Form 6045C Volunteer Confidentiality Statement

Volunteer Service Application

na_6045c_Confidentiality_Statement_Draft2022Renewal_JMedits

Volunteer Service Application

OMB: 3095-0060

Document [pdf]
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OMB CONTROL NO. 3095-0060 • EXPIRES 0X/30/20XX

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:
Freedom of Information Act 5 U.S.C. § 552 et seq.
Privacy Act 5 U.S.C. § 552a
Presidential Records Act 44 U.S.C. § 2204 et al.
	OTHER:

____________________ 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
		

___________________
Date

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION • NA FORM 6045C (10-22)

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File Typeapplication/pdf
File TitleVolunteer Confidentiality Statement, NA Form 6045c (10-22)
AuthorNARA
File Modified2022-05-11
File Created2021-10-29

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