10 SSE Nondisclosure Statement for Consultant

Sworn Statement (Affirmation) of Nondisclosure

for Consultant to BEA

I, _____________________________, a consultant to the Bureau of Economic Analysis (BEA), do solemnly swear (or affirm) that I will not disclose to unauthorized persons any confidential information collected by BEA under the International Investment and Trade in Services Survey Act to which I may have access. Further, I will not publish the information or make it available to any other person in a way in which the person, including a business enterprise or establishment, that furnished the information to BEA can be specifically identified. I have read and understand the provisions of law regarding disclosure of BEA confidential information. I also understand that any unlawful disclosure of BEA confidential information on my part will result the immediate termination of my status as a BEA consultant and that I will be subject to any and all penalties imposed by law, including 22 U.S.C 3104 (e), Sections 8(b) and (c) of P.L. 101-533, and 18 U.S.C. 1905.

Additionally, I have read and will abide by the “Guidelines for Obtaining Access to Business Confidential Information Collected by the Bureau of Economic Analysis,” including subjecting to review and clearance by BEA all reports or materials derived from its confidential data for the purpose of ensuring that the confidentiality of the data is maintained.

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Signature Date

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Typed Name

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University or Organization with which Affiliated

Witness:

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Typed Name

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Signature of Witness