U.S. Department of Labor, Civil Rights Center
NOTICE ABOUT INVESTIGATORY USES OF PERSONAL
INFORMATION
Two Federal laws govern personal information to Federal agencies,
including the Civil Rights Center (CRC), the Privacy Act of 1974, (5 U.S.C.
552) and the Freedom of Information Act (5 U.S.C. 552) or FOIA.
Please read the description of how these laws apply to information connected
with your complaint. After reading this notice, please sign and return the
consent agreement printed on the back of this notice, along with your complaint
form.
The PRIVACY ACT protects individuals from misuse of personal information
held by the Federal Government. The law applies to records that are kept and
can be located by the individuals name, social security number, or other
personal identification system. Anyone who submits information to CRC in
connection with a discrimination complaint should know the following:
- CRC has been authorized to investigate complaints of discrimination
on the basis of race, color, national origin, age, and handicap and in some
programs on the basis of sex, religion, citizenship, and political affiliation
or belief, in programs that receive Federal funds through the Department of
Labor, CRC is also authorized to conduct reviews of federal funded program to
assess their compliance with civil rights laws.
- Information that CRC collects is analyzed by authorized personnel
with CRC. This information may include personnel or program participant
records, and other personal information. CRC staff may want to reveal some of
the personal information to individuals outside the office in order to verify
facts related to the complaint, or to discover new facts which will help CRC
determine whether the law has been violated. Such information could include,
for example, the physical condition or age of a complainant. CRC may also have
to reveal personal information to a person who submits a request for disclosure
authorized by the Freedom of Information Act.
- Information submitted to CRC may also be revealed to persons
outside of CRC because it is necessary in order to complete enforcement
proceedings against a program that CRC finds to have violated the law or
regulations. Such information could include, for example, the name, income,
age, marital status or physical condition of the complainant.
- Any personal information you provide may be used only for the
specific purpose for which it was requested. CRC requests personal information
only for the purpose of carrying out authorized activities to enforce, and
determine compliance with, civil rights laws and regulations. CRC will not
release personal information to any person or organization unless the person
who submitted the information gives written consent, or unless release is
required by the Freedom of Information Act.
- No law requires that a complainant reveal personal information CRC,
and no action will be taken against a person who denies CRCs request for
personal information. However, if CRC cannot obtain the information needed to
fully investigate the allegations in the complaint, CRC may close the case.
- Any person may ask for, and receive, copies of all personal
materials CRC keeps in his or her file for investigatory use.
AS A POLICY, CRC DOES NOT REVEAL NAMES AND OTHER IDENTIFYING INFORMATION
ABOUT INDIVIDUALS UNLESS IT IS NECESSARY TO COMPLETE INVESTIGATION OR
ENFORCEMENT ACTIVITIES AGAINST A PROGRAM WHICH HAS VIOLATED THE LAW. CRC never
reveals to the program under investigation the identity of the person who filed
the complaint, unless the complainant first gave CRC written permission to do
so.
The FREEDOM OF INFORMATION ACT (FOIA) gives the public maximum access to
Federal government files and records. Persons can request and receive
information from many types of records kept by the Federal government-not just
materials that apply to them personally. The Civil Rights Center must honor
most requests for information submitted under FOIA, but there are exceptions.
- CRC is usually not required to release information during an
investigation or an enforcement proceeding if that release would limit
CRCs ability to do its job effectively; and
- CRC can refuse to disclose information if release would result in a
clearly unwarranted invasion of a persons privacy.
PLEASE READ AND SIGN SECTION A OR SECTION B OF THE CONSENT FORM PRINTED
ON THE BACK OF THIS NOTICE, AND RETURN IT TO THE CIVIL RIGHTS CENTER WITH YOUR
SIGNED COMPLETED COMPLAINT INFORMATION FORM.
CONSENT FORM
I have read the Notice about Investigatory Uses of Personal Information,
printed on the front of this form. I understand the following provisions of the
Privacy Act and Freedom of Information Act, which apply to personal information
I reveal to the Civil Rights Center in connection with my complaint:
In the course of investigating my complaint, CRC may have to reveal my
identity to staff of the program named in my complaint in order to obtain facts
and evidence regarding my complaint;
I do not have to reveal any personal information to CRC, but CRC may
close my complaint if I refuse to reveal information needed to fully
investigate my complaint;
I may request and receive a copy of any personal information CRC keeps
in my complaint file for investigatory uses; and
Under certain conditions, CRC may be required by the Freedom of
Information Act to reveal to others personal information I have provided in
connection with my complaint.
SECTION A
[ ] YES, CRC MAY DISCLOSE MY IDENTITY IF NECESSARY TO INVESTIGATE MY
COMPLAINT. I have read and understand the notice, and I consent for CRC to
disclose my identity during investigation of my complaint.
(Signature)________________________________ (Date)_______________
SECTION B
[ ] NO, CRC MAY NOT DISCLOSE MY IDENTITY, EVEN IF NECESSARY TO PROCESS
MY COMPLAINT. I have read and understand the notice, and I do not consent for
CRC to disclose my identity during investigation on of my complaint. I request
that CRC process my complaint, however, I understand that CRC may cancel my
complaint if it cannot fully investigate without disclosing my identity. I also
understand CRC may close my complaint if it cannot begin an investigation
because I have not consented for CRC to reveal my identity.
(Signature)________________________________ (Date)_______________
Persons are not required to respond to a collection of information
unless it displays a currently valid OMB control number. Completing this form
is voluntary; however, the requested information must be provided in order to
file a complaint of discrimination. The Department of Labor's Civil Rights
Center will use the information to investigate your complaint of
discrimination. The estimated average response time to complete this form is 15
minutes per response. Send comments regarding this estimate or any other
aspects of this collection of information to the U.S. Department of Labor,
Office of the Assistant Secretary for Administration and Management, Civil
Rights Center, Room N-4123, Washington, D.C. 20210. Please reference OMB
control number 1225-0077.
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