Pt. 505, App. C
Appendix C to Part 505—Privacy Act Statement Format
(a) Authority: The specific federal statute or Executive Order that authorizes collection of the requested information.
(b) Principal Purpose(s): The principal purpose or purposes for which the information is to be used.
(c) Routine Uses(s): Disclosure of the information outside DOD.
(d) Disclosure: Whether providing the information is voluntary or mandatory and the effects on the individual if he or she chooses not to provide the requested information.
(1) Example of a Privacy Act Statement
(i) Authority: Emergency Supplement Act of 2000; Public Law 106-246; 5 U.S.C. 3013, Secretary of the Army; 10 U.S.C. 5013, Secretary of the Navy; 10 U.S.C. 8013, Secretary of the Air Force; Department of Defense Directive 8500.aa, Information Assurance (IA); and E.O. 9397 (SSN).
(ii) Principal Purpose(s): To control access to DOD information, information based systems and facilities by authenticating the identity of a person using a measurable physical characteristic(s). This computer system uses software programs to create biometrics templates and summary statistics, which are used for purposes such as assessing system performance or identifying problem areas.
(iii) Routine Use(s): None. The DoD “Blanket Routine Uses” set forth at the beginning of the Army's Compilations of System of Records Notices applies to this system.
(iv) Disclosure: Voluntary; however, failure to provide the requested information may result in denial of access to DOD information based systems and/or DOD facilities.