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pdfThe Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, [email protected]
www.dhs.gov/privacy
Privacy Threshold Analysis
Version date: June 10, 2010
Page 1 of 6
PRIVACY THRESHOLD ANALYSIS (PTA)
This form is used to determine whether
a Privacy Impact Assessment is required.
Please use the attached form to determine whether a Privacy Impact Assessment (PIA) is required under
the E-Government Act of 2002 and the Homeland Security Act of 2002.
Please complete this form and send it to your component Privacy Office. If you do not have a component
Privacy Office, please send the PTA to the DHS Privacy Office:
Rebecca J. Richards
Director of Privacy Compliance
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
Tel: 703-235-0780
[email protected]
Upon receipt from the component Privacy Office, the DHS Privacy Office will review this form. If a PIA
is required, the DHS Privacy Office will send you a copy of the Official Privacy Impact Assessment Guide
and accompanying Template to complete and return.
A copy of the Guide and Template is available on the DHS Privacy Office website, www.dhs.gov/privacy,
on DHSConnect and directly from the DHS Privacy Office via email: [email protected], phone: 703-235-0780.
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, [email protected]
www.dhs.gov/privacy
Privacy Threshold Analysis
Version date: June 10, 2010
Page 2 of 6
PRIVACY THRESHOLD ANALYSIS (PTA)
SUMMARY INFORMATION
Date Submitted for Review: February 15, 2012
Name of Project: Forms G-1041 and G-1041A
System Name in TAFISMA: Not applicable
Name of Component: U.S. Citizenship and Immigration Services
Name of Project Manager: Marian Smith
Email for Project Manager: [email protected]
Phone Number for Project Manager: 202-587-9744
Type of Project:
Information Technology and/or System. ∗
A Notice of Proposed Rule Making or a Final Rule.
Form or other Information Collection.
Other:
∗
The E-Government Act of 2002 defines these terms by reference to the definition sections of Titles 40 and
44 of the United States Code. The following is a summary of those definitions:
•“Information Technology” means any equipment or interconnected system or subsystem of
equipment, used in the automatic acquisition, storage, manipulation, management, movement,
control, display, switching, interchange, transmission, or reception of data or information. See 40
U.S.C. § 11101(6).
•“Information System” means a discrete set of information resources organized for the collection,
processing, maintenance, use, sharing, dissemination, or disposition of information. See: 44. U.S.C. §
3502(8).
Note: for purposes of this form, there is no distinction made between national security systems or
technologies/systems managed by contractors. All technologies/systems should be initially reviewed for
potential privacy impact.
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, [email protected]
www.dhs.gov/privacy
Privacy Threshold Analysis
Version date: June 10, 2010
Page 3 of 6
SPECIFIC QUESTIONS
1.
Describe the project and its purpose:
The USCIS Genealogy Program provides access to historical immigration and naturalization records
of deceased immigrants to family historians and other researchers through two fee-based services:
2.
•
Index Search: Form G-1041, Genealogy Index Search Request is used to request a search of
USCIS historical databases. Request for searches of these databases are used to determine
whether any records pertaining to a subject exists, and, if such records exist, to collect record
citations (i.e., USCIS file numbers). The fee for an index search is $.20.00.
•
Record Copy Request: Form G-1041A, Genealogy Records Request is used to obtain copies of
USCIS historical records. Researchers with valid record citations, gained through the index
search (Form G-1041) or through independent research, may request microfilm and/or paperbased copies of genealogy records. The fee for a record copy request depends on the record
type but varies between $20.00 -$35.00.
Status of Project:
This is a new development effort.
This is an existing project.
Date first developed:
Date last updated: 4/30/2009
This is first submission of Forms G-1041 and G-1041A. This is a request to extend the
use of these forms under the Paperwork Reduction Act, which are set to expire on
April 30, 2012.
3.
From whom do you collect, process, or retain information on: (Please check all that apply)
DHS Employees.
Contractors working on behalf of DHS.
The Public.
The System does not contain any such information.
4.
Do you use or collect Social Security Numbers (SSNs)? (This includes truncated SSNs)
No.
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, [email protected]
www.dhs.gov/privacy
Privacy Threshold Analysis
Version date: June 10, 2010
Page 4 of 6
Yes. Why does the program collect SSNs? Provide the function of the SSN and the
legal authority to do so:
Not applicable. Forms G-1041 and G-1041A do not request SSNs for index searches and copies of
genealogy records.
5.
What information about individuals could be collected, generated or retained?
Form G-1041 requires the following information to initiate a search of USCIS historical
indices: the requester’s full name, address, and contact information; immigrant’s full name,
aliases, date of birth, country of birth, and proof of death if the immigrant is less than 100
years of age. Additional information about the deceased immigrant may be provided by the
requester to facilitate the identification of a subject from others with the same name. This
information may include the immigrant’s arrival and residence in the United States.
Form G-1041A requires the following information to process requests for copies of genealogy
records: the requester’s full name, address, and contact information; immigrant’s full name,
aliases, date of birth, and country of birth; and type of files requested and file numbers
associated with each request.
USCIS requires a filing fee to be submitted for both forms. Payment for the forms can be
accomplished electronically through pay.gov, or a cashier's check or money order. Personal
checks are not accepted and are returned to the requester. USCIS destroys the original
paper-based payment but maintains a copy of it for payment confirmation purposes.
6.
If this project is a technology/system, does it relate solely to infrastructure? [For example, is
the system a Local Area Network (LAN) or Wide Area Network (WAN)]?
No. Please continue to the next question.
Yes. Is there a log kept of communication traffic?
No. Please continue to the next question.
Yes. What type of data is recorded in the log? (Please choose all that apply.)
Header.
Payload Please describe the data that is logged.
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, [email protected]
www.dhs.gov/privacy
Privacy Threshold Analysis
Version date: June 10, 2010
Page 5 of 6
7.
Does the system connect, receive, or share Personally Identifiable Information with any other
DHS systems 1?
No.
Yes.
Please list:
8.
Is there a Certification & Accreditation record within OCIO’s FISMA tracking system?
Unknown.
No.
Yes. Please indicate the determinations for each of the following:
Confidentiality:
Low
Moderate
High
Undefined
Integrity:
Low
Moderate
High
Undefined
Availability:
Low
Moderate
High
Undefined
PRIVACY THRESHOLD REVIEW
(TO BE COMPLETED BY THE DHS PRIVACY OFFICE)
Date reviewed by the DHS Privacy Office: April 4, 2012
Name of the DHS Privacy Office Reviewer: Catherine Bauer
1
PII may be shared, received, or connected to other DHS systems directly, automatically, or by manual processes.
Often, these systems are listed as “interconnected systems” in TAFISMA.
The Privacy Office
U.S. Department of Homeland Security
Washington, DC 20528
703-235-0780, [email protected]
www.dhs.gov/privacy
Privacy Threshold Analysis
Version date: June 10, 2010
Page 6 of 6
DESIGNATION
This is NOT a Privacy Sensitive System – the system contains no Personally Identifiable
Information.
This IS a Privacy Sensitive System
Category of System
IT System.
National Security System.
Legacy System.
HR System.
Rule.
Other: Forms
Determination
PTA sufficient at this time.
Privacy compliance documentation determination in progress.
PIA is not required at this time.
PIA is required.
System covered by existing PIA: DHS/USCIS/PIA-038 FIPS
New PIA is required.
PIA update is required. DHS/USCIS/PIA-017 MiDAS PIA update
required.
SORN not required at this time.
SORN is required.
System covered by existing SORN: DHS/USCIS/ICE/CBP-001 A-File and
DHS/ALL-001 DHS FOIA/PA Record System SORNs; Also see comments.
New SORN is required.
DHS PRIVACY OFFICE COMMENTS
Update to existing SORN or new SORN determination to be made during PIA update process.
| File Type | application/pdf |
| File Title | DHS PRIVACY OFFICE |
| Author | pia |
| File Modified | 2012-04-04 |
| File Created | 2012-04-04 |