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pdfSECNAV 5213-1 (Exp 11/31/2019)
SECNAVINST 5213.16
SSN REDUCTION REVIEW
DATE COMPLETED:
EMAIL
SUBMIT
Form Number:
Submission for (Check one):
FORM
IT SYSTEM
USNA 1531/3
Form Revision Date:
30 Nov 2021
SHARE DRIVE / WEB PORTAL
Requiring Document: 10
U.S.C 8456/8458
11/21
SECTION 1
TO BE COMPLETED BY FORM ORIGINATOR/SPONSOR. Forms that collect and retrieve by SSN/PII must be covered by a System of Record
Notice (SORN), be call for within a requiring document, and have Privacy Act Officer approval for Privacy Act Statements. Return
completed packages that contain the SSN Reduction Review Form, Justification, and if need the DD 67 to the
cognizant forms manager.
1. Is the form covered by a System of Record Notice (SORN)?
a. If yes, what is the SORN number?
N01531-1
YES
NO
b. If no, contact the Privacy Act Officer for instructions.
YES
NO
YES
NO
b. If no, contact the Privacy Act Officer for instructions.
3. Is the SSN Field needed?
YES
NO
a. If no, complete DD67 to request revision of the form.
4. Could an alternative to the SSN be used?
YES
2. Does the form contain a Privacy Act Statement (PAS)?
a. If yes, has the PAS been approved by a Privacy Act Officer?
NO
a. If yes, complete DD67 to request revision of the form.
YES
NO
a. If yes, is the SSN field masked or truncated?
YES
NO
b. If no, could it be?
YES
NO
YES
NO
YES
NO
YES
NO
5. Is this form electronic?
6. Is this form part of an IT system?
a. If yes, what is the IT System name and DITPR DON ID?
DITPR ID# 5737 and DITPR-DON ID# 21020
b. If yes, does the IT System mask or truncate the display of the SSN on the form?
c. If no, Could it be?
YES
7. Is Justification Memorandum for the Record attached?
NO
CONTACT INFORMATION - IT System Owner or Form Originator/Sponsor
Name, Code, Mailing Address
Admissions Office, 52 King George St,, Annapolis, MD 21402
Office Telephone Number:
410-293-1800
E-mail Address
[email protected]
SECTION 2 TO BE COMPLETED BY PRIVACY ACT OFFICER
To verify information given in Section 1 is accurate, is in compliance with Privacy Act Regulations, and meets requirements of the
SSN Reduction Plan.
1. Is Privacy Act Statement (PAS) correct?
YES
NO
2. If there is not a PAS, is one needed?
YES
NO
3. If a PAS needed, what is the correct PAS? (Originator/owner of form/IT system will work with the Privacy Act Officer to draft a PAS if needed) (Field will expand
to fit typed data))
Authority: 10 U.S.C. § 2005, Advanced Education Assistance: Active Duty Agreement; Reimbursement Requirements; 10 U.S.C.
347, International engagement authorities for service academies; 10 U.S.C. § 5013, Secretary of the Navy; 10 U.S.C. § 8454,
Midshipmen: number; 10 U.S.C. § 8456, Midshipmen: Nomination and Selection to fill Vacancies; 10 U.S.C. § 8458, Midshipmen:
Qualifications for Admission; 10 U.S.C. § 8462, Midshipmen: Discharge for Unsatisfactory Conduct or Inaptitude; 10 U.S.C. §
8463, Midshipmen: Discharge for Deficiency; 10 U.S.C. § 8459, Midshipmen: Agreement for Length of Service; DoDI 1322.22,
Service Academies; OPNAVINST 1531.5E, Nominations to the United States Naval Academy for Children of Members of the
Armed Forces, Including Reserves, Active, Retired, Disabled or Deceased; OPNAVINST 1531.6D, Nomination and Admission of
Citizens of Foreign Countries to the U.S. Naval Academy; and E.O. 9397 (SSN), as amended., and N01531-1.
Purpose: Applicant files contain information used for personal information verification and to evaluate/determine competitive
standing and eligibility for appointments to the Naval Academy. Midshipmen records consist of academic, military, and physical
records used to track each student’s progress at the Naval Academy.
Routine Uses: Information will be used by the United States Naval Academy faculty and staff for executing all aspects of the
mission of the Academy. Information may be shared within the DoD pursuant to a valid need to know and outside the DoD pursuant
to a routine use authorized by N01531-1.
SECNAV 5213/1 (REV Oct 2019)
Page 1 of 4
SECNAV 5213-1 (Exp 11/31/2019)
SECNAVINST 5213.16
Disclosure: Voluntary; however, failure to provide the required information may result in a delay or inability to process the
respondent’s application or allow for the continued enrollment of a midshipman at the Naval Academy.
4. Is the System of Records Notice (SORN) number cited in Section 1 correct?
YES
NO
5. Does a SORN need to be initiated?
YES
NO
YES
NO
(Determination of need for SORN will be worked between the originator/owner of form/IT system and Command Privacy Act Office)
6. Is use of SSN Justification Form complete and approved?
APPROVED
DISAPPROVED
Shannon Campbell
Privacy Act Officer Printed Name
CAMPBELL.SHANNON.CARA.1 Digitally signed by
CAMPBELL.SHANNON.CARA.1268432309
268432309
Date: 2021.11.30 16:39:01 -05'00'
Privacy Act Officer Signature
30 Nov 2021
Date
SECTION 3 - COMMAND FORMS MANAGER
APPROVED
DISAPPROVED
NOTES:
Shannon Campbell
Forms Manager Printed Name
CAMPBELL.SHANNON.CARA. Digitally signed by
CAMPBELL.SHANNON.CARA.1268432309
1268432309
Date: 2021.11.30 16:39:23 -05'00'
Forms Manager Approval Signature
30 Nov 2021
Date:
(1) For IT systems / applications, this completed SECNAV 5213/1 will be posted in the DOC tab of DITPR DON / DADMS respectively.
(2) For forms, post the date this SECNAV 5213/1 is approved in Naval Forms Online https://navalforms.documentservices.dla.mil/web/public/home.
and maintain the SECNAV 5213/1 in the form's history/case file.
(3) Approved share drive / web portal forms will be maintained locally by the share drive / web portal owner.
SECNAV 5213/1 (REV Oct 2019)
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SECNAV 5213-1 (Exp 11/31/2019)
SECNAVINST 5213.16
SSN USE REVIEW AND JUSTIFICATION FOR FORMS
30 Nov 2021
Date
MEMORANDUM FOR THE RECORD
Subj: JUSTIFICATION FOR THE USE OF THE SOCIAL SECURITY NUMBER (SSN)
1. What is the purpose of this form?
The candidate application requires a SSN in order to differentiate academic and personal information
between applicants as well as to conduct mandatory clearance and background investigations. There is
not another unique identifier available that can be used to verify information across schools throughout the
world, Federal agencies, and among law enforcement agencies.
Applicants report their academic information and extra curricular activities via these online forms which are
then verified by a school administrator. USNA gets applicants from across the globe and there is not a
world-wide system used across different schools in different countries that can standardize the student
identification process. The requirement that applicants be US citizens and that US citizens have SSNs
allows Admissions to use SSNs to identify students to school administrators.
2. Why is collection of the SSN necessary?
Impact if eliminated
If eliminated, confirming applicants' data will be more difficult and labor intensive. School and law
enforcement officials would need to expend more time and effort to verify data for a particular individual
which would delay the data verification for USNA Office of Admission's staff. This would require more time
per record for processing. There is also a reasonable expectation for an increase in having the wrong
information added to applicant records with duplicate names resulting in more man hours spent resolving
mistakes. The quality of customer service and capacity of record production for getting completed records
to the Admissions board would both decrease as more man hours would be spent resolving student-to-data
correlation issues.
3. List the acceptable use criteria for the SSN (found at this link: http://www.doncio.navy.mil/ContentView.aspx?ID=1833)
Confirmation of Employment Eligibility: Federal statute requires that all persons employed within the United
States must provide an SSN or comparable identifier to prove that he or she is eligible to work for or with
the U.S. government. Any system that deals with employment eligibility must contain the SSN.
Computer Matching: Systems, processes or forms that interact with other government agencies may
require the continued use of the SSN as a primary identifier until such time as the applications to which they
are linked move to some other identifier as a primary means for transferring, matching or checking
information. These applications should be rigorously scrutinized to determine the availability of some other
means of conducting these transactions.
Foreign Travel: DoD personnel are often required to travel beyond U.S. borders, which may require official
clearance prior to travel. Currently, the SSN is used as the identifier for these purposes.
4. If collection of the SSN is no longer necessary and a unique identifier can be substituted for the SSN or the SSN can be eliminated,
on what date will either the substitution or elimination occur?
NA
SECNAV 5213/1 (REV Oct 2019)
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SECNAV 5213-1 (Exp 11/31/2019)
SECNAVINST 5213.16
BATES.JAMES.STANISL
AUS.II.1014042187
Digitally signed by
BATES.JAMES.STANISLAUS.II.1014042187
Date: 2021.12.07 12:22:39 -05'00'
Commanding Officer
SECNAV 5213/1 (REV Oct 2019)
U.S. Naval Academy
Command/Activity
Page 4 of 4
File Type | application/pdf |
File Modified | 2021-12-07 |
File Created | 2016-09-22 |