Form 6045C Volunteer Confidentiality Statement

OMB CONTROL NO. 3095-0060 • EXPIRES 02/29/2016

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 hard-copy 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.

________________________________________

________________

Volunteer Signature Date
________________________________________
Printed Name

email

reset

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION • NA FORM 6045C (10-15)