SSN Social Security number Medical & Health Information e.g. blood test results Financial Information e.g. credit card number Clearance Information e.g. "Q" Type of Information Biometric Information e.g. finger print, retinal scan Collected or Maintained by the Name Mother’s Maiden System: DoB, Place of Birth Employment Information Criminal History Name, Phone, Address Other Please Specify – YES or NO Has there been any attempt to verify PII does not exist on the system? Some systems employ software DOE Order 206.1, Department of Energy Privacy Program, defines PII as tools to scan content (information or any information collected or maintained by the Department about an individual, data) to search for types of data including but not limited to, education, financial transactions, medical history such as Social Security numbers. and criminal or employment history, and information that can be used to distinguish or trace an as his/her name, Social individual’s identity, such Security number, date and place of name, biometric birth, mother’s maiden data, and including any other personal information that is linked or linkable to a specific individual. If was used to verify the system did not Tools, processes, types of “Yes,” what method contain PII? (e.g. system scan) information is scanned for, and frequency of the scanning. Threshold Questions Does system contain (collect and/or maintain), or plan to YES or NO contain any information about individuals? Is the information in identifiable form? YES or NO Is the information about individual Members of the Public? YES or NO
Type of Information Collected or Maintained by the System: SSN Social Security number Medical & Health Information e.g. blood test results Financial Information e.g. credit card number Clearance Information e.g. "Q" Biometric Information e.g. finger print, retinal scan Mother’s Maiden Name DoB, Place of Birth Employment Information Criminal History Name, Phone, Address Other – Please Specify Has there been any attempt to verify PII does not exist on the system? DOE Order 206.1, Department of Energy Privacy Program, defines PII as any information collected or maintained by the Department about an individual, including but not limited to, education, financial transactions, medical history and criminal or employment history, and information that can be used to distinguish or trace an individual’s identity, such as his/her name, Social Security number, date and place of birth, mother’s maiden name, biometric data, and including any other personal information that is linked or linkable to a specific individual. YES or NO Some systems employ software tools to scan content (information or data) to search for types of data such as Social Security numbers. If “Yes,” what method was used to verify the system did not contain PII? (e.g. system scan) Tools, processes, types of information is scanned for, and frequency of the scanning. Threshold Questions Does system contain (collect and/or maintain), or plan to contain any information about individuals? YES or NO Is the information in identifiable form? YES or NO Is the information about individual Members of the Public? YES or NO
PIA%20Template%20August%202017%20%28Final%29.docx