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:

Electronic Application (eApp)
3. PIA APPROVAL DATE:

2. DOD COMPONENT NAME:

Defense Information Systems Agency

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.

The Electronic Application (eApp) will collect information about individuals to determine their trustworthiness to have access to US
Government facilities, information, and information systems. The new system will manage and mitigate risk through the use of automation
to the greatest extent to operate in a secure manner. Applicant demographic data, including but not limited to name, sex, address, phone
number, the Department of Defense (DoD) Identification (ID) number, race, ethnicity and primary language. Suitability or eligibility data to
include but not limited to name, date of birth, place of birth, social security number, citizenship information,drivers license, marriage
certificate, birth certificate , height, weight, hair color, eye color, current and previous address information (up to 10 years). Passport
information, personal and work contact information including phone and email address, reference information including references from
friends, peers, colleagues, roommates, associates, etc. and duty location. In addition, previous names used, aliases, education history from the
past ten years, Military history information including foreign military services, current and former spouse information to include but not
limited to name, previous names, social security number, date of birth, place of birth, citizenship, and contact information, such as email
address, phone number and home address. Cohabitant name, date of birth, place of birth, social security number, email address, phone
number and home address. Foreign activities; involving their spouse, cohabitant or dependents including foreign travel, financial interests,
business professional activities; foreign Government activities, foreign contact(s) including name(s), date of birth, citizenship, contact
information, associations with terrorists and/or organizations dedicated to be use of violence, and involvement by individual in activities
designed to overthrow the United States Government. Police records detailing information on arrests, convictions, probation, criminal
charges, imprisonment; specially information related to illegal use of drugs or controlled substances and/or alcohol consumption. Financial
information pertaining to gambling, credit cards, financial difficulties, alimony, child support payments, and foreclosures. Inappropriate use
of information technology systems. Physical and emotional health is not able to be used in the system due to not having the ability to have
access to medical records. According to privacy laws medical records can only be used if they are signed by the individual within the CECD
population.
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)

eApp is the automated process used by NBIS to replace e-QUIP with a secure automated cloud access environment for background
investigation application submission for individuals and organizations to include new applicants with no prior association, DoD, federal,
state and tribal agencies. Applicants will have the capability to provide the necessary information to determine suitability, eligibility, or
qualifications for federal civilian employment, military service, and federal contractor’s access to classified information. The capability
will also provide an interactive, web-based platform across all programming languages.
Records will be destroyed/deleted 15 years after date of separation of the member from the armed service (service members) (Service
Treatment Record (STR); records will be destroyed/deleted 15 years after separation of member sponsor.
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.

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(2) If "No," state the reason why individuals cannot object to the collection of PII.

The requested PII data is required to conduct individuals background investigations. Individuals seeking access to information about
themselves contained in this system of records should address inquires in writing to the Chief, Freedom of Information Act (FOIA) Services
Center, Defense Agency Privacy and Civil Liberties Office, 7700 Arlington Boulevard, Suite 5101, Falls Church, VA 22042-5101. Signed,
written request should contain the requests full name, DoD ID number, current address, and telephone number and this system of records
notice number. In addition, the requester must provide a notarized statement of an unsworn declaration made in accordance with 28 U.S.C.
1746, in the follow format: If executed outside the United States: "I declare (or certify, verify, or state) under penalty of perjury under the
laws of the United States of America that the foregoing is true and correct. Executed on (date). (Signature)." If executed within the United
States, its territories, possessions, or commonwealths: "I declare (or certify, verify, or state) under penalty of perjury that the foregoing is
true and correct. Executed on (date). (Signature)."
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.

Individuals seeking to determine whether information about themselves is contained in this system of records should address inquiries in
writing to the Chief, Freedom of Information Act (FOIA) Service Center, Defense Health Agency Privacy and Civil Liberties Office, 7700
Arlington Boulevard, Suite 5101, Falls Church, VA 22042-5101. Signed, written request should contain the requests full name, DoD ID
number, current address, and telephone number and this system of records notice number. In addition, the requester must provide a notarized
statement of an un-sworn declaration made in accordance with 28 U.S.C. 1746, in the follow format: If executed outside the United States: "I
declare (or certify, verify, or state) under penalty of perjury under the laws of the United States of America that the foregoing is true and
correct. Executed on (date). (Signature)." If executed within the United States, its territories, possessions, or commonwealths: "I declare (or
certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date). (Signature)."
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

This system of records contains Personal Identifiable Information (PII). The DoD Directive 5400.11, “DoD Privacy Program"
The Privacy Act (5 U.S.C. 552a, as amended) issued and pursuant to DoD 5400.7-R (h) "Code of Fair Information Practices” that regulates
the collection, maintenance, use, and dissemination of Personally Identifiable Information. DoD Manual 8910.01 may place additional
procedural requirements on the uses and disclosures of such information beyond those found in the Privacy Act of 1974 or mentioned in this
system of records notice.
h. With whom will the PII be shared through data exchange, both within your DoD Component and outside your Component? (Check all that apply)

To the Under Secretary of Defense for Intelligence, for the
purpose of oversight and research.
To the DoD CAF, for the purpose of rendering adjudications
Specify. eligibility for personnel security, suitability, and HSPD-12.
To Military Services, for the purpose of Initiation,
investigation/verification to conduct, security clearances.

Within the DoD Component

To the DoD CAF, for the purpose of rendering adjudications
eligibility for personnel security, suitability, and HSPD-12.
To all Federal agencies, who request an investigation/
verification clearance for employees and contractors.
To Data Aggregators, including law enforcement to track
Specify. individuals but is not limited to checks of the National
Crime Information Center; state criminal histories; and
Federal Bureau of Investigation records checks; and to
obtain information on applicants.

Other DoD Components

Specify.

Other Federal Agencies

State and Local Agencies

Specify.

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.

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To Fourth Estate (all non-Service DoD components), for the
purpose of adjudications eligibility for suitability and
Specify. HSPD-12.
To credit bureaus, that link to financial institutions as a
form of identification or authentication for applicants.

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

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

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

Website/E-Form

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

SF85, SF85-P and SF86
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

DUSDI.02 DoD

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

10/17/2018

(3) Retention Instructions.

Draft Records Retention/Disposition Schedule is currently in development, pending submission to and approval from the Archivist of the
United States, National Archives and Records Administration (NARA). Unscheduled NBIS records will be treated as permanent until receipt
of retention/disposition instruction approval from the Archivist of the United States, NARA.

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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.

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

Pending

(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.

17 Oct 2018

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