Draft PIA

PRIVACY IMPACT ASSESSMENT (PIA)
PRESCRIBING AUTHORITY: DoD Instruction 5400.16, "DoD Privacy Impact Assessment (PIA) Guidance". Complete this form for Department of Defense
(DoD) information systems or electronic collections of information (referred to as an "electronic collection" for the purpose of this form) that collect, maintain, use,
and/or disseminate personally identifiable information (PII) about members of the public, Federal employees, contractors, or foreign nationals employed at U.S.
military facilities internationally. In the case where no PII is collected, the PIA will serve as a conclusive determination that privacy requirements do not apply to
system.
1. DOD INFORMATION SYSTEM/ELECTRONIC COLLECTION NAME:

Military Child Care (MCC)
3. PIA APPROVAL DATE:

2. DOD COMPONENT NAME:

Department of the Navy
Commander, Navy Installations Command (CNIC)
SECTION 1: PII DESCRIPTION SUMMARY (FOR PUBLIC RELEASE)
a. The PII is: (Check one. Note: foreign nationals are included in general public.)

✖

From members of the general public

From Federal employees and/or Federal contractors

From both members of the general public and Federal employees and/or
Federal contractors

Not Collected (if checked proceed to Section 4)

b. The PII is in a: (Check one)

✖

New DoD Information System

New Electronic Collection

Existing DoD Information System

Existing Electronic Collection

Significantly Modified DoD Information System
c. Describe the purpose of this DoD information system or electronic collection and describe the types of personal information about individuals
collected in the system.

MCC is an OSD-funded, Navy-sponsored, globally-accessible Child and Youth Program (CYP) web-based child care management system.
All four military services, Air Force, Army, Marine Corps and Navy, use MCC. It is designed to address the child care needs of DoD service
members, civilians and contractors worldwide. It is a singular website service that enables DoD customers to request Child and Youth
services, programs to manage care, and leadership to obtain data related to child care demand. Additionally, the system manages
registration, enrollment and subsidy payments for families using the Military Child Care in Your Neighborhood (MCCYN) fee assistance
and Family Child Care programs. The system is used to manage FCC and Program Certification requirements, which includes conducting
annual child and youth inspections, family program certification reviews and monthly family child care visits.
Elements of Pll potentially collected includes: Full name, date of birth, personal mobile and/or home telephone number, personal email
address, home mailing address, emergency contact, employment information, branch of service and employer/command, pertinent medical &
disability information (general questions with yes/no selections, yes opens free form comment box for self-disclosed input). SSN are not
collected in this system.
d. Why is the PII collected and/or what is the intended use of the PII? (e.g., verification, identification, authentication, data matching, mission-related use,
administrative use)

Information, to include elements of PII, is collected during applicant registration to validate DoD family status and to facilitate a detailed
administrative search for child care services resulting in offering and placing qualified applicants with programs and providers that best suit
the requesting family needs. Uploaded artifacts with potential to include elements of PII are used to support and validate child care site/
facility inspection results.
e. Do individuals have the opportunity to object to the collection of their PII?

✖

Yes

No

(1) If "Yes," describe the method by which individuals can object to the collection of PII.
(2) If "No," state the reason why individuals cannot object to the collection of PII.

Consumers/Parents objecting to collecting elements of PII may choose not to participate in the on-line service. However, failure to register
and provide required information results in the inability to process and/or provide military child care services.
Information collected, including PII elements, is required and integral to identify, vet, and certify child care service providers. Failure to
provide required information disqualifies an applicant from participation in the program.
f. Do individuals have the opportunity to consent to the specific uses of their PII?

Yes

✖

No

(1) If "Yes," describe the method by which individuals can give or withhold their consent.
(2) If "No," state the reason why individuals cannot give or withhold their consent.

Program applicants/participants effectively consent to the use of information provided in order to process requests for military child care
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services when voluntarily providing required information during program registration through the on-line service (militarychildcare.com).
For elements of PII not specifically or directly collected from individuals but derived from external sources or systems (e.g. derivative PII)
and subsequently introduced (e.g. via uploaded attachment) - the original source/entity responsible for collecting the PII elements is likewise
responsible for determining appropriateness and capability for individual consent to specific use(s) of the PII collected.
g. When an individual is asked to provide PII, a Privacy Act Statement (PAS) and/or a Privacy Advisory must be provided. (Check as appropriate and
provide the actual wording.)
✖

Privacy Act Statement

Privacy Advisory

Not Applicable

1. AUTHORITY: 10 U.S.C. 5013, Secretary of the Navy; 10 U.S.C. 5041, Headquarters, Marine Corps; DoD Instruction 6060.2, Child
Development Programs; DoD Instruction 6060.4, Youth Programs; OPNAV Instruction 1700.9 series, Child and Youth Programs; Marine
Corps Order 1710.30, Child and Youth Programs (CYP); and E.O. 9397 (SSN) as amended.
2. PRINCIPLE PURPOSES(S): To develop child care programs that meet the needs of children and families; provide child and family
program eligibility and background information; and verify health status of children and verify immunizations.
3. ROUTINE USES: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, these records
contained therein may specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: To local, State
and Federal officials involved in Child Care Services, if required, in the performance of their official duties relating to child abuse reporting
and investigations. The DoD Blanket Routine Uses that appear at the beginning of the Navy’s compilation of systems of records notices
apply to this system.
4. DISCLOSURE: Voluntary. However, failure to provide requested information may impact eligibility for military child care facilities.
Introduction
This is a Department of Defense (DoD) interest computer system sponsored by the Office of Military Family Readiness Policy (OMFRP)
Office of the Secretary of Defense Military Community and Family Policy as a public service. This statement details the steps we take to
protect your personal information when you visit our website. It describes the personal information we collect, the purposes for which we
use such information, and your choices regarding our use of it. By accessing our website, you are consenting to the information collection
and use practices described in this privacy statement.
Our collection of information
Information collected directly from you. The personal information we collect may include the following. You are not required to provide any
of this information, but if you do not, we may not be able to provide you the requested service.
contact details, such as your name, company/organization name, e-mail address, telephone, and physical address;
child care request information such as child name, date of birth, and date care is needed;
your e-mail communication preferences; and
information used to customize and facilitate your use of our websites, including login information.
Information collected automatically. We collect information about your visit to our sites, including what pages you view, the number of
bytes transferred, the links you click, the materials you access, and other actions taken within the site. We also collect certain standard
information that your browser sends to every website you visit, such as your Internet Protocol (IP) address, your browser type and
capabilities and language, your operating system, the date and time you access the site, and the website from which you linked to our site.
Our use of information
We use your personal information to (1) manage the request for care process (e.g., waitlist) and (2) to inform you about the status of your
child care request(s). Program staff may contact you directly or you may receive system-generated email notifications. You are able to optout of receiving many system generated emails.
Our use of cookies
Cookies are small files that websites save to your hard disk or to your browser's memory. We may use them to track the number of times you
have visited the site, to track the number of visitors to the site, to determine and analyze visitors' use of our site, to store information that you
provide such as your preferences, and to store technical information useful for your interactions with our website. We may use session
cookies (cookies that are deleted when your browser session ends) to store your user ID, elements of your user profile, to facilitate your
movement around our website and other information useful in administering the session. You have the ability to accept or decline cookies.
Most Internet browsers automatically accept cookies, but you can usually modify your browser settings to decline cookies or to notify you
when a cookie is being placed on your computer. If you choose to decline cookies, you may not be able to fully experience the features of
our website or other websites that you visit.
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MilitaryChildCare.com does not use the information associated with cookies to track individual user activity on the Internet outside Defense
Department websites, nor does it share the data obtained through such technologies, without the user's explicit consent, with other
departments or agencies.
Use of web analytics
This website uses Google Analytics, a web analytics service provided by Google, Inc. ("Google"). Google Analytics uses "cookies", which
are text files placed on your computer, to help the website analyze how users use the site. The information generated by the cookie about
your use of the website (including your IP address) will be transmitted to and stored by Google on servers in the United States. Google will
use this information for the purpose of evaluating your use of the website, compiling reports on website activity for website operators and
providing other services relating to website activity and internet usage. Google may also transfer this information to third parties where
required to do so by law, or where such third parties process the information on Google's behalf. Google will not associate your IP address
with any other data held by Google. You may refuse the use of cookies by selecting the appropriate settings on your browser. By using this
website, you consent to the processing of data about you by Google in the manner and for the purposes set out above.
Disclosure of your personal information
Except as described below, personal information you provide to MilitaryChildCare.com through our website will not be shared outside of
MilitaryChildCare.com programs without your permission.
Disclosure in connection with child care requests. In connection with certain requests, we may disclose some or all of your personal
information to promote effective communication and planning (e.g., Inclusion Action Team, Special Needs Review Team) and respond to
your child’s individual needs.
Security
MilitaryChildCare.com is committed to protecting the security of your personal information. We use a variety of security technologies and
procedures to help protect your personal information from unauthorized access, use, or disclosure. For example, we store the personal
information you provide on computer systems with limited access that are located in facilities to which access is limited. For sites to which
you login, it is your responsibility to ensure the security of your password and not to reveal this information to others.
Links to other sites
Our website may contain links to other sites such as school districts associated with your child care request. While we try to link only to sites
that share our high standards and respect for privacy, we are not responsible for the content, security, or privacy practices employed by other
sites.
Changes to this privacy statement
MilitaryChildCare.com may occasionally update this privacy statement. When we do, we will revise the "last updated" date at the top and
bottom of the privacy statement.
h. With whom will the PII be shared through data exchange, both within your DoD Component and outside your Component? (Check all that apply)

✖

Within the DoD Component

Specify.

✖

Other DoD Components

Specify.

Other Federal Agencies

Specify.

State and Local Agencies

Specify.

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No system-to-system electronic data exchange pertains or
occurs. Authorized US Navy and Marine Corps Child and
Youth Programs (CYP) employees supporting CYP program
mission objectives (e.g. program administrators; inspectors
etc.); have controlled access to stored data on a need-toknow basis.
Office of SECDEF (OSD); US Army CYP; US Air Force
CYP; DLA.

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✖

Contractor (Name of contractor and describe the language in
the contract that safeguards PII. Include whether FAR privacy
clauses, i.e., 52.224-1, Privacy Act Notification, 52.224-2,
Privacy Act, and FAR 39.105 are included in the contract.)

Specify.

✖

Other (e.g., commercial providers, colleges).

Specify.

American Systems Corp. (ASC)
Property/program information management accountability
requirements include: Compliance with all DoD Pll and
security requirements. The program must adhere to
Department of defense (DoD) mandates and best practices
for securing and safeguarding Personally Identifiable
Information (PII).
Pll policies are outlined in OMB-M-06-16; OMB-M-06-19;
and DoD instruction 8500.2.
These Mandates and best practices are included in the
SECNAV Instruction 5211.5E or CN IC Instruction 5211.1
or review in the Department of the Navy Personally
Identifiable Information (PII) training module.
The Online system is to include servers that must comply
with DoDI8500.2. With these responsibilities contractors
should ensure that their employees: Safeguard DON
information to which their employees have access at all
times. Obtain DON management's written approval prior to
taking any DON sensitive information away from the office.
The DON manager's approval must identify the business
necessity for removing such information from the DON
facility. Contractors undergo National Agency Checks and
all personnel who use or view the data are required to
complete the DoD privacy training annually and complete
the CompTIA Sec + Certification successfully.
Access to data is granted by system permissions.
The FAR Privacy clauses are included in the contract.
ICF, International is the software developer and software
support contractor. However, multiple support contracts and
contractor support personnel may be assigned depending on
the separate contracts established by the respective service
components (e.g., Air Force, Marine Corps).Authorized care
givers are contracted separately. Standard contract
requirements include language for contractors to undergo an
appropriate background investigation; complete annual
privacy act training, and complete annual security training to
include proper information handling, and acceptable use of
government Information Technology (IT). data are required
to complete the DoD privacy training annually. Access to
data is granted by system permissions.
Authorized care givers (end users of the system) are
contracted separately. Standard contract requirements
include language for contractors to undergo an appropriate
background investigation. End user access is restricted by
system permissions.

i. Source of the PII collected is: (Check all that apply and list all information systems if applicable)
✖

Individuals

Databases

Existing DoD Information Systems

Commercial Systems

Other Federal Information Systems

No specific information systems, databases, or collection of records (e.g. paper-based file system) - but elements of PII can potentially be
derived from an alternate source and subsequently introduced via uploaded attachment, for example.
j. How will the information be collected? (Check all that apply and list all Official Form Numbers if applicable)
E-mail

Official Form (Enter Form Number(s) in the box below)

Face-to-Face Contact

Paper

Fax

Telephone Interview

Information Sharing - System to System

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✖

Website/E-Form

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✖

Other (If Other, enter the information in the box below)

In the course of an inspection, inspectors can potentially collect a supporting artifact that contains one or more elements of PII and
subsequently introduce/upload the artifact (e.g. via an attachment) to the MCC web-based IT system - where it is stored in an DoDcompliant encrypted database.
k. Does this DoD Information system or electronic collection require a Privacy Act System of Records Notice (SORN)?
A Privacy Act SORN is required if the information system or electronic collection contains information about U.S. citizens or lawful permanent U.S. residents that
is retrieved by name or other unique identifier. PIA and Privacy Act SORN information must be consistent.
✖ Yes

No

If "Yes," enter SORN System Identifier

NM01754-3

SORN Identifier, not the Federal Register (FR) Citation. Consult the DoD Component Privacy Office for additional information or http://dpcld.defense.gov/
Privacy/SORNs/
or
If a SORN has not yet been published in the Federal Register, enter date of submission for approval to Defense Privacy, Civil Liberties, and Transparency
Division (DPCLTD). Consult the DoD Component Privacy Office for this date
If "No," explain why the SORN is not required in accordance with DoD Regulation 5400.11-R: Department of Defense Privacy Program.

l. What is the National Archives and Records Administration (NARA) approved, pending or general records schedule (GRS) disposition authority
for the system or for the records maintained in the system?
(1) NARA Job Number or General Records Schedule Authority.

DAA-NU-2015-0001-0031

(2) If pending, provide the date the SF-115 was submitted to NARA.

(3) Retention Instructions.

Old SSICs 1754.1b and 1700 updated SSIC 1000-34. TEMPORARY: Cutoff at CY. Destroy when 3 years old.
m. What is the authority to collect information? A Federal law or Executive Order must authorize the collection and maintenance of a system of
records. For PII not collected or maintained in a system of records, the collection or maintenance of the PII must be necessary to discharge the
requirements of a statue or Executive Order.
(1) If this system has a Privacy Act SORN, the authorities in this PIA and the existing Privacy Act SORN should be similar.
(2) If a SORN does not apply, cite the authority for this DoD information system or electronic collection to collect, use, maintain and/or disseminate PII.
(If multiple authorities are cited, provide all that apply).
(a) Cite the specific provisions of the statute and/or EO that authorizes the operation of the system and the collection of PII.
(b) If direct statutory authority or an Executive Order does not exist, indirect statutory authority may be cited if the authority requires the
operation or administration of a program, the execution of which will require the collection and maintenance of a system of records.
(c) If direct or indirect authority does not exist, DoD Components can use their general statutory grants of authority (“internal housekeeping”) as
the primary authority. The requirement, directive, or instruction implementing the statute within the DoD Component must be identified.

SORN NM01754-3, DON Child and Youth Program (May 27, 2010, 75 FR 29728), authorities:
10 U.S.C. 5013, Secretary of the Navy
10 U.S.C. 5041, Headquarters, Marine Corps
DoD Instruction 6060.2, Child Development Programs
DoD Instruction 6060.4, Youth Programs
OPNAV Instruction 1700.9 series, Child and Youth Programs
Marine Corps Order P1710.30E, Children, Youth, and Teen Program (CYTP)
E.O. 9397 (SSN), as amended.
n. Does this DoD information system or electronic collection have an active and approved Office of Management and Budget (OMB) Control
Number?
Contact the Component Information Management Control Officer or DoD Clearance Officer for this information. This number indicates OMB approval to
collect data from 10 or more members of the public in a 12-month period regardless of form or format.
Yes

No

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✖ Pending
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(1) If "Yes," list all applicable OMB Control Numbers, collection titles, and expiration dates.
(2) If "No," explain why OMB approval is not required in accordance with DoD Manual 8910.01, Volume 2, " DoD Information Collections Manual:
Procedures for DoD Public Information Collections.”
(3) If "Pending," provide the date for the 60 and/or 30 day notice and the Federal Register citation.

Military Child Care (MCC) is part of Child and Youth (CYP) Programs. The data collection is included in the CYP OMB Control Number
packet being reviewed by the CNIC Privacy Compliance Officer for submission.

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SECTION 2: PII RISK REVIEW
a. What PII will be collected (a data element alone or in combination that can uniquely identify an individual)? (Check all that apply)
Biometrics

✖

Birth Date

Citizenship

✖

Disability Information

DoD ID Number

Driver's License

✖

Education Information

✖ Emergency Contact

✖

Employment Information

✖

Financial Information

✖ Gender/Gender Identification

✖

Home/Cell Phone

✖

Law Enforcement Information

✖

Mailing/Home Address

✖

Marital Status

✖ Medical Information

Mother's Middle/Maiden Name

✖ Name(s)

✖

Official Duty Address

✖

Official Duty Telephone Phone

Other ID Number

Passport Information

✖

Personal E-mail Address

Photo

Place of Birth

Position/Title

Race/Ethnicity

Rank/Grade

Protected Health Information (PHI)1
Religious Preference

Records

Security Information

Military Records

✖

Work E-mail Address

✖

✖ Child Information

Legal Status

Social Security Number (SSN) (Full or in any
form)

If Other, enter the information in the box below

Spouse Information: Name (First, Last), Address; Phone Number, Email, Employer; Employment Status; Emergency Contact.
Child information: Name, Parent(s), Address, Grade, School information (school they attend), DOB/Projected DOB, special needs.
Medical Information: Flu shot received (Provider)
Disability Information: Level of Special Need (Child)
Law Enforcement Information: Have you ever been arrested or charged for a crime involving a child victim, a sex crime, a substance abuse
felony, or a violent crime? Yes/No. Have you ever been asked to resign a position or been decertified from a position for a sexual offense?
Yes/No
Education Information: Highest Level of Education Received, Degree (if attended college)
Support and Accommodations (includes medical information): general question with yes/no selection, yes opens free form comment box for
input
Employment information: Branch of Service (mandatory), Employer/ Command (mandatory)-free form field, employment type (active
duty, civilian or reserve (mandatory), Employment Status, Have you ever been asked to resign a position or been decertified from a position
for a sexual offense? Yes/No
For Providers only Flu shot date and if Health Screening was done Y/N information is collected.
For Financial information only household income summary is collected which is used to determine service rates.
Disability information is required in order to accommodate special needs.
If the SSN is collected, complete the following questions.
(DoD Instruction 1000.30 states that all DoD personnel shall reduce or eliminate the use of SSNs wherever possible. SSNs shall not be used in spreadsheets,
hard copy lists, electronic reports, or collected in surveys unless they meet one or more of the acceptable use criteria.)
(1) Is there a current (dated within two (2) years) DPCLTD approved SSN Justification on Memo in place?
Yes

✖

No

If "Yes," provide the signatory and date approval. If “No,” explain why there is no SSN Justification Memo.

(2) Describe the approved acceptable use in accordance with DoD Instruction 1000.30 “Reduction of Social Security Number (SSN) Use within DoD”.

(3) Describe the mitigation efforts to reduce the use including visibility and printing of SSN in accordance with DoD Instructoin 1000.30, “Reduction of
Social Security Number (SSN) Use within DoD”.

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(4) Has a plan to eliminate the use of the SSN or mitigate its use and or visibility been identified in the approved SSN Justification request?
If "Yes," provide the unique identifier and when can it be eliminated?
If "No," explain.
Yes

No

b. What is the PII confidentiality impact level2?

✖ Low

Moderate

High

1The definition of PHI involves evaluating conditions listed in the HIPAA. Consult with General Counsel to make this determination.
2Guidance on determining the PII confidentiality impact level, see Section 2.5 “Categorization of PII Using NIST SP 800-122.” Use the identified PII confidentiality impact level to apply the appropriate Privacy Overlay
low, moderate, or high. This activity may be conducted as part of the categorization exercise that occurs under the Risk Management Framework (RMF). Note that categorization under the RMF is typically
conducted using the information types described in NIST Special Publication (SP) 800-60, which are not as granular as the PII data elements listed in the PIA table. Determining the PII confidentiality impact level is
most effective when done in collaboration with the Information Owner, Information System Owner, Information System Security Manager, and representatives from the security and privacy organizations, such as the
Information System Security Officer (ISSO) and Senior Component Official for Privacy (SCOP) or designees.

c. How will the PII be secured?
(1) Physical Controls. (Check all that apply)
✖

Cipher Locks

✖

Closed Circuit TV (CCTV)

Combination Locks

✖

Identification Badges

✖

Key Cards

Safes

✖

Security Guards

If Other, enter the information in the box below

MCC is a web-based application consisting entirely of virtual servers hosted at the DISA DECC Mechanicsburg, PA facility, on an approved
DoD Information Network (DoDIN) enclave from which applicable site-specific physical and environmental security controls are inherited.
Evidence supporting security control inheritance and the compliance status of all applicable site-specific physical and environmental security
controls is available for review in the eMASS (10768) record.
(2) Administrative Controls. (Check all that apply)
✖

Backups Secured Off-site

✖

Encryption of Backups

✖

Methods to Ensure Only Authorized Personnel Access to PII

✖

Periodic Security Audits

✖

Regular Monitoring of Users' Security Practices
If Other, enter the information in the box below

MCC is a web-based application consisting entirely of virtual servers hosted at the DISA DECC Mechanicsburg, PA facility, on an
approved DoD Information Network (DoDIN) enclave from which a portion of applicable administrative security controls are inherited.
Evidence supporting security control inheritance and the compliance status of all applicable and implemented administrative security
controls is available for review in the eMASS (10768) record.
(3) Technical Controls. (Check all that apply)
Biometrics

✖ Common Access Card (CAC)

✖ DoD Public Key Infrastructure Certificates

✖

Encryption of Data at Rest

✖ Encryption of Data in Transit

✖ External Certificate Authority Certificates

✖

Firewall

✖ Intrusion Detection System (IDS)

✖ Least Privilege Access

✖

Role-Based Access Controls

✖ Used Only for Privileged (Elevated Roles)

✖ User Identification and Password

✖

Virtual Private Network (VPN)

If Other, enter the information in the box below

NIST/FIPS-compliant encryption of Data in Transit and Data at Rest. MCC is a web-based application consisting entirely of virtual servers
hosted at the DISA DECC Mechanicsburg, PA facility, on an approved DoD Information Network (DoDIN) enclave from which a portion
of applicable technical security controls are inherited. Evidence supporting security control inheritance and the compliance status of all
applicable and implemented technical security controls is available for review in the eMASS (10768) record.
d. What additional measures/safeguards have been put in place to address privacy risks for this information system or electronic collection?

The NIST SP 800-53 Rev 4 - security control Privacy Overlay has been applied.

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SECTION 3: RELATED COMPLIANCE INFORMATION
a. Is this DoD Information System registered in the DoD IT Portfolio Repository (DITPR) or the DoD Secret Internet Protocol Router Network
(SIPRNET) Information Technology (IT) Registry or Risk Management Framework (RMF) tool3?
✖

✖

Yes, DITPR

DITPR System Identification Number

Yes, SIPRNET

SIPRNET Identification Number

Yes, RMF tool

RMF tool Identification Number

DITPR-DON ID: 22914
eMASS: 10768

No
If “No,” explain.

b. DoD information systems require assessment and authorization under the DoD Instruction 8510.01, “Risk Management Framework for DoD
Information Technology”.
Indicate the assessment and authorization status:
✖

Authorization to Operate (ATO)

Date Granted:

ATO with Conditions

Date Granted:

Denial of Authorization to Operate (DATO)

Date Granted:

Interim Authorization to Test (IATT)

Date Granted:

3/19/2019

(1) If an assessment and authorization is pending, indicate the type and projected date of completion.

(2) If an assessment and authorization is not using RMF, indicate the projected transition date.

c. Does this DoD information system have an IT investment Unique Investment Identifier (UII), required by Office of Management and Budget (OMB)
Circular A-11?
Yes

✖ No

If "Yes," Enter UII

3

If unsure, consult the component IT Budget Point of Contact to obtain the UII

Guidance on Risk Management Framework (RMF) tools (i.g., eMASS, Xacta, and RSA Archer) are found on the Knowledge Service (KS) at https://rmfks.osd.mil.

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SECTION 4: REVIEW AND APPROVAL SIGNATURES
Completion of the PIA requires coordination by the program manager or designee through the information system security manager and privacy representative at
the local level. Mandatory coordinators are: Component CIO, Senior Component Official for Privacy, Component Senior Information Security Officer, and
Component Records Officer.
a. Program Manager or
Designee Name

Diane Brewer

(1) Title

Progam Manager

CNIC (N926)

(3) Work
Telephone

901-830-4049

(4) DSN

(5) E-mail address

[email protected]

(6) Date of Review

(7) Signature

(2) Organization

b. Other Official (to be
used at Component
discretion)

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

c. Other Official (to be
used at Component
discretion)

signed by
BREWER.DIANE. Digitally
BREWER.DIANE.LYNN.1067582957
LYNN.1067582957 Date: 2021.09.09 09:03:42 -04'00'

Hakim S. Anbiya

(1) Title

Privacy Compliance Officer

(2) Organization

CNIC

(3) Work
Telephone

202-433-4325

(4) DSN

288-4325

(5) E-mail address

[email protected]

(6) Date of Review

09/20/21

(7) Signature

ANBIYA.ABDULHAKIM.S.1031557840

d. Component Privacy
Officer (CPO)

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

DD FORM 2930, JUN 2017

Digitally signed by
ANBIYA.ABDULHAKIM.S.1031557840
Date: 2021.09.20 11:29:57 -04'00'

PREVIOUS EDITION IS OBSOLETE.

AEM Designer

Page 10 of 11

e. Component Records
Officer

Karolina Lewandowska

(1) Title

Command Records Manager

(2) Organization

CNIC HQ

(3) Work
Telephone

202-433-6515

(4) DSN

288-0895

(5) E-mail address

[email protected]

(6) Date of Review

09/09/21

(7) Signature

LEWANDOWSKA.KA
ROLINA.L.1515237808

Carol Floyd

(1) Title

CYPM

(2) Organization

DON/CNIC

(3) Work
Telephone

(202) 433-3602

(4) DSN

284-3602

(5) E-mail address

[email protected]

(6) Date of Review:

09/09/21

(7) Signature

FLOYD.CAROL.NA FLOYD.CAROL.NANETTE.105
NETTE.1054406696 4406696
Date: 2021.09.09 10:13:06 -04'00'

f. Component Senior
Information Security
Officer or Designee
Name

Digitally signed by
LEWANDOWSKA.KAROLINA.
L.1515237808
Date: 2021.09.09 10:44:07 -04'00'

Digitally signed by

g. Senior Component
Official for Privacy
(SCOP) or Designee
Name

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

h. Component CIO
Reviewing Official
Name

(1) Title

(2) Organization

(3) Work
Telephone

(4) DSN

(5) E-mail address

(6) Date of Review

(7) Signature

Publishing: Only Section 1 of this PIA will be published. Each DoD Component will maintain a central repository of PIAs on the Component's public Web site.
DoD Components will submit an electronic copy of each approved PIA to the DoD CIO at: [email protected].
If the PIA document contains information that would reveal sensitive information or raise security concerns, the DoD Component may restrict the
publication of the assessment to include Section 1.

DD FORM 2930, JUN 2017

PREVIOUS EDITION IS OBSOLETE.

AEM Designer

Page 11 of 11