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Exhibit D: Security Agreement Form Onp4 tAA�hr • ~a O O SECURITY AGREEMENT FORM Mrruwiuuoou The Department of Children and Families has authorized you: Employee's or Other System User's Name/Organization to have access to sensitive data using computer-related media (e.g., printed reports, microfiche, system inquiry, on-line update, or any magnetic media). Computer crimes are a violation of the department's Standards of Conduct. In addition to departmental discipline, committing computer crimes may result in Federal or State felony criminal charges. I understand that a security violation may result in criminal prosecution according to the provisions of Federal and State statutes and may also result in disciplinary action against me according to the departments Standards;of Conduct in the Employee Handbook. By my signature below, I acknowledge that I have received, read, understand and agree to be bound by the following: 6 The Computer Related Crimes Act, Chapter 815, F.S. 6 Sections 7213, 7213A, and 7431 of the Internal Revenue Code, which provide civil and criminal penalties for unauthorized inspection or disclosure of Federal tax data. • 6i 030)(7) of the Internal Revenue Code, which provides confidentiality and disclosure of returns and return information. • CFOP 50-2. 6 It is ;the policy of the: Department of Children and Families that no contract employee shall have. access to IRS tax information or FDLE Information, unless approved in writing, by name and position to. access.specffied information, as authorized by regulation and/or statute. • It is the. policy of the Department of Children and Families that I do not disclose personal passwords. • It is the policy of the Department, of Children and Families that I do not obtain information for my oven or another person's personal use. • 1.will'only access or view information or data for which I am authorized and have a legitimate business reason,to see when performing my duties. I shall maintain the integrity of all confidential and sensitive information accessed. •. "Casual viewing" of employee or client data, even data that is not confidential orotherwise exempt from disclosure as a public record, constitutes misuse of access and is not,acceptable, The Department.of Children and Families will perform regular database queues to ider*misuseof access. s Chapter 119.0712, Florida Statutes, and the Driver Privacy Protection Act (DPPA). .PRIVACY :ACT 'STATEMENT: Disclosure of your social security number is voluntary, but.must be provided in order to gain access to department systems. It is requested, however, pursuant to Section, 282.318, Florida Statutes, the Security .of Data and information Technology Resources Act. The .Department requests -social security numbers to ensure secure access to data systems, prevent unauthorized access to confidential and sensitive information collected and stored by the Department; and provide a unique identifier in our systems. Print Employee or Other System User Name Signature of Employee or Other System User Date PrintSuperv'rsor Name Signature of Supervisor Date. CF 1:14. PDF 03/2013 Distribution of Copies: Original —Personnel: File/011ier Svstem'User File: Coov — Emolrnee/Other systeni User 8 1 P a a e P80