Required Protected Critical Infrastructure Information (PCII) Regulation Statements

This page provides information for required statements that must be included with all Protected Critical Infrastructure Information (PCII) protection requests. All information submitted for PCII protection must include:

• An Express Statement requesting the protection offered by the CII Act;
• A Certification Statement including the submitter’s contact information and certifying that the information is not customarily in the public domain;
• A Protection Statement provided by the PCII Program Office or the PCII Program Manager Designee.

Express Statement

The Express Statement must be included with all information submitted for PCII protection.

Please copy and paste the following information for your Express Statement:

This information is voluntarily submitted to the federal government in expectation of protection from disclosure as provided by the provisions of the Critical Infrastructure Information Act of 2002.

Certification Statement

The Certification Statement must be included with all information submitted for PCII protection.

Please copy and paste the following information for your Certification Statement. This must be completed, signed and dated:

To the best of my knowledge, information, and belief, the information being submitted is not customarily in the public domain. 

I attest that I am not submitting this information in lieu of complying with a regulatory requirement. 

I am authorized to submit this information to be considered for protection under the Critical Infrastructure Information Act of 2002.

Affix your signature and date signed.

Submitter Name:
Submitter Title:
Organization or Company Name (if applicable):
Mailing Address:
City:
Office Telephone:
Alternate Telephone:
E-mail Address:

Alternate Contact Name:
Alternate Contact Title:
Organization or Company Name (if different from submitter):
Mailing Address:
City:
State:
Office Telephone:
Alternate Telephone:
E-mail Address:

Please be aware that any knowing or willful false representations provided in this submission may constitute a violation of 18 U.S.C. 1001 and are punishable by fine and imprisonment.

Protection Statement

All PCII is labeled with the Protection Statement by the PCII Program Office or the PCII Program Manager Designee to help ensure the material is safeguarded and protected as PCII. If PCII does not have the Protection Statement, please notify the PCII Program Office at pcii-info@dhs.gov or 202-360-3023.

All PCII materials, or the cases or containers in which they are stored, must be labeled with the following statement:

This document contains Protected Critical Infrastructure Information.  In accordance with the provisions of the Critical Infrastructure Information Act, 6 U.S.C. §§ 131 et seq., it is exempt from release under the Freedom of Information Act (5 U.S.C. § 552) and similar State and local disclosure laws.  Unauthorized release may result in criminal and administrative penalties. It is to be safeguarded and disseminated in accordance with the Critical Infrastructure Information Act, 6 U.S.C. §§ 131 et seq., the implementing Regulation, 6 C.F.R. Part 29 and PCII Program requirements.

More Information

Learn How PCII is Protected. For more details about the submission process see How to Submit Critical Infrastructure Information (CII) For PCII Protection.