Pt. 310, App. F
Appendix F to Part 310
—Format for New or Altered System Report
(See paragraph (c) of § 310.33
The report on a new or altered system shall consist of a transmittal letter, a narrative statement, and include supporting documentation.
A. Transmittal Letter
The transmittal letter shall be prepared by the Defense Privacy Office and shall contain assurances that the new or altered system does not duplicate any existing Component systems, DoD-wide systems or government-wide systems. The narrative statement, and the system notice, shall be attached thereto.
B. Narrative Statement
The statement shall include information on the following:
1. System Identifier and name;
2. Responsible official;
3. Purpose of establishing the system [for a new system only] or Nature of the changes proposed for the system [for altered system only];
4. Authority for maintenance of the System;
5. Probable or potential effects on the privacy of individuals;
6. Is the system, in whole or part, being maintained by a contractor;
7. Steps taken to minimize risk of unauthorized access;
8. Routine use compatibility;
9. OMB information collection requirements; and
10. Supporting documentation.
Attachment 1—Sample Format for Narrative Statement
DEPARTMENT OF DEFENSE
Narrative Statement on a [New/Altered] System of Records
Under the Privacy Act of 1974
1. System Identifier and Name.
This caption sets forth the identification and name of the system (see subparagraphs (b)(c) of § 310.32
2. Responsible Official. The name, title, address, and telephone number of the official responsible for the report and to whom inquiries and comments about the report may be directed by Congress, the Office of Management and Budget, or the Defense Privacy Office.
3. Purpose of establishing the system or nature of the changes proposed for the system: Describe the purpose of the new system or how an existing system is being changed.
4. Authority for maintenance of the system.
See paragraph (g) of § 310.32
5. Probable or potential effects on the privacy of individuals. What effect, if any, will the new or altered system impact the personal privacy of the affected individuals.
6. Is the system, in whole or in part, being maintained by a contractor.
If yes, Components shall ensure that the contract has incorporated the Federal Acquisition privacy clause (see paragraph (a)(1) of § 310.12
7. Steps taken to minimize risk of unauthorized access. Describe actions taken to reduce the vulnerability of the system to potential threats. See Appendix A to this part.
8. Routine use compatibility. Provide assurances that any records contained in the system that are disclosed outside the DoD shall be for a use that is compatible with the purpose for which the record was collected. Advise whether or not the blanket routine uses apply to this system.
9. OMB collection requirements. If information is to be collected from members of the public, the requirements of reference ( ) apply and OMB must be advised.
10. Supporting documentation. The following are typical enclosures that may be required:
a. An advance copy of the system notice for a new or altered system that is proposed for publication.
b. An advance copy of a proposed exemption rule if the new or altered system is to be exempted in accordance with subpart F.
c. Any other supporting documentation that may be pertinent or helpful in understanding the need for the system or clarifying its intended use.
Attachment 2—SAMPLE NARRATIVE STATEMENT
DEPARTMENT OF DEFENSE
Office of the Secretary
Narrative Statement on a New System of Records
Under the Privacy Act of 1974
1. System identifier and name: NSLRB 01, entitled “The National Security Labor Relations Board (NSLRB).”
2. Responsible official: Mr. John Miller, National Security Labor Relations Board (NSLRB), 0000 Smith Boulevard, Arlington, VA 22209, Telephone (703) 000-0000.
3. Purpose of establishing the system: The Office of the Secretary of Defense is proposing to establish a system of records that will document adjudication of unfair labor practice charges, negotiability disputes, exceptions to arbitration awards, and impasses filed with the National Security Labor Relations Board.
4. Authority for the maintenance of the system:
The National Defense Authorization Act for FY 2004, Pub Law 108-136, Section 1101; 5 U.S.C. 9902(m)
, Labor Management Relations in the Department of Defense; and 5 CFR 9901.907
, National Security Labor Relations Board.
5. Probable or potential effects on the privacy of individuals: None
6. Is the system, in whole or in part, being maintained by a contractor? No
7. Steps taken to minimize risk of unauthorized access: Records are maintained in a controlled facility. Physical entry is restricted by the use of locks, guards, and is accessible only to authorized personnel. Access to records is limited to person(s) responsible for servicing the record in performance of their official duties and who are properly screened and cleared for need-to-know. Access to computerized data is restricted by passwords, which are changed periodically.
8. Routine use compatibility: Any release of information contained in this system of records outside of the DoD will be compatible with purposes for which the information is collected and maintained. The DoD “Blanket Routine Uses” apply to this system of records.
9. OMB information collection requirements: None.
10. Supporting documentation: None.