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Privacy Act Statement


Federal agencies are required to provide what is commonly referred to as a “Privacy Act Statement” to all persons asked to provide personal information about themselves, which will go into a system of records (i.e., the information will be stored and retrieved using the individual’s name or other personal identifier such as a Social Security number).

The Privacy Act of 1974, 5 U.S.C. 552a, provides protection to individuals by ensuring that personal information collected by federal agencies is limited to that which is legally authorized and necessary, and is maintained in a manner which precludes unwarranted intrusions upon individual privacy.

Posted here is a sample Privacy Act Statement template you may use for reference.

October 2020

Attachment Ext. Size Date
Privacy Act Statement Template PDF 312.31 KB 10/02/2020
Last Updated: 07/08/2022
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