Name of Institution / Organization:
_____________________________________________________________________
PPO Name: ___________________________
PPO Address:
_____________________________________________
PPO Phone Number: ___________________________
Type of Security Plan:
License Number: ___________________________
Physical Location of Data
Physical Security of Data
___________________________________________
Computer Security Requirements
Computer Operating System: ___________________________
Anti-Virus Software Installed on Computer: ___________________________
The following physical location and computer security procedures must be implemented when in possession of restricted-use data. By checking the box next to each security procedure, you signify that these procedures will be implemented for the duration of the project and License period:
W A R N I N G
U.S. Government Restricted-use Data
Unauthorized Access to Data (Individually identifiable Information) on this Computer is a Violation of Federal Law and Will Result in Prosecution.
Do you wish to continue? (Y)es or (N)o
Notice
Proposed Publications Using Restricted-use Data
Licensees are required to round all unweighted sample size numbers to the nearest ten (nearest 50 for ECLS-B) in all information products (i.e.: proposals, presentations, papers or other documents that are based on or use restricted-use data). Licensees are required to provide a draft copy of each information product that is based on or uses restricted-use data to the IES Data Security Office for a disclosure review. The Licensee must not release the information product to any person not authorized to access the data you are using until formally notified by IES that no potential disclosures were found. This review process usually takes 3 to 5 business days.
The PPO shall also forward a final, approved copy of each publication containing information based on restricted-use data to the IES Data Security Office.
Signature Page – Management Review and Approval
I have reviewed the requirements of the License agreement and the security procedures in this plan that describe the required protection procedures for securing, accessing and using the restricted-use data.
I hereby certify that the computer system, physical location security procedures, and access procedures meet all of the License requirements and will be implemented for the duration of the project and License period.
Note: The National Center for Education Statistics (NCES) processes licenses and disseminates restricted-use data for all centers in the Institute of Education Sciences (IES) including the National Center for Education Research (NCER), the National Center for Education Statistics (NCES), the National Center for Education Evaluation (NCEE), and the National Center for Special Education Research (NCSER).