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EXAMPLE

DESCRIPTION

INTERIOR/BIA-13

System name: Indian Loan Files-Interior BIA-13

The system name should reflect the categories of individuals on whom records are maintained in the system. This is to facilitate an annual compilation by the Federal Register. The number of the system should follow the system name; i.e. Safety Management Information System BInterior, Office of the Secretary B60; (Note: If a new system, contact the Departmental Privacy Act Officer for a system number).

System Location: Division of Land Acquisition, National Park Service, U.S. Department of the Interior, Washington, D.C. 20240

Specify each address at which records are maintained in the system. For a system with many locations the notice may provide a generic description of the locations, and advise the reader where a specific listing may be obtained. If records are stored at a Federal Records Center, this fact should be stated.

Categories of individuals covered by the system: Visitors to NPS administered areas who have participated in surveys conducted during their visits to the areas or via mail or telephone as a result of their visit.

The categories of individuals on whom records are maintained in the system must be clearly stated so an individual may easily recognize whether he or she is a member of the group being described. Any change in the system which adds new categories of individuals requires publication of a revised system notice.

Categories of records in the system: Information identifying the employee such as: name, sex, birth date, color of hair, color of eyes, height, social security number, accident summary, accident reports, driver=s license number, date issued, date expires, types of vehicles operated, corrective lenses, and hearing aids.

This portion of the system notice should briefly describe, in non-technical terms, the types of information the system contains. The addition of new types of information to the system requires publication of a revised system notice.

Authority for maintenance of the system: (1) Occupational Safety and Health Act of 1970, as amended, 29 U.S.C. Sec. 668 and 5 U.S.C. Sec. 7902. (2) Executive Order 11807 (September 28, 1974). (3) Federal Employees Compensation Act, as amended, 5 U.S.C. Sec. ' 101, et. seq.

The specific statutory provisions or Executive orders which authorize the maintenance of the information must be cited. Note: a statute or Executive order must be used as authority for maintaining a system, but citations to pertinent regulatory provisions also may be included.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND THE PURPOSES OF SUCH USES: The primary uses of the records are to account for monies paid and collected by the Minerals Management Service, Financial Management Division, and for billing and follow-up. Disclosure outside the Department of the Interior may be made (1) to the U.S. Department of Justice or in a proceeding before a court or adjudicative body when (a) the United States, the Department of the Interior, a component of the Department, or when represented by the government, an employee of the Department is a party to litigation or anticipated litigation or has an interest in such litigation, and (b) the Department of the Interior determines that the disclosure is relevant or necessary to the litigation and is compatible with the purpose for which the records were compiled; (2) to disclose pertinent information to an appropriate Federal, State, local, or foreign agency responsible for investigating, prosecuting, enforcing, or implementing a statute, regulation, rule, or order, where the disclosing agency becomes aware of an indication of a violation or potential violation of civil or criminal law or regulation; (3) to a Member of Congress from the record of an individual in response to an inquiry made at the request of that individual; (4) to the Department of the Treasury to effect payment to Federal, State, and local government agencies, nongovernmental organizations, and individuals; (5) to a Federal agency for the purpose of collecting a debt owed the Federal government through administrative or salary offset; and (6) to other Federal agencies conducting computer matching programs to help eliminate fraud and abuse and to detect unauthorized overpayments made to individuals.

A Aroutine use@ is, with respect to the disclosure of a record, a use which is compatible with the purpose for which the record is maintained. Each system notice should include both present and anticipated uses, the categories of users, and the purpose for each use. Any new use or significant change in an existing use that expands the availability of information in the system will require a revised system notice. Any such change in a routine use must also be described in a Federal Register notice describing new/revised routine uses prior to implementation as required by the Act (5 U.S.C. 552a(e)(11)). See 383 DM 5.3.

Disclosure to Consumer Reporting Agencies: Disclosures pursuant to 5 U.S.C. 552 a(b)(12). Disclosure may be made from the system to consumer reporting agencies as defined in the Fair Credit Reporting Act (15 U.S.C. 168a(f) or the Federal Claims Collection Act of 1966 (31 U.S.C. 3701(a)(3)).

A separate statement as shown is used if compatible disclosures will be made from the system of records to consumer reporting agencies for debt collection purposes.

Storage: Accountable capitalized property maintained on computer with subsequent inventory listings furnished to individuals. Inventory listings and hand receipts for other property and supplies maintained manually in file folders arranged by individual names.

Retrievability: Indexed by name of individual.

Safeguards: Maintained with safeguards meeting the requirements of 43 CFR 2.51 for computerized and manual records.

Retention and disposal: Records are disposed of in accordance with items 16 through 18 and 25 through 28 of General Records Schedule 14.

This portion of the system notice should indicate the medium in which the records are maintained (storage), how the system is indexed (retrievability), what measures have been taken to prevent unauthorized disclosure of records (safeguards), and how long the records are maintained and how they are destroyed (retention and disposal). The retention and disposal statement also must identify the General Records Schedule (GRS) or bureau schedule, and item number that governs disposal of the records. If the records are not covered by a GRS or a bureau schedule approved by the Archivist of the U.S., the statement must indicate that determination of the disposition is pending approval of the Archivist.

System manager(s) and address: Chief, Division of Personnel Management and Organization, U.S. Fish and Wildlife Service, Room 3455, Main Interior Bldg. 18^th and C Streets, NW, Washington, D.C. 20240.

The title and business address of the official responsible for the system=s policies, operations, and practices must be included in the system notice.

Notification procedure: A written request addressed to the System Manager stating that the requester seeks information concerning records pertaining to him is required. See 43 CFR 2.60

The notice must include office addresses to which inquiries can be sent and at which the individuals may appear to request notification of the existence of records pertaining to themselves, and any identifying information that the individuals are required to provide. Any change in an address at which an individual must appear in person will require publication of a revised system notice; a change in an address to which an individual may mail a request for notification does not in itself require a revised notice if internal bureau procedures have been established for forwarding such mail.

Record access procedures: A request for access may be addressed to the System Manager. The request must be in writing and be signed by the requester. The request must meet the content requirements of 43 CFR 2.63.

This portion of the system notice advises individuals concerning procedures for obtaining access to their records.

Contesting Record Procedures: A petition for amendment should be addressed to the System Manager and must meet the content requirements of 43 CFR 2.71.

This portion of the system notice advises individuals concerning procedures for contesting the accuracy of their records.

Record source categories: (1) Individual employees. (2) Supervisors. (3) Cooperating individuals. (4) Participating organizations.

The system notice should list all categories of sources used in obtaining information for the system of records.

Systems exempted from certain provisions of the act: Under the specific authority provided by 5 U.S.C. 552a(k)(2), the Department of the Interior has adopted a regulation, 43 CFR 2.79(b) which exempts this system from the provisions of 5 U.S.C. 552a(c)(3), (d), (e)(1), (e)(4) (G), (H) and (I), and (f) and the portions of 43 CFR, Part 2, Subpart D which implement these provisions. The reasons for adoption of this regulation are set out at 40 FR 37217 (August 26, 1975). Under the specific authority provided by 5 U.S.C. 552a(j)(2), the Department of the Interior has adopted a regulation, 43 CFR 2.79(a) which exempts this system from all of the provisions of 5 U.S.C. 552a and Department of the Interior regulations in 43 CFR Part 2, Subpart D - Privacy Act. Except subsections (b), (c)(1) and (2), (e)(4)(A) through (F), (e)(6), (7), (9), (10), and (11) and (i) of 5 U.S.C. 552a and the portions of the regulations in Subpart D implementing these subsections.

If the system is exempted from any provisions of the Act sate the coverage of the exemption. See 383 DM 6.4.

(Note: If a system of records has been exempted from certain provisions of the Act, the applicable sections of the notice may be omitted, i.e., Notification Procedure, Record Access Procedures, Contesting Record Procedures, Record Source Categories.)