Privacy Impact Assessment Template - Ohio：隐私影响评估模板-俄亥俄州.doc

Attachment B Privacy Impact Assessment for the Project or System Name: Publication Date: Contact Point for Project or System Contact Person: Agency and Division: Contact Phone: Contact E-mail Data Privacy Point of Contact (DPPOC) Name of DPPOC: Title of DPPOC: Agency and Division of DPPOC: State of Ohio The purpose of a Privacy Impact Assessment is to determine the privacy implications of collecting Personally Identifiable Information (PII), including why PII is collected and how it will be used and secured. PII is defined as personally identifiable information and is information that can be used directly or in combination with other information to identify a particular individual. It includes: a name, identifying number, symbol, or other identifier assigned to a person, any information that describes anything about a person, any information that indicates actions done by or to a person, any information that indicates that a person possesses certain personal characteristics. This document helps identify PII in a given information system. The Ohio Office of Information Technology designed and tested this document in Microsoft Word 2007. Agencies should complete the shaded portions of this document and then submit a copy to your agency’s Data Privacy Point of Contact. Abstract The abstract should be no longer than five sentences and should address the following three items: ? The name of the component and system. ? A brief description of the system and its function. ? An explanation as to why the PIA is being conducted. Overview The overview is the most important section of the PIA. A thorough and clear overview gives the reader the appropriate context to understand the responses in the PIA. The overview should contain the following elements: The system name and the name of the agency who own(s) the system; The purpose of the program, system, or technology and how it relates to the agency’s mission; A general description of