Privacy Impact Assessment

PRIVACY IMPACT ASSESSMENT (PIA)
PRESCRIBING AUTHORITY: DoD Instruction 5400.16, "DoD Privacy Impact Assessment (PIA) Guidance". Complete this form for Department of Defense
(DoD) information systems or electronic collections of information (referred to as an "electronic collection" for the purpose of this form) that collect, maintain, use,
and/or disseminate personally identifiable information (PII) about members of the public, Federal employees, contractors, or foreign nationals employed at U.S.
military facilities internationally. In the case where no PII is collected, the PIA will serve as a conclusive determination that privacy requirements do not apply to
system.
1. DOD INFORMATION SYSTEM/ELECTRONIC COLLECTION NAME:

ACTS - ARBA Case Tracking System
3. PIA APPROVAL DATE:

2. DOD COMPONENT NAME:

Office of Secretary of Defense
ASA(M&RA) - Army Review Boards Agency (ARBA)
SECTION 1: PII DESCRIPTION SUMMARY (FOR PUBLIC RELEASE)
a. The PII is: (Check one. Note: foreign nationals are included in general public.)
From members of the general public

From Federal employees and/or Federal contractors

From both members of the general public and Federal employees and/or
Federal contractors

Not Collected (if checked proceed to Section 4)

b. The PII is in a: (Check one)
New DoD Information System

New Electronic Collection

Existing DoD Information System

Existing Electronic Collection

Significantly Modified DoD Information System
c. Describe the purpose of this DoD information system or electronic collection and describe the types of personal information about individuals
collected in the system.

The Deputy Assistant Secretary of the Army (Review Boards) (DASA(RB)) is responsible to the Assistant Secretary of the Army for
Manpower and Reserve Affairs (ASA(M&RA)) for the review and adjudication of applications and cases submitted by various parties for the
correction of military records, for past and present members of the United States Army (USA) and Army National Guard (NG), or their
authorized representative. ACTS Online was designed to allow members of the public to submit applications online for changes to military
records, discharges, medical records, legal issues and tracking clemency and parole issues. The DASA(RB) is also the Director of the Army
Review Boards Agency (ARBA). ACTS Online operates on a Microsoft Windows operating system platform. Web application and database
servers are located in the the Acquisition Logistics, Technology Enterprise Systems &Service (ALTESS) cloud under PEO EIS. Its Cloud
Security System Provider (CSSP) is C5ISR in Aberdeen Proving grounds, Md. Users can access the online applications at https://
arba.army.pentagon.mil/online-application.html. ARBA's HPRM and ACTS database servers interconnect to the ACTS Online database
server to retrieve applications.
Information in identifiable form that will be collected includes: Application for Correction of Military Record (DD Form 149), Application
for the Review of Discharge from the Armed Forces of the United States (DD-293), PII collected includes personal, law enforcement, legal,
medical, employment, education, and military. Information is collected directly from the applicant, or surviving spouse, or next of kin, or
authorized representative. Other supporting documentation containing information in identifiable information is collected from the Army's
interactive Personnel Electronic Record Management System (iPERMS) and/or from the National Archive and Records Administration
(NARA). Information will be collected from any activity having a stake in, or responsive information pertaining to an applicant's request for
correction.
d. Why is the PII collected and/or what is the intended use of the PII? (e.g., verification, identification, authentication, data matching, mission-related use,
administrative use)

Verification and Identification - The information is used to ensure the proper identification of the individual and his/her appropriate records.
To execute the review of a discharge, dismissal or any other correction, reinstatement or in order to provide corrective action and update
records, information in identifiable form is collected to verify the identity of the applicant and, potentially, to make a determination
regarding discharge, dismissal, or the potential correction of a military record.
Administrative use - Information in identifiable form is collected to process and respond to submitted requests and to render a final
determination regarding those requests. To execute the review of a discharge, dismissal or any other correction, reinstatement or in order to
provide corrective action and update records, information in identifiable form is collected to verify the identity of the applicant and,
potentially, to make a determination regarding discharge, dismissal, or correction of a military record.
e. Do individuals have the opportunity to object to the collection of their PII?

Yes

No

(1) If "Yes," describe the method by which individuals can object to the collection of PII.
(2) If "No," state the reason why individuals cannot object to the collection of PII.

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Applicants are given the opportunity to consent to the use, collection and storage of their information in identifiable form by signing DD
Form 149 or DD Form 293, each of which contains a Privacy Act Statement. A Privacy Notice is located on the ACTS Online website that
informs the individual of their option to consent by signing, or object to the collection and/or use of their information in identifiable form. It
also informs the applicant of ARBA's use sharing and collection practices.
f. Do individuals have the opportunity to consent to the specific uses of their PII?

Yes

No

(1) If "Yes," describe the method by which individuals can give or withhold their consent.
(2) If "No," state the reason why individuals cannot give or withhold their consent.

Applicants are given the opportunity to consent to the use, collection and storage of their information in identifiable form by signing DD
Form 149 or DD Form 293, each of which contains a Privacy Act Statement. A Privacy Notice is located on the ACTS Online website that
informs the individual of their option to consent by signing, or object to the collection and/or use of their information in identifiable form. It
also informs the applicant of ARBA's use sharing and collection practices.
g. When an individual is asked to provide PII, a Privacy Act Statement (PAS) and/or a Privacy Advisory must be provided. (Check as appropriate and
provide the actual wording.)
Privacy Act Statement

Privacy Advisory

Not Applicable

The Privacy Act statement reads as follows:
PRIVACY ACT INFORMATION: The authority for collection of information on the DD Form 149 or DD form 293 is Title 10, U. S. Code,
section 1552, EO 9397. The principal purpose is to initiate an application for correction of military records. The form is used by Board
member’s to review of pertinent information in making a determination of relief through the correction of a military record.
Routine Use: None.
Disclosure is voluntary; however, failure to provide identifying information may impede processing of this application.
SOCIAL SECURITY INFORMATION: The request for Social Security number is strictly to assure proper identification of the individual
and appropriate military records.
h. With whom will the PII be shared through data exchange, both within your DoD Component and outside your Component? (Check all that apply)

Within the DoD Component

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Not all information in identifiable form is shared with all the
Army agencies listed below. Only final determinations are
sent to relevant agencies to initiate appropriate changes
related to that decision (e.g. a decision regarding a pay
grade may be sent to Defense Finance Accounting Service
(DFAS) in order to initiate a change in pay for the
individual). Information in identifiable form may
be shared with the following Army agencies: Army
Inspector General (IG); Assistant Secretary of the Army
for Manpower and Reserve Affairs (ASA(M&RA)); Deputy
Chief of Staff, G-1; Human Resources Command (HRC);
Office of the Chief, Army Reserve (OCAR), Army General
Counsel (GC); Secretary of the Army; US Army Reserve
Command (USARC); Army Recruiting Command
Specify.
(USAREC); US Army Cadet Command; US Army Military
Academy (USMA); and Army Physical Disability Agency
(PDA).
Other Army agencies that would obtain access to PII in this
system, on request in support of an authorized investigation
or audit, may include Army Staff Principals in the chain of
command, Department of Army Inspector General, Army
Audit Agency, US Army Criminal Investigative Command,
and US Army Intelligence and Security Command. In
addition, the Army blanket routine uses apply to this system.
ACTS is an internal Army Review. Boards Agency system
that is only accessed by authorized ARBA personnel
employees. All ARBA employees are required to take PII
training.

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Other DoD Components

Not all information in identifiable form is shared with all the
DoD agencies listed below. Information in identifiable form
may be shared with the following DoD agencies: Office of
the Judge Advocate General (OT JAG); National Personnel
Records Center (NPRC), a division of the National Archives
and Records Administration (NARA); State Adjutants
Specify. General for all states and territories; and National Guard
Bureau. Internal DoD agencies that would obtain access to
PII in this system, on request in support of an authorized
investigation or audit, may include Department of Defense
Inspector General, and Defense Criminal Investigative
Service. In addition, the DoD blanket routine uses apply to
this system.

Other Federal Agencies

Specify.

State and Local Agencies

Specify.

Contractor (Name of contractor and describe the language in
the contract that safeguards PII. Include whether FAR privacy
clauses, i.e., 52.224-1, Privacy Act Notification, 52.224-2,
Privacy Act, and FAR 39.105 are included in the contract.)

Company Name: InterImage
4.2.1.1 Protection of PII
4.2.4.1.1 Privacy Policies and Updates
4.2.4.1.2 Develop and maintain local policies required for
Specify. maintaining a sound privacy program per DoD 5400.11-R
and Army Regulation 340-21.
Create and/or update these policies regarding the protection
of Pll in accordance with federal, DoD and Army
regulations.

Other (e.g., commercial providers, colleges).

Specify.

i. Source of the PII collected is: (Check all that apply and list all information systems if applicable)
Individuals

Databases

Existing DoD Information Systems

Commercial Systems

Other Federal Information Systems

Data is collected directly from the individual that is filing a claim. The individual can complete either DD Form 149 or DD Form 293, both
provide the individual with a Privacy Act statement. Individuals can also complete these forms online at https://arba.army.pentagon.mil/
online-application.html.
j. How will the information be collected? (Check all that apply and list all Official Form Numbers if applicable)
E-mail

Official Form (Enter Form Number(s) in the box below)

Face-to-Face Contact

Paper

Fax

Telephone Interview

Information Sharing - System to System

Website/E-Form

Other (If Other, enter the information in the box below)

DD form 149 and DD form 293
k. Does this DoD Information system or electronic collection require a Privacy Act System of Records Notice (SORN)?
A Privacy Act SORN is required if the information system or electronic collection contains information about U.S. citizens or lawful permanent U.S. residents that
is retrieved by name or other unique identifier. PIA and Privacy Act SORN information must be consistent.
Yes

No

If "Yes," enter SORN System Identifier

A0015-l85 SFMR

SORN Identifier, not the Federal Register (FR) Citation. Consult the DoD Component Privacy Office for additional information or http://dpcld.defense.gov/
Privacy/SORNs/
or
If a SORN has not yet been published in the Federal Register, enter date of submission for approval to Defense Privacy, Civil Liberties, and Transparency
Division (DPCLTD). Consult the DoD Component Privacy Office for this date

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If "No," explain why the SORN is not required in accordance with DoD Regulation 5400.11-R: Department of Defense Privacy Program.

l. What is the National Archives and Records Administration (NARA) approved, pending or general records schedule (GRS) disposition authority for
the system or for the records maintained in the system?
(1) NARA Job Number or General Records Schedule Authority.

N1-AU-06-1

(2) If pending, provide the date the SF-115 was submitted to NARA.

(3) Retention Instructions.

Disposition T20. Keep in CFA until no longer needed for conducting business, then retire to RHA/AEA. The RHA/AEA will destroy record
when the record is 20 years old. NOTE: Original or copy of individual case documents are retained in individual's Official Military
Personnel File (OMPF) records permanently.
The electronic version of all records on this schedule that are created by electronic mail or word processing applications will be deleted
m. What
thecopy
authority
to collect
A Federal
Executiveor
Order
must authorize
theiscollection
and maintenance of a system of
when
the isfile
is generated
orinformation?
when no longer
neededlaw
fororreference
updating;
whichever
later.
records. For PII not collected or maintained in a system of records, the collection or maintenance of the PII must be necessary to discharge the
requirements of a statue or Executive Order.
(1) If this system has a Privacy Act SORN, the authorities in this PIA and the existing Privacy Act SORN should be similar.
(2) If a SORN does not apply, cite the authority for this DoD information system or electronic collection to collect, use, maintain and/or disseminate PII.
(If multiple authorities are cited, provide all that apply).
(a) Cite the specific provisions of the statute and/or EO that authorizes the operation of the system and the collection of PII.
(b) If direct statutory authority or an Executive Order does not exist, indirect statutory authority may be cited if the authority requires the
operation or administration of a program, the execution of which will require the collection and maintenance of a system of records.
(c) If direct or indirect authority does not exist, DoD Components can use their general statutory grants of authority (“internal housekeeping”) as
the primary authority. The requirement, directive, or instruction implementing the statute within the DoD Component must be identified.

5 U.S. 301, Departmental Regulations
10 U.S.C. 3013, Secretary of the Army
10 U.S.C. 1552, Correction of Military Records
10 U.S.C. 1214, Armed Forces; Right to Full and Fair Hearing
10 U.S.C. 1216, Secretaries, powers, functions and duties
10 U.S.C. 1553, Review of Discharge or Dismissal
10 U.S.C 1554, Military Personnel Benefits
Executive Order 9397 SSN, as amended
n. Does this DoD information system or electronic collection have an active and approved Office of Management and Budget (OMB) Control
Number?
Contact the Component Information Management Control Officer or DoD Clearance Officer for this information. This number indicates OMB approval to
collect data from 10 or more members of the public in a 12-month period regardless of form or format.
Yes

No

Pending

(1) If "Yes," list all applicable OMB Control Numbers, collection titles, and expiration dates.
(2) If "No," explain why OMB approval is not required in accordance with DoD Manual 8910.01, Volume 2, " DoD Information Collections Manual:
Procedures for DoD Public Information Collections.”
(3) If "Pending," provide the date for the 60 and/or 30 day notice and the Federal Register citation.

0704-0003, Application for Correction of Military Record Under the Provisions of Title 10, U.S. Code, Section 1552, 10/31/2022
0704-0004, Application for the Review of Discharge or Dismissal from the Armed Forces of the United States, 12/31/2022

DD FORM 2930, JUN 2017

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AEM Designer

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