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| I. |
INFORMATION
SUBJECT TO THIS UNDERSTANDING |
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A. |
All data containing individually
identifiable information collected by or on the behalf of IES under
section 183 of the Education Sciences Reform Act of 2002 (PL 107-279);Title
V, subtitle A of the E-Government Act of 2002 (PL 107-347) that are
provided to the ________________________________________ and all information
derived from those data, and all data resulting from merges, matches,
or other uses of the data provided by IES with other data are subject
to this agreement and are referred to in this Memorandum of Understanding
as "subject data." |
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B. |
Subject data under this
Memorandum of Understanding may be in the form of computer tapes,
diskettes, CD-ROMs, hard copy, etc., the ______________________________
__________ may only use the subject data in a manner and to a purpose
consistent with:
the statistical purpose for which the data were supplied,
______________________________________________________ description
of the planned research and analysis as described
is attached and made a part of this Memorandum of Understanding
(Attachment No. 1),
the limitations imposed under the provisions of this Memorandum
of Understanding, and
Section 183 of the Education Sciences Reform Act of 2002 (P.L. 107-279); Title
V, subtitle A of the E-Government Act of 2002 (P.L. 107-347); and the Privacy Act of 1974 (5 U.S.C. 552a),
which are attached to and made a part of this Memorandum of Understanding
(Attachment No. 2.)
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| II. |
INDIVIDUALS
WHO MAY HAVE ACCESS TO SUBJECT DATA |
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A. |
There are three categories
of individuals that the ____________________________________________
may authorize to have access to subject data. The three categories
of individuals are as follows:
The Principal Project Officer (PPO) is the most senior statistical
officer in charge of the day-to-day operations involving the use
of subject data and is responsible for liaison with IES.
Professional/Technical Staff (P/TS) who conduct the research
for which this Memorandum of Understanding is issued.
Support staff which includes secretaries, typists, computer
technicians, messengers, etc. The ________________________________________
may disclose subject data to support staff who come in contact
with the subject data in the course of their duties only to the
extent necessary to support the research under this Memorandum
of Understanding.
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B. |
The ________________________________________
may disclose subject data to only seven (7) P/TS unless IES provides
written authorization for a larger number of P/TS.
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| III. |
LIMITATIONS
ON DISCLOSURE |
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A. |
The ________________________________________
shall not use or disclose subject data for any administrative purposes
nor may they be applied in any manner to change the status, condition,
or public perception of any individual regarding whom subject data
is maintained. |
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B. |
The _______________________________________
shall not disclose subject data or other information containing, or
derived from, subject data at fine levels of geography, such as school
district, institution, or school, to anyone other than IES employees
working in the course of their employment or individuals for whom
access is authorized under this Memorandum of Understanding. The _______________________________
_________ may make disclosures of subject data to individuals other
than those specified in this paragraph only if those individuals have
executed an Affidavit of Nondisclosure and the ________________________________________,
has obtained advance written approval from IES. |
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C. |
The ________________________________________
shall not make any publication or other release of subject data listing
information regarding individuals even if the individual identifiers
have been removed. |
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D. |
The ________________________________________
may publish the results, analysis, or other information developed
as a result of any research based on subject data made available under
this Memorandum of Understanding only in summary or statistical form
so that the identity of individuals contained in the subject data
is not revealed.
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| IV. |
ADMINISTRATIVE
REQUIREMENTS |
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A. |
The research conducted
under this Memorandum of Understanding and the disclosure of subject
data needed for that research must be consistent with the statistical
purpose for which the data were supplied. |
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B. |
Execution of Affidavits
of Nondisclosure.
The _______________________________________ shall provide
a copy of this Memorandum of Understanding to each employee
of the _______________________________________ who will have
access to subject data and shall require each of those employees
to execute an Affidavit of Nondisclosure.
The _______________________________________ must ensure
that each individual who executes an Affidavit of Nondisclosure
reads and understands the materials provided to her or him before
executing the Affidavit.
The _______________________________________ shall ensure
that each Affidavit of Nondisclosure is notarized upon execution.
The _______________________________________ may not permit
any individual specified in paragraph II.A. to have access to
subject data until the procedures in paragraphs IV.B.1. through
3. of this Memorandum of Understanding are fulfilled for that
individual.
The _______________________________________ shall promptly,
after the execution of each affidavit, send the original affidavit
to IES for inclusion in the System of Records as published in
the Federal Register.
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C. |
Notification regarding
authorized individuals to IES.
The _______________________________________ shall promptly
notify IES when an employee who has been authorized to have access
to subject data is no longer authorized access to those data.
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D. |
Publications made available
to IES.
The _______________________________________ shall provide
IES a copy of each publication containing information based on
subject data or other data product based on subject data made
available to individuals who have not executed an Affidavit of
Nondisclosure.
When publication or other release of research results could
raise reasonable questions regarding disclosure of individually
identifiable information contained in subject data, copies of
the proposed publication or release must be provided to IES before
that disclosure is made so that IES may advise whether the disclosure
is authorized under this Memorandum of Understanding and the provisions
of section 183 of the Education Sciences Reform Act of 2002 (P.L. 107-279); Title
V, subtitle A of the E-Government Act of 2002 (P.L. 107-347); and the Privacy
Act of 1974, (5 U.S.C. 552a). The ________________________________________
agrees not to publish or otherwise release research results provided
to IES if IES advises that such disclosure is not authorized.
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E. |
The ________________________________________
shall notify IES immediately upon receipt of any legal, investigatory,
or other demand for disclosure of subject data. |
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F. |
The ________________________________________
shall notify IES immediately upon discovering any breach or suspected
breach of security or any disclosure of subject data to unauthorized
parties or agencies. |
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G. |
The ________________________________________
agrees that representatives of IES have the right to make unannounced
and unscheduled inspections of the facilities of the ________________________________________
including any associated computer center, to evaluate compliance with
the terms of this Memorandum of Understanding and the requirements
of section 183 of the Education Sciences Reform Act of 2002 (P.L. 107-279); Title
V, subtitle A of the E-Government Act of 2002 (P.L. 107-347); and the Privacy
Act of 1974, (5 U.S.C. 552a)..
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| V. |
SECURITY
REQUIREMENTS |
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A. |
Maintenance of, and access
to, subject data.
The ________________________________________ shall retain
the original version of the subject data at a single location
and may make no copy or extract of the subject data available
to anyone except a P/TS as necessary for the purpose of the statistical
research for which the subject data were made available to the
________________________________________.
The _______________________________________ shall keep
subject data (whether maintained on a personal computer or on printed or other material)
in a space where access is limited to only authorized personnel.
The ________________________________________ shall ensure
that access to subject data maintained in computer memory is controlled
by password protection. The
________________________________________ shall maintain all printouts,
diskettes, personal computers with subject data on hard disks,
or other physical products containing individually identifiable
information derived from subject data in locked cabinets, file
drawers, or other secure locations when not in use.
The ________________________________________ shall ensure
that all printouts, tabulations, and reports are edited for any
possible disclosures of subject data.
The ________________________________________ shall establish security
procedures to ensure that subject data cannot be used or taken by unauthorized
individuals.
The ________________________________________ shall not permit
removal of any subject data from the limited access space protected
under the provisions of this Memorandum of Understanding without first notifying
and obtaining written approval from IES.
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B. |
Retention of subject data.
The ________________________________________ shall return to the IES data security office all
subject data, or destroy those data under IES supervision or by approved
IES procedures, when the statistical research that is the subject
of this Memorandum of Understanding has been completed or this Memorandum
of Understanding terminates, whichever occurs first. |
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C. |
Compliance with established
security procedures.
The ________________________________________ shall comply with the
SECURITY PROCEDURES attached to this Memorandum of Understanding.
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| VI. |
PENALTIES |
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A. |
Any violation of the terms
and conditions of this Memorandum of Understanding may subject the
________________________________________ to immediate abrogation by
IES, and the return of all subject data materials.
The IES official responsible for liaison with the ________________________________________
shall initiate abrogation of this Memorandum
of Understanding by written notice to the ________________________________________
indicating the factual basis and grounds for abrogation.
Upon receipt of the notice specified in paragraph VI.A.1.
of this Memorandum of Understanding, the ________________________________________
has thirty (30) days to submit written argument and evidence to
the Director of IES indicating why the Memorandum of Understanding
should not be abrogated.
The Director shall decide whether to abrogate the Memorandum
of Understanding based solely on the information contained in
the notice to the ________________________________________ and
the rebuttal provided by the ________________________________________.
The Director shall provide written notice of the decision to the
________________________________________ within forty-five (45)
days after receipt of the response of the _______________________________________.
The Director may extend this time period for good cause.
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B. |
Any violation of this
Memorandum of Understanding may also be a violation of Federal criminal
law under the Privacy Act of 1974, (5 U.S.C. 552a); Title V, subtitle A of the E-Government Act of 2002 (P.L. 107-347); and/or
section 183 of the Education Sciences Reform Act of 2002 (P.L 107-279). Alleged violations under the 183 of the
Education Sciences Reform Act of 2002, Title V, subtitle A of the
E-Government Act of 2002 are subject to prosecution by the United
States Attorney. The penalty for violation of section 183 of the Education
Sciences Reform Act of 2002 and Title V, subtitle A of the E-Government
Act of 2002, is a fine of not more than $250,000 and imprisonment
for a period of not more than five (5) years.
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| VII. |
PROCESSING
OF THIS MEMORANDUM OF UNDERSTANDING |
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A. |
This Memorandum of Understanding
shall be for a period of five (5) years. If before the expiration
of this MOU, the Director establishes regulatory standards for the
issuance and content of Memorandum of Understanding, the recipient
agrees to comply with the regulatory standards. |
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B. |
This Memorandum of Understanding
may be amended, extended or terminated by mutual written agreement
between the ________________________________________ and the Director,
IES. Any amendment must be signed by the ________________________________________
and by the Director and is effective on the date that all required
parties have signed the Memorandum of Understanding. |
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C. |
The ____________________,
________________________________________ shall sign this Memorandum
of Understanding. The ___________________, ________________________________________
certifies, by his/her signature, that:
- The organization has
the authority to undertake the commitments in this Memorandum
of Understanding;
- The ____________________,
________________________________________, has the authority to
bind the organization to the provisions of this Memorandum of
Understanding; and
- The Principal Project
Officer (PPO) designated by the ________________, ________________________________________,
is a senior statistical officer for the ________________________________________,
who has the authority to manage the day-to-day statistical operations
of the reasearch, P/TS, and support staff.
________________________________________
Signature of the ____________________,
__________________________________
Date _______________ Telephone: (____)__________
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D. |
The individual described
in paragraph II.A1., and VII.C.3, as the PPO shall sign below.
__________________________________________________
Signature of the Principal Project Officer Date
Title: __________________________ Telephone: (____)__________ |
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E. |
The Director of the
Institute for Education Sciences concurs in this Memorandum of Understanding
and authorizes the access of the _________________________________________________________
to the subject data. This is effective as of the date of the Director's
signature below.
_________________________________________________________
Director, Institute for Education Sciences
Date____________________
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