D-1652 U.S. Department of Commerce

U.S. Census Bureau

> **2008 Census Dress Rehearsal Local Update of Census Addresses (LUCA)
> Program**
>
> **Self-Assessment Checklist for the Confidentiality and Security
> Guidelines**

Please review the *Confidentiality and Security Guidelines*, and then
check the appropriate response on this form. If you select LUCA
Participation Option 1 or Option 2, **sign and return** this form
together with your completed 2008 Census Dress Rehearsal LUCA
Registration form, Product Preference form, and signed Confidentiality
Agreement form, either in the enclosed, postage-paid envelope or by
faxing the documents to \[xxx-xxx-xxxx\].

Each LUCA liaison is responsible for protecting and safeguarding the
confidential Census Bureau materials covered by Title 13, United States
Code. This includes any list or file that shows individual Census Bureau
addresses and any Census Bureau map that shows structure location points
for dwellings. The primary liaison must restrict access to the Census
Bureau's address information to only those individuals who have signed
the Confidentiality Agreement. **All individuals directly involved in
reviewing the materials for the 2008 Census Dress Rehearsal LUCA Program
must sign the Confidentiality Agreement making a permanent commitment to
protect the confidentiality of**

**Title 13 information.**

**Protecting Paper Copies of Census Bureau Address Information and
Maps**

Keep all Census Bureau address information and maps showing structure
location points in a locked-room during nonwork hours. During work
hours, do not leave a room unattended where Census Bureau address
information and maps are being reviewed. Do not leave Census Bureau
address information and maps unattended at your desk.

**Protecting Electronic Census Bureau Address Information and Maps**

Operating systems, programs, applications, and data related to the
review of Census Bureau addresses must be accessible only to LUCA
Program liaisons and reviewers. The automated data processing (ADP)
system should restrict the read, write, delete, and execute functions
applicable to the Census Bureau's addresses. If Census Bureau address
information is placed on a shared computer system, create electronic
security profiles to allow only LUCA Program liaisons and reviewers
access to the Census Bureau's address information. Lock all rooms with
computers that contain Census Bureau address information and all
associated media during nonwork hours.

1.  **Can the paper maps containing structure location points, the paper
    address list, and/or CD-ROM/DVD containing the address list be
    stored in a secure location?**

-   Yes

-   No

2.  **If staff members, other than the LUCA liaisons and reviewers, have
    access to the offices, cabinets, etc. where the Census Bureau's
    address list and/or maps are stored, can the LUCA materials be
    secured to prevent unauthorized staff from accessing these
    materials?**

-   Yes

-   No

> **3. If Census Bureau address information is placed on a shared
> computer system, are you able to construct electronic security
> profiles to allow only LUCA Program liaisons and reviewers access to
> the Census Bureau's address information?**
>
> Yes
>
> No
>
> **4. Is your ADP system capable of restricting the read, write,
> delete, and execute functions applicable to the Census Bureau's
> address list file?**
>
> Yes
>
> No
>
> **5. Are you able to assign an encrypted, unique user-ID and password
> for each LUCA Program liaison and reviewer?**
>
> Yes
>
> No
>
> **6. Are you able to keep LUCA data separate from your other data?
> (LUCA data cannot be backed-up, mixed with, or stored with other
> data.)**
>
> Yes

-   No

**Destruction of Confidential Census Materials**

Once the LUCA Program is over (after you have received the Feedback
materials), the primary liaison must destroy all remaining Title 13
materials according to the Census Bureau's specific guidelines for
destroying confidential material. The Census Bureau requires that the
primary liaison verify that the participating government has destroyed
all Title 13 Census Bureau address information by signing and returning
the "Destruction Form" to the Census Bureau.

> **1. Will you clear all magnetic media (tapes, disks, hard drives)
> containing Census Bureau address information before reuse?**
>
> Yes
>
> No
>
> **2. Will you destroy all paper Census Bureau address lists and maps
> containing structure location points though appropriate destruction
> methods such as shredding, burning in an approved Environmental
> Protection Agency facility, chemical decomposition, or pulverizing, or
> return these Title 13 materials to the Census Bureau Regional
> Office?**
>
> Yes
>
> No

**Onsite Visits**

To ensure that participating organizations are maintaining adequate
security safeguards, the Census Bureau may make on-site visits to review
your organization's security procedures. The Census Bureau will strive
not to disrupt your office's operations.

1.  **Do you understand that the Census Bureau may conduct unannounced
    visits to your office to inspect your security measures regarding
    the Census Bureau's address list?**

> Yes

-   No

**Environmental or Natural Disasters**

> **1. Do you have an implementation plan in the event of a fire drill
> or other environmental or natural disaster?**
>
> Yes
>
> No

**LUCA Liaison Information**

If your jurisdiction can meet the above requirements, the LUCA liaison
must print and sign his/her name, job title, telephone number, and enter
the date below.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**(Printed Name of LUCA Liaison)**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**(Signature of LUCA Liaison)** **(Date)**

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**(Title)** **(Telephone Number, including Area Code)**