or more for each act of unauthorized inspection or disclosure of FTI. (IRC 7431)

• A fine up to $1,000 for each act of unauthorized access to or disclosure of information in the National Directory of New Hires. (42 U.S.C. § 653(l)(2))

• Conviction of a Class B misdemeanor, which can result in a fine up to $1,000 and up to 90 days in jail. (Ark. Code Ann. § 9-14-210)

• Administrative action including immediate dismissal.

DFA Agreement to Safeguard

I agree that my obligation to safeguard the confidentiality of any data obtained during the course of my employment or role as a contractor for the DFA OIS shall survive the termination of my employment or role as a contractor with the DFA OIS, and that I may be subject to criminal and civil penalties for disclosure after my employment or role as a contractor ends.

Employee/Contractor Signature Employee/Contractor Printed Name Date

Supervisor’s Signature Supervisor’s Printed Name Date