I hereby acknowledge all information pertaining to the Mississippi Department of Human Services, subgrantees, clients, employees and data, regardless of the source shall be kept confidential and the use of this information confirms my agreement to the following guidelines:

• 1. I shall not duplicate Department information other than for specific job requirements;
• 2. I shall abide by all security regulations established by the Department in regards to computer access(es);
• 3. All hard copy information shall be kept in a secure area, distributed accordingly, and not duplicated for the intent of misuse; after I have completed the task assigned, any hard copy information not needed shall be shredded;
• 4. I shall use the computer assigned to me by the subgrantee agency or agencies by the Department for State business only;
• 5. I am responsible for any products on my computer;
• 6. I shall be responsible for all computer access(es) assigned to me and maintain all computer access codes in the strictest of confidence; immediately change them if I suspect that their secrecy has been compromised and report suspected misuse to the respective authority; and
• 7. Any conversations related to clients, employees or case record data shall be confidential and not discussed unless it directly relates to the job assignment.

I understand that willful violations of, or disregard for, any of these guidelines will result in disciplinary action up to and including the termination of my employment and possible prosecution under the provisions of the Computer Crimes Act as cited at TCA 39-14-601 et seq. and Federal and State laws and regulations as cited in 45 CFR 205.50, 7 CFR 272.1, Mississippi Code of 1972, annotated, Section §43-1-19, and the Privacy Act of 1974, 5

I understand that as an employee or subgrantee agency staff or contract employee of the Mississippi Department of Human Services, I must use individually identifiable information disclosed to me or obtainable by me only for the purposes related to my assigned Mississippi Department of Human Services job duties.

MDHS Employees or subgrantee agency or contractors that have access to Federal Tax Information are advised of the provisions of IRC Sections §7431, §7213(a), 7213A (see Exhibit 5, IRC Sec. 7431 Civil Damages for Unauthorized Disclosure of Returns and Return Information and Exhibit 10, IRC Sec, 7213 Unauthorized Disclosure of Information). The unauthorized use of IRS information herein constitutes a felony punishable upon conviction by a fine as much as $5,000 or imprisonment for as long as five years, or both, together with the cost of prosecution.

Additionally, I also understand the penalties for improper disclosure implied by the Privacy Act of 1974, 5 U.S.C. 552a. Specifically, 5 U.S.C. 552a (i)(1), which is made applicable to contractors by 5 U.S.C. a (m)(1), provides that any officer or employee of a 6e+ rector, who by virtue of his/her employment or official position, has possession of or access to agency records which contain individually identifiable information, the disclosure of which is prohibited by the Privacy Act or regulations established there under, and who knowing that disclosure of the specific material is prohibited, willfully discloses that material in any manner to any person or agency not entitled to receive it, shall be guilty of a misdemeanor and fined up to $5,000.

I have read and agree to comply with the guidelines set forth above.