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Privacy Act System of Records: Telework Application and Agreement Records, EPA-61

[excerpted from: Federal Register: March 4, 2013 (Volume78, Number 42)]

System Name: Telework Application and Agreement Records.

System Location: All EPA Headquarters Offices, Regions, Laboratories or other EPA facilities.

Categories of Individuals Covered by the System: Employees who voluntarily apply to participate in EPA’s Telework Program.

Categories of Records in the System:

a. Information provided on the  Telework Application Form  and  Work Agreement forms  (e.g., employee’s name, grade,  job title  and  series, office location, office email address, office telephone number, alternate work location address, alternate work  location facsimile, alternate work  location and  telephone number).
b. Safety Checklist, Annual Re-certification Form  and  Discontinuation Form.
c. Description of alternate work location equipment and software.
d. Medical documentation (required for medical telework, only).

Authority for Maintenance of System (Includes any Revisions or Amendments): The Telework Enhancement Act of
2010 (December 9, 2010); Public Law 111–292.

Purpose(s)To manage telework applications and conduct telework program evaluations and audits.

Routine Uses of Records Maintained in the System, Including Categories of Users and the Purposes(s):
Home address, home safety checklists and home safety reports may be disclosed to the Department of Labor when an employee is injured while working at home. Raw data such as the number of employees participating in telework by job title, series and grade may be disclosed to Headquarters and local bargaining unions to provide raw data on the number of bargaining employees covered under the applicable negotiated collective bargaining agreement(s). General routine uses A, E, F, G, H, I, J, K, and L apply to this system.

Policies and Practices for Storing, Retrieving, Accessing, Retaining, and Disposing of Records in the System:

Storage:  Paper files and electronic databases.
Retrievability: Primarily by the applicant’s name.
Safeguards: Computer records are maintained in a secure, password protected computer system. Paper records are maintained in lockable file cabinets. All records will have appropriate administrative, technical and physical safeguards to ensure their security and confidentiality. All records will be maintained in secure, access- controlled areas of buildings. Medical telework records must be protected in accordance with Agency policies and procedures for accessing and safeguarding sensitive personally identifiable information.
Retention and Disposal: Records stored in this system are subject to EPA schedule 039.

System Manager(s) and AddressThe system of records is maintained by agency supervisors whose employees have  applied for telework and  by program and  regional office telework coordinators.

Notice Procedures: Requests to determine whether this system of records contains a record pertaining to you must be sent to the Agency’s Freedom of Information Office. The address is U.S. Environmental Protection Agency; 1200 Pennsylvania Ave. NW., Room 6416 West; Washington, DC 20460;  (202) 566–1667; Email: FOIA (; Attn:  Privacy Act Officer.

Record Access ProceduresIndividuals seeking access to their own  personal information in this  system of records will  be required to provide adequate identification (e.g., driver’s license, military identification card, employee badge  or identification card and, if necessary, proof  of authority). Additional identity verification procedures may be required as warranted. Requests must meet the requirements of EPA regulations at 40 CFR part 16.

Contesting ProceduresRequests for correction or amendment must identify the record to be changed and  the corrective action sought. Complete EPA Privacy Act procedures are set out in 40 CFR part 16.

Record Source Categories: Supervisors and all telework coordinators.

Systems Exempted from Certain Provisions of the ActNone.

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