Fillable Printable Instructions for Non-Disclosure Agreement

Instructions for Non-Disclosure Agreement

INSTRUCTIONS FOR NON-DISCLOSURE AGREEMENTS

The attached Sample Non-Disclosure Agreement can be found in the Department of the

Treasury Security Manual, TDP 71-10, dated 10/29/97, Chapter II, Section 2,

Investigative Requirements for Contract Employees.

The attached sample is also shown as Exhibit 1.23.2.2-5 (page 62-64) of IRM 1.23.2.2,

dated July 18, 2000. Further instructions when to use a Non-Disclosure Agreement may

be found in the TDP 71-10, Chapter 2, Section 2, #11, Non-Disclosure Agreement for

Sensitive but Unclassified Information.

Also refer to IRM 1.23.2.2.7.3 (page 14 & 15.)

When a determination has been made that a Non-Disclosure Agreement is required,

COTRs should complete the following steps before giving the Non-Disclosure

Agreement to the contract employee to sign.

COTR modifies all highlighted areas as they pertain to the identified

contract.

(COTR may only modify the agreement by insertion of specific language

in blank or parenthetical spaces relative to the contract, contracting

Treasury/bureau or project. Other modifications require legal counsel and

Office of Security approval.)

Contract employee signs and dates the agreement.

COTR signs and dates agreement for acceptance on behalf of the agency.

COTR forwards the original signed and dated Non-Disclosure Agreement

to the National Background Investigations Center (along with other

necessary investigative documents) for retention with the personnel

security file.

COTR maintains a copy of the agreement in the official contract file.

COTR may furnish copy of the agreement to the individual signatory, if

requested.

ATTACHMENT #

Project or Contract Name/number

Conditional Access to Sensitive but Unclassified Information

Non-disclosure Agreement

I, , hereby consent to the terms in this Agreement in consideration of my

being granted conditional access to certain United States Government documents or material

containing sensitive but unclassified information.

I understand and agree to the following terms and conditions:

1. By being granted conditional access to sensitive but unclassified information, the

United States Government has placed special confidence and trust in me and I

am obligated to protect this information from unauthorized disclosure, in

accordance with the terms of this Agreement.

As used in this Agreement, sensitive but unclassified information is any information, the loss,

misuse, or unauthorized access to or modification of which could adversely affect the

national interest or the conduct of Federal programs, or the privacy to which individuals are

entitled under Title 5 U.S.C. § 552a, but which has not been specifically authorized under

criteria established by an Executive Order or an Act of Congress to be kept secret in the

interest of national defense or foreign policy.

I am being granted conditional access contingent upon my execution of this Agreement for

the sole purpose of (identify the nature of contract work or special project). This approval

will permit me conditional access to certain information, (identify type(s) of information, e.g.,

documents, memoranda, reports, testimony, deliberations, maps, drawings, schematics, plans,

assessments, etc.) and/or to attend meetings in which such information is discussed or

otherwise made available to me. This Agreement will not allow me access to materials which

the Internal Revenue Service has predetermined, in its sole discretion, are inappropriate for

disclosure pursuant to this Agreement. This may include sensitive but unclassified

information provided to Treasury by other agencies of the United States Government.

I will never divulge any sensitive but unclassified information, which is provided to me

pursuant to this Agreement to anyone, unless I have been advised in writing by the Internal

Revenue Service that the individual is authorized to receive it. Should I desire to make use of

any sensitive but unclassified information, I will do so in accordance with paragraph 6 of this

Agreement. I will submit to the Internal Revenue Service for security review, prior to any

submission for publication, any book, article, column or other written work for general

publication that is based upon any knowledge I obtained during the course of my work on the

Ethernet Switch Replacement Project in order for the Internal Revenue Service to ensure that

no sensitive but unclassified information is disclosed.

I hereby assign to the United States Government all royalties, remunerations, and

emoluments that have resulted will result or may result from any disclosure, publication, or

revelation of sensitive but unclassified information not consistent with the terms of this

Agreement.

If I am permitted, at the sole discretion of the Internal Revenue Service, to review any official

documents containing sensitive but unclassified information, such review will be conducted

at a secure facility or under circumstances which will maintain the security protection of such

material. I will not be permitted to and will not make any copies of documents or parts of

documents to which conditional access is granted to me. Any notes taken during the course of

such access will remain at the Internal Revenue Service to be placed in secure storage unless

it is determined by the Internal Revenue Service officials that the notes contain no sensitive

but unclassified information. If I wish to have the notes released to me, Internal Revenue

Service officials will review the notes for the purposes of deleting any sensitive but

unclassified information to create a redacted copy of the notes. If I do not wish a review of

any notes that I make, those notes will remain in sealed in secure storage at the Internal

Revenue Service.

If I violate the terms and conditions of this Agreement, I understand that the unauthorized

disclosure of sensitive but unclassified information could compromise the security of the

Internal Revenue Service.

If I violate the terms and conditions of this Agreement, such violation may result in the

cancellation of my conditional access to sensitive but unclassified information. This may

serve as a basis for denying me conditional access to Internal Revenue Service information,

both classified and sensitive but unclassified information in the future. If I violate the terms

and conditions of this Agreement, the United States may institute a civil action for damages

or any other appropriate relief. The willful disclosure of information to which I have agreed

therein not to divulge may constitute a criminal offence.

Unless and until I am provided a written release by the Internal Revenue Service from this

Agreement or any portions of it, all conditions and obligations contained in this Agreement

apply both during my period of conditional access, which shall terminate at the conclusion of

my work on the Ethernet Switch Replacement Project, and at all times thereafter.

10.

Each provision of this Agreement is severable. If a court should find any provision of this

Agreement to be unenforceable, all other provisions shall remain in full force and effect.

11.

I understand that the United States Government may seek any remedy available to it to

enforce this Agreement, including, but not limited to, application for a court order prohibiting

disclosure of information in breach of this Agreement.

12.

By granting me conditional access to information in this context, the United States

Government does not waive any statutory or common law evidentiary privileges or

protections that it may assert in any administrative or court proceeding to protect any

sensitive but unclassified information to which I have been given conditional access

under the terms of this Agreement.

13. These restrictions are consistent with and do not supersede, conflict with or otherwise alter

the

employee obligations, rights or liabilities created by Executive Order 12356; Section 7211 of

Title 5, United States Code (governing disclosures to Congress); Section 1034 of Title 10,

United States Code, as amended by the Military Whistleblower Protection Act (governing

disclosure to Congress by members of the military); Section 2302(b)(8) of Title 5, United

States Code, as amended by the Whistleblower Protection Act (governing disclosures of

illegality, waste, fraud, abuse or public health or safety threats); the Intelligence Identities

Protection Act of 1982 (50 U.S.C. 421 et seq.)(Governing disclosures that could expose

confidential Government agents), and the statutes which protect against disclosure that may

compromise the national security, including Sections 641, 793, 794, 798, and 952 of Title 18,

United States Code, and Section 4(b) of the Subversive Activities Act of 1950 (50 U.S.C.

Section 783 (b)). The definition, requirements, obligations, rights, sanctions and liabilities

created by said Executive Order and listed statutes are incorporated into this Agreement and

are controlling.

14. My execution of this Agreement shall not nullify or effect in any manner any other secrecy or

nondisclosure Agreement which I have executed or may execute with the United States

Government.

15. I make this Agreement in good faith, without mental reservation or purpose of evasion.

__________________________ __________________________

Name Date

This Agreement was accepted by the undersigned on behalf of the Internal Revenue Service as a

prior condition of conditional access to sensitive but unclassified information.

___________________________ ___________________________

Department of the Treasury Date

Internal Revenue Service