Form 6045C Volunteer Confidentiality Statement

OMB control no. 3095-0060 • expires 01/31/2013

Volunteer Confidentiality Statement
The undersigned, _______________________, is working as a volunteer for the
National Archives and Records Administration. [Describe what the volunteer will be
doing and what records will be involved.]
This project will require the undersigned to view records that are currently restricted
from public access. By law, Federal records may be disclosed only in accordance with
the [insert appropriate law: e.g. Freedom of Information Act 5 U.S.C. § 552 et seq. and
the Privacy Act 5 U.S.C. § 552a or the Presidential Records Act 44 U.S.C. § 2204 et al.]
_________________agrees to maintain the confidentiality of any of the information to
which s/he may have access during the course of his/her work,whether in electronic or hardcopy format, and to take all reasonable precautions to prevent unauthorized disclosures
of these records. _____________________ understands that if s/he fails to uphold this
confidentiality agreement s/he may be terminated and/or subject to further legal action.

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Volunteer Signature Date
________________________________________
Printed Name

National archives and records administration • na form 6045C (11-12)

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