Non Disclosure Agreement

Attachment 7_Non Disclosure Agreement.pdf

Evaluation of the Food and Drug Administration's 'Fresh Empire' Multicultural Youth Tobacco Prevention Campaign.

Non Disclosure Agreement

OMB: 0910-0788

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DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION

COMMITMENT TO PROTECT NON-PUBLIC INFORMATION
EMPLOYEE AGREEMENT
Whereas access to non-public information from the files of the Food and Drug Administration (FDA) is required
in the performance of my official duties, under Contract Number
between FDA and my
employer
I, on this
day of
, 20
hereby agree that I shall not further release,
publish or disclose such information and that I shall protect such information in accordance with the provisions
of 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905 and other pertinent laws and regulations governing the
confidentiality of non-public information.
I understand the provisions of 21 U.S.C. 331(j), 21 U.S.C. 360j(c), 18 U.S.C. 1905 and that I am subject to
criminal penalties prescribed by law for any violation(s) thereof.

Signature:

Date:

Type or Print Name:
Witnessed by:

Date:

Type or Print Name:

DESCRIPTION OF INFORMATION RELEASED:

FORM FDA 3398 (10/10)

PSC Graphics (301) 443-1090

EF


File Typeapplication/pdf
File TitleFDA-3398
SubjectDepartment of Health and Human Services ..Food and Drug Administration..Commitment to Protect Non-Public Information Employee Ag
File Modified2010-11-18
File Created2003-10-20

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