Program: 096-S

Term: September 1, 2021 to August 31, 2022

Title: EAD, YCER, BEVE, and eRPA Notices

BASIS OF

ITEM NO. DESCRIPTION AWARD UNIT RATE COST UNIT RATE COST UNIT RATE COST UNIT RATE COST UNIT RATE COST

I. COMPOSITION:

 (a) Envelopes..........................................................................per envelope............ 8 $10.00 $80.00 No Charge $0.00 $50.00 $400.00 No Charge $0.00 No Charge $0.00

II. PROCESSING /FORMATTING FILES:

 (a) Processing/Formatting Files.............................................per Mailer.............. 9 No Charge $0.00 No Charge $0.00 $50.00 $450.00 No Charge $0.00 No Charge $0.00

III. PREPRODUCTION TESTS:

 (a) Transmission Test.............................................................per test............. 1 No Charge $0.00 No Charge $0.00 No Charge $0.00 No Charge $0.00 No Charge $0.00

 (b) Preproduction Validation Tests.......................................per test............. 1 No Charge $0.00 No Charge $0.00 No Charge $0.00 No Charge $0.00 No Charge $0.00

 (c) Payment Stub Validation Test (eRPA OP1 only)............per test............. 1 No Charge $0.00 No Charge $0.00 No Charge $0.00 No Charge $0.00 No Charge $0.00

IV. PRINTING, IMAGING, BINDING AND CONSTRUCTION:

 (a) * Daily Makeready/Setup Charge 250 $200.00 $50,000.00 $110.00 $27,500.00 $174.24 $43,560.00 No Charge $0.00 No Charge $0.00

 (b) Notice Leaves..............................................................per 1,000 leaves... 15,076 $11.75 $177,143.00 $11.00 $165,836.00 $7.40 $111,562.40 $11.25 $169,605.00 $12.00 $180,912.00

 (c) White CRM Envelope (5-3/4 x 8-3/4").....................per 1,000 envelopes... 23 $14.60 $335.80 $10.40 $239.20 $14.86 $341.78 No Charge $0.00 No Charge $0.00

 (d) White BRM Envelope (5-3/4 x 8-3/4").....................per 1,000 envelopes... 149 $9.85 $1,467.65 $10.40 $1,549.60 $14.86 $2,214.14 No Charge $0.00 No Charge $0.00

 (e) Green BRM Envelope (3-7/8 x 8-7/8')......................per 1,000 envelopes... 50 $17.78 $889.00 $33.80 $1,690.00 $32.04 $1,602.00 No Charge $0.00 No Charge $0.00

 (f) Mail-Out Envelope (4-1/8 x 9-1/2")........................ per 1,000 envelopes... 5,352 $7.97 $42,655.44 $11.00 $58,872.00 $8.44 $45,170.88 No Charge $0.00 No Charge $0.00

 (g) Mail-Out Envelope (6-1/8 x 9-1/2").........................per 1,000 envelopes... 2,186 $11.67 $25,510.62 $12.98 $28,374.28 $11.20 $24,483.20 No Charge $0.00 No Charge $0.00

V. PAPER: Per 1,000 leaves

 (a) Personalized Notices: White OCR Bond (20-lb.) 15,056 $8.56 $128,879.36 $7.96 $119,845.76 $5.02 $75,581.12 $6.50 $97,864.00 $6.50 $97,864.00

 (b) White CRM Envelope (5-3/4 x 8-3/4"): White Writing envelope (20-lb.) 23 $14.60 $335.80 $6.80 $156.40 $14.86 $341.78 $12.50 $287.50 $14.50 $333.50

 (c) White BRM Envelope (5-3/4 x 8-3/4"): White Writing envelope (20-lb.) 149 $9.85 $1,467.65 $6.80 $1,013.20 $14.86 $2,214.14 $12.50 $1,862.50 $22.00 $3,278.00

 (d) Green BRM Envelope (3-7/8 x 8-7/8"): Green Writing envelope (20-lb.) 50 $17.78 $889.00 $22.55 $1,127.50 $32.04 $1,602.00 $19.00 $950.00 $12.50 $625.00

 (e) Mail-Out Envelope (4-1/8 x 9-1/2): White Writing envelope (24-lb.); 

or at contractor's option, White Uncoated Text (60-lb.) 5,352 $7.97 $42,655.44 $6.65 $35,590.80 $8.44 $45,170.88 $14.50 $77,604.00 $12.50 $66,900.00

 (f) Mail-Out Envelope (6-1/8 x 9-1/2"): White Writing envelope (24-lb.); 

or at contractor's option, White Uncoated Text (60-lb.) 2,186 $11.67 $25,510.62 $8.60 $18,799.60 $11.20 $24,483.20 $20.00 $43,720.00 $19.00 $41,534.00

VI. INSERTING AND MAILING:

(a) Mailers.........................................................................per 1,000 Mailers... 7,538 $20.00 $150,760.00 $8.79 $66,259.02 $12.20 $91,963.60 $10.00 $75,380.00 $10.00 $75,380.00

CONTRACTOR TOTALS $648,579.38 $526,853.36 $471,141.12 $467,273.00 $466,826.50

DISCOUNT 0.00% $0.00 0.00% $0.00 0.25% $1,177.85 1.00% $4,672.73 1.00% $4,668.27

DISCOUNTED TOTALS $648,579.38 $526,853.36 $469,963.27 $462,600.27 $462,158.23

AWARDED

SOURCELINK OHIO dba

PINNACLE DATA SYSTEMS

PINNACLE DATA SYSTEMS

SUWANEE, GA

CURRENT CONTRACTOR

MIAMISBURG, OH LIVERPOOL, NY CLAYSBURG, PA

AMSIVE OH. IMS, INC. NPC, INC.

1 of 1
Program 96-S Page 1 of 58

Specifications by MRN 

U.S. GOVERNMENT PUBLISHING OFFICE 

Washington, DC

GENERAL TERMS, CONDITIONS, AND SPECIFICATIONS

For the Procurement of

EAD, YCER, BEVE, and eRPA Notices

as requisitioned from the U.S. Government Publishing Office (GPO) by the

Social Security Administration (SSA)

Single Award

TERM OF CONTRACT: The term of this contract is for the period beginning from September 1, 2021 and 

ending August 31, 2022, plus up to four (4) optional 12-month extension period(s) that may be added in accordance 

with the “OPTION TO EXTEND THE TERM OF THE CONTRACT” clause in SECTION 1 of this contract. 

Contractor interfacing with SSA’s National File Transfer Management System (FTMS) for electronic 

transmission of files from SSA to the production facility will take place from September 1, 2021 through

November 30, 2021. Transmission of live production files will commence on December 1, 2021. 

BID OPENING: Bids shall be opened at 11:00 a.m., prevailing Washington, DC Time, on June 14, 2021, at 

the Government Publishing Office, Washington, DC. (Due to the COVID-19 pandemic, this will NOT be a 

public bid opening.) 

BID SUBMISSION: Due to the COVID-19 pandemic, the physical office will NOT be open. Based on this, bidders 

must submit email bids to bidsapsdc@gpo.gov for this solicitation. No other method of bid submission will be 

accepted at this time. 

The program 096-S and bid opening date must be specified in the subject line of the emailed bid submission. Bids

received after 11:00 a.m. on the bid opening date specified above will not be considered for award.

BID RESTRICTION: Due to travel restrictions as a result of COVID-19, bidders must have an SSA pre-approved 

security clearance at the bidder’s physical location(s) that will be used in the production of products for this contract. 

NOTE: If bidder does not have these requirements completed prior to bid submission, the bidder will be declared

non-responsible.

BIDDERS, PLEASE NOTE: These specifications have been revised; therefore, all bidders are cautioned to 

familiarize themselves with all provisions of these specifications before bidding, with particular attention to 

“SECURITY AND SUITABILITY REQUIREMENTS FOR GOVERNMENT PRINTING (NOV 2018)” and 

“100% ACCOUNTABILITY OF PRODUCTION AND MAILING” requirements.

Abstracts of contract prices are available at: https://www.gpo.gov/how-to-work-with-us/vendors/contract-pricing. 

For information of a technical nature, call David Love at (202) 512-0307 or email dlove@gpo.gov
EAD, YCER, BEVE, and eRPA Notices Page 2 of 58

96-S (08/22)

SECTION 1. - GENERAL TERMS AND CONDITIONS

GPO CONTRACT TERMS: Any contract which results from this Invitation for Bid will be subject to the 

applicable provisions, clauses, and supplemental specifications of GPO Contract Terms (GPO Publication 310.2, 

effective December 1, 1987 (Rev. 01-18)) and GPO Contract Terms, Quality Assurance Through Attributes 

Program, for Printing and Binding (GPO Publication 310.1, effective May 1979, (Rev. 09-19)).

GPO Contract Terms (GPO Publication 310.2) – https://www.gpo.gov/docs/default-source/forms-and-standardsfiles-for-vendors/contractterms2018.pdf.

GPO QATAP (GPO Publication 310.1) – https://www

.gpo.gov/docs/default-source/forms-and-standards-files-for-vendors/qatap-rev-09-19.pdf.

SUBCONTRACTING: The predominant production functions are the laser/ion deposition imaging, inserting of 

data from electronically transmitted files, and disposal/destruction of waste materials. Any bidder who cannot 

perform the predominant production functions of this contract will be declared non-responsible. (NOTE: Inkjet 

printing is not allowed.)

The contractor is responsible for enforcing all contract requirements outsourced to a subcontractor.

If the presorting and mailing is subcontracted, the subcontractor must complete and pass the same security 

clearances as the prime contractor.

If the contractor wishes to add a subcontractor at any time after award, the subcontractor must be approved by the 

Government prior to production starting in that facility. If the subcontractor is not approved by the Government, 

then the contractor must submit a new subcontractor’s information to the Government for approval 30 calendar days 

prior to the start of production at that facility.

If the contractor plans to enter into a “Contractor Team Arrangement” or Joint Venture to fulfill any requirements 

of this contract, they must comply with the terms and regulations as detailed in the Printing Procurement Regulation

(GPO Publication 305.3; Rev. 4-14).

QUALITY ASSURANCE LEVELS AND STANDARDS: The following levels and standards will apply to these 

specifications:

Product Quality Levels:

(a) Printing (page related) Attributes – Level III.

(b) Finishing (item related) Attributes – Level III.

Inspection Levels (from ANSI/ASQC 1.4):

(a) Non-destructive Tests - General Inspection Level I.

(b) Destructive Tests - Special Inspection Level S-2.

(c) Low-gloss, transparent, poly-type window material covering the envelope window must pass a readability 

test with a rejection rate of less than 1/4 of 1% when run through a USPS OCR Scanner.

(d) Exception: ANSI X3.17 “Character Set for Optical Character Recognition (OCR A)” must apply to these 

specifications. The revisions of this standard which are effective as of the date of this contract are those 

which must apply.

(e) Exception: The notices (front and back) will be read by a high-speed document scanner. These notices must 

function properly when processed through a high-speed document scanner. A form is a reject and will be 

considered a major defect when its OCR print cannot be correctly deciphered on the first pass through the 

specified reading equipment.
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96-S (08/22)

(f) Exception: Data Matrix 2-D barcodes must be in accordance with ISO/IEC 16022 – “International 

Symbology Specification, Data Matrix;” ISO/IEC 15418:1999 – “Symbol Data Format Semantics;” 

ISO/IEC 15434:1999 – “Symbol Data Format Syntax;” and ISO/IEC 15415 – “Print Quality Standard.”

(g) Exception: Code 39 (3 of 9) barcodes must be in accordance with ANSI MH 10.8M-1983.

(h) Exception: The payment portion below the micro-perforation on the “payment stub” (eRPA SSA-L732-

OP1), once detached, will be scanned and must function properly when processed through the current 

high-speed scanning equipment at SSA. The payment stub produced requires precision spacing, printing, 

and trimming. It is critical that the bottom of the OCR-A scanline be 1/2” from the bottom of the payment 

stub page and that, when reading from the right, the first encodable character is encountered at least 1/4” 

but no more than 5/16” (plus or minus 1/16”) from the right leading edge of the payment stub. A form is 

a reject and will be considered a major defect when its OCR print cannot be correctly deciphered on the 

first pass through the scanning equipment (See “PRINTING/IMAGING” for eRPA SSA-L732-OP1and 

“BINDING” for additional information regarding perforated payment stub.) 

NOTE: Use of equipment or ink which in any way adversely affects the scannability of the payment stub will not 

be allowed. ANSI Standards may be obtained from the American National Standards Institute, 25 West 43rd Street, 

4th Floor, New York, NY 10036.

Specified Standards: The specified standards for the attributes requiring them must be:

Attribute Specified Standard

P-7. Type Quality and Uniformity O.K. Press Sheets

Special Instructions: In the event that inspection of press sheets is waived by the Government, the following listed 

alternate standards (in order of precedence) must become the Specified Standards:

P-7. O.K. Preproduction Test Samples; O.K. Proofs; Electronic Media; Camera/Manuscript Copy.

OPTION TO EXTEND THE TERM OF THE CONTRACT: The Government has the option to extend the 

term of this contract for a period of 12 months by written notice to the contractor not later than 30 days before the 

contract expires. If the Government exercises this option, the extended contract shall be considered to include this 

clause, except, the total duration of the contract may not exceed five (5) years as a result of, and including, any

extension(s) added under this clause. Further extension may be negotiated under the “EXTENSION OF 

CONTRACT TERM” clause. See also “ECONOMIC PRICE ADJUSTMENT” for authorized pricing 

adjustment(s).

EXTENSION OF CONTRACT TERM: At the request of the Government, the term of any contract resulting 

from this solicitation may be extended for such period of time as may be mutually agreeable to the GPO and the

contractor.

ECONOMIC PRICE ADJUSTMENT: The pricing under this contract shall be adjusted in accordance with this 

clause, provided that in no event will any pricing adjustment be made that would exceed the maximum permissible 

under any law in effect at the time of the adjustment. There will be no adjustment for orders placed during the

first period specified below. Pricing will thereafter be eligible for adjustment during the second and any

succeeding performance period(s). For each performance period after the first, a percentage figure will be 

calculated as described below and that figure will be the economic price adjustment for that entire next period. 

Pricing adjustments under this clause are not applicable to reimbursable postage or transportation costs, or

to paper, if paper prices are subject to adjustment by separate clause elsewhere in this contract.
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96-S (08/22)

For the purpose of this clause, performance under this contract will be divided into successive periods. The first 

period will extend from September 1, 2021 to August 31, 2022, and the second and any succeeding period(s)

will extend for 12 months from the end of the last preceding period, except that the length of the final period may

vary. The first day of the second and any succeeding period(s) will be the effective date of the Economic Price

Adjustment for that period.

Pricing adjustments in accordance with this clause will be based on changes in the seasonally adjusted “Consumer 

Price Index For All Urban Consumers - Commodities Less Food” (Index) published monthly in the CPI Detailed 

Report by the U.S. Department of Labor, Bureau of Labor Statistics.

The economic price adjustment will be the percentage difference between Index averages as specified in this 

paragraph. An index called the variable index will be calculated by averaging the monthly Indexes from the 12-

month interval ending three (3) months prior to the beginning of the period being considered for adjustment. This 

average is then compared to the average of the monthly Indexes for the 12-month interval ending May 31, 2021

called the base index. The percentage change (plus or minus) of the variable index from the base index will be

the economic price adjustment for the period being considered for adjustment.

The Government will notify the contractor by contract modification specifying the percentage increase or decrease

to be applied to invoices for orders placed during the period indicated. The contractor shall apply the percentage 

increase or decrease against the total price of the invoice less reimbursable postage or transportation costs and

separately adjusted paper prices. Payment discounts shall be applied after the invoice price is adjusted.

PAPER PRICE ADJUSTMENT: Paper prices charged under this contract will be adjusted in accordance with 

“Table 9 - Producer Price Indexes and Percent Changes for Commodity Groupings and Individual Items” in 

Producer Price Indexes report, published by the Bureau of Labor Statistics (BLS), as follows:

NOTE: For the purpose of this contract, the Paper Price Adjustment will be based on the date of actual 

production. Actual production begins December 1, 2021.

1. BLS code 0913 for All Paper will apply to all paper required under this contract.

2. The applicable index figures for the month of November 2021 will establish the base index.

3. There shall be no price adjustment for the first three (3) production months of the contract.

4. Price adjustments may be monthly thereafter, but only if the index varies by an amount (plus or minus) 

exceeding 5% by comparing the base index to the index for that month which is two months prior to the 

month is being considered for adjustment.

5. Beginning with order placement in the fourth month, index variances will be calculated in accordance with 

the following formula:

X – base index __________________________ x 100 = ____________ %

base index

where X = the index for that month which is two months prior to the month being considered for adjustment.

6. The contract adjustment amount, if any, will be the percentage calculated in 5 above less 5%.

7. Adjustments under this clause will be applied to the contractor’s bid price(s) for Item V., “PAPER” in the 

“SCHEDULE OF PRICES” and will be effective on the first day of any month for which prices are to be 

adjusted.
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96-S (08/22)

The Contracting Officer will give written notice to the contractor of any adjustments to be applied to invoices for 

orders placed during months affected by this clause.

In no event, however, will any price adjustment be made which would exceed the maximum permissible under any 

law in effect at the time of the adjustment. The adjustment, if any, shall not be based upon the actual change in cost 

to the contractor, but shall be computed as provided above.

The contractor warrants that the paper prices set forth in this contract do not include any allowance for any 

contingency to cover anticipated increased costs of paper to the extent such increases are covered by this price 

adjustment clause.

ALL REQUIREMENTS, STARTING WITH “SECURITY REQUIREMENTS” BELOW, THROUGH 

THE SECTION ENTITLED “SENDING AN ENCRYPTED ZIP FILE VIA EMAIL,” MUST BE 

COMPLETED AND APPROVED AT TIME OF BID SUBMISSION; IF NOT, THE BIDDER MAY BE 

DECLARED NON-RESPONSIVE.

SECURITY REQUIREMENTS: Protection of Confidential Information:

(a) The contractor shall restrict access to all confidential information obtained from the Social Security 

Administration in the performance of this contract to those employees and officials who need it to perform the

contract. Employees and officials who need access to confidential information for performance of the contract

will be determined at the postaward conference between the Contracting Officer and the responsible contractor

representative.

(b) The contractor shall process all confidential information obtained from SSA in the performance of this contract 

under the immediate supervision and control of authorized personnel and in a manner that will protect the 

confidentiality of the records in such a way that unauthorized persons cannot retrieve any such records.

(c) The contractor shall inform all personnel with access to the confidential information obtained from SSA in the 

performance of this contract of the confidential nature of the information and the safeguards required to protect 

this information from improper disclosure.

(d) For knowingly disclosing information in violation of the Privacy Act, the contractor and the contractor 

employees may be subject to the criminal penalties as set forth in 5 U.S.C Section 552a (i)(1), which is made 

applicable to contractors by 5 U.S.C. 552a (m)(1) to the same extent as employees of the SSA. For knowingly 

disclosing confidential information as described in section 1106 of the Social Security Act (42 U.S.C. 1306), 

the contractor and contractor’s employees may also be subject to the criminal penalties as set forth in that 

provision.

(e) The contractor shall assure that each contractor employee with access to confidential information knows the 

prescribed rules of conduct, and that each contractor employee is aware that he/she may be subject to criminal 

penalties for violations of the Privacy Act and/or the Social Security Act. When the contractor employees are 

made aware of this information, they will be required to sign the Contractor Personnel Security Certification, 

Form SSA-301 (see Exhibit A). A copy of this signed certification must be forwarded to: SSA, Printing 

Management Branch (see Exhibit K).

(f) All confidential information obtained from SSA for use in the performance of this contract shall, at all times, 

be stored in an area that is physically safe from unauthorized access.
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96-S (08/22)

(g) Performance of this contract may involve access to tax return information as defined in 26 U.S.C. Section 

6103(b) of the Internal Revenue Code (IRC). All such information shall be handled as confidential and may not 

be disclosed without the written permission of SSA. For willingly disclosing confidential tax return information

in violation of the IRC, the contractor and contractor employees may be subject to the criminal penalties set

forth in 26 U.S.C. Section 7213.

(h) The Government reserves the right to conduct on-site visits to review the contractor’s documentation and inhouse procedures for protection of confidential information.

(i) If a subcontractor is used for the sorting and/or mailing of the notices of this contract, the subcontractor must 

conform to all security requirements of the contract.

SSA EXTERNAL SERVICE PROVIDER SECURITY REQUIREMENTS: This resource identifies the basic 

information security requirements related to the procurement of Information Technology (IT) services hosted 

externally to SSA’s Network.

The following general security requirements apply to all External Service Providers (ESP): 

a. The solution must be located in the United States, its territories, or possessions.

NOTE: “United States” means the 50 States, the District of Columbia, Puerto Rico, the Northern Mariana 

Islands, American Samoa, Guam, the U.S. Virgin Islands, Johnston Island, Wake Island, and Outer 

Continental Shelf Lands as defined in the Outer Continental Shelf Lands Act (43 U.S.C. 1331, et seq.), but 

does not include any other place subject to U.S. jurisdiction or any U.S. base or possession within a foreign 

country (29 CFR 4.112).

b. Upon request from the SSA Contracting Officer Technical Representative (COTR), the ESP shall provide 

access to the hosting facility to the U.S. Government or authorized agents for inspection and facilitate an 

on-site security risk and vulnerability assessment.

c. The solution must meet Federal Information Processing Standards (FIPS) and guidance developed by the 

National Institute of Science and Technology (NIST) under its authority provided by the Federal 

Information Security Modernization Act (FISMA) to develop security standards for federal information 

processing systems, and Office of Management and Budget’s (OMB) Circular A-130 Appendix III.

d. ESPs classified as Cloud Service Providers (CSP) must be FedRAMP authorized. Further information may 

be found at: http://www.gsa.gov/portal/category/102371. As part of these requirements, CSPs must have a 

security control assessment performed by a Third Party Assessment Organization (3PAO).

e. The ESP shall submit to the SSA COTR documentation describing how the solution implements security 

controls in accordance with the designated categorization (FIPS 199) and the Minimum Security 

Requirements for Federal Information and Information Systems (FIPS 200) which requires the use of NIST 

SP 800-53 Rev4 before SSA provides data.

f. All ESPs that process or store Personally Identifiable Information (PII) are considered a Moderate impact 

categorization. If PII or sensitive data (defined by the COTR) is stored or processed by the ESP, then the 

ESP shall provide a Security Authorization Package (SAP) created by an independent assessor. The SAP 

should include a System Security Plan (SSP), Security Assessment Report (SAR), Risk Assessment Report 

(RAR), and Plan of Action & Milestone Report (POA&M). The SAP must be reviewed by SSA before the 

SSA transfers data to the ESP. Refer to NIST SP 800-37 for more information on the Security Authorization 

Package.
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NOTE: PII is any information about an individual maintained by an agency, including (1) any information

that can be used to distinguish or trace an individual’s identity, such as name, social security number, date

and place of birth, mother’s maiden name, or biometric records; and (2) any other information that is

linked or linkable to an individual, such as medical, educational, financial, and employment information.

NOTE: Independent assessor is any individual or group capable of conducting an impartial assessment of

security controls employed within or inherited by an information system.

g. SSA will consider a self-assessment of security controls for solutions that do not involve sensitive 

information or PII.

For additional security requirements and NIST 800-53, REV 4 organization defined parameters, refer to “ESP 

Additional Security Controls Document.”

References - Refer to most up to date revision:

 Federal Information Security Modernization Act (P.L. 113-283), December 2014.

https://www.govinfo.gov/app/details/PLAW-113publ283

 Clinger-Cohen Act of 1996 also known as the “Information Technology Management Reform Act of 1996.”

 Privacy Act (P.L. 93-579), December 1974.

https://www.govinfo.gov/app/details/STATUTE-88/STATUTE-88-Pg1896

 Homeland Security Presidential Directive (HSPD‐12), “Policy for a Common Identification Standard for 

Federal Employees and Contractors,” August 27, 2004.

https://www.dhs.gov/homeland-security-presidential-directive-12

 Revision of OMB Circular No. A–130, “Managing Information as a Strategic Resource,” July 28, 2016.

https://www.govinfo.gov/content/pkg/FR-2016-07-28/pdf/2016-17872.pdf

 OMB Memorandum M-04-04, “E-Authentication Guidance for Federal Agencies,” December 16, 2003.

https://obamawhitehouse.archives.gov/sites/default/files/omb/assets/omb/memoranda/fy04/m04-04.pdf

and

ITL BULLETIN FOR DECEMBER 2011 REVISED GUIDELINE FOR ELECTRONIC 

AUTHENTICATION OF USERS HELPS ORGANIZATIONS PROTECT THE SECURITY OF THEIR 

INFORMATION SYSTEMS.

https://csrc.nist.gov/csrc/media/publications/shared/documents/itl-bulletin/itlbul2011-12.pdf

 FIPS PUB 199, National Institute of Standards and Technology Federal Information Processing Standards 

Publication 199, Standards for Security Categorization of Federal Information and Information Systems, 

February 2004.

https://doi.org/10.6028/NIST.FIPS.199

 FIPS PUB 200, National Institute of Standards and Technology Federal Information Processing Standards 

Publication 200, Minimum Security Requirements for Federal Information and Information Systems, 

March 2006. 

https://doi.org/10.6028/NIST.FIPS.200
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 FIPS 140-3 Security Requirements for Cryptographic Modules, March 22, 2019.

https://csrc.nist.gov/publications/detail/fips/140/3/final

 NIST Special Publication 800-18, Guide for Developing Security Plans for Federal Information Systems, 

February 2006.

https://doi.org/10.6028/NIST.SP.800-18r1

 NIST SP 800-30, Guide for Conducting Risk Assessments, September 2012.

https://doi.org/10.6028/NIST.SP.800-30r1

 ITL Bulletin Contingency Planning for Information Systems NIST Special Publication (SP) 800-34, Rev. 

1.

https://csrc.nist.gov/CSRC/media/Publications/Shared/documents/itl-bulletin/itlbul2010-07.pdf

 NIST SP 800‐37 Revision 2, Risk Management Framework for Information Systems and Organizations -

A System Life Cycle Approach for Security and Privacy, December 2018.

https://csrc.nist.gov/publications/detail/sp/800-37/rev-2/final

 NIST SP 800-47, National Institute of Standards and Technology Special Publication 800-47, Security 

Guide for Interconnecting Information Technology Systems, August 2002.

https://csrc.nist.gov/publications/detail/sp/800-47/final

 NIST SP 800-53 Revision 4, Security and Privacy Controls for Federal Information Systems and 

Organizations, April 2013.

https://csrc.nist.gov/publications/detail/sp/800-53/rev-4/final

 NIST SP 800-53A Revision 4, Assessing Security and Privacy Controls in Federal Information Systems 

and Organizations: Building Effective Assessment Plans, December 2014.

https://csrc.nist.gov/publications/detail/sp/800-53a/rev-4/final

 NIST SP 800-60 Volume 1 Revision 1, Guide for Mapping Types of Information and Information Systems 

to Security Categories, August 2008.

https://csrc.nist.gov/publications/detail/sp/800-60/vol-1-rev-1/final

and

NIST SP 800-60 Volume 1 Revision 1, Guide for Mapping Types of Information and Information Systems 

to Security Categories: Appendices, August 2008.

https://csrc.nist.gov/publications/detail/sp/800-60/vol-2-rev-1/final

 OMB M-07-16, Safeguarding Against and Responding to the Breach of Personally Identifiable Information, 

May 22, 2007.

https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/memoranda/2007/m07-16.pdf

See Exhibit B, “SSA External Service Provider Additional Security Requirements” for complete details regarding 

this requirement.

Templates for Required Security Documents:

 Exhibit C: Security Assessment Report (SAR) Template

 Exhibit D: Risk Assessment Report (RAR) Template

 Exhibit E: System Security Plan (SSP) Template
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PHYSICAL SECURITY: Contractor’s facilities storing SSA assets and information are required to meet the 

Interagency Security Committee’s (ISC) standard for Federal facilities. This information can be found in the 

“Facility Security Plan: An Interagency Security Committee Guide,” dated February 2015, 1st Edition. SSA reserves 

the right to inspect contractor facilities to ensure compliance with the ISC guidelines. If facilities are found deficient, 

the contractor must implement corrective actions within 45 calendar days of notification. Requirements can include, 

but not be limited to, the physical security countermeasures, such as access control systems, closed circuit television 

systems, intrusion detection systems, and barriers.

Contractor must pass all External Service Provider Security and Physical Security requirements as specified above 

before the Government can award this contract. Any bidder who cannot obtain approval for any of these security 

requirements within 60 calendar days of approval of production plans and physical security inspection will be 

declared non-responsible.

SECURITY WARNING: It is the contractor’s responsibility to properly safeguard personally identifiable 

information (PII) from loss, theft, or inadvertent disclosure and to immediately notify the Government of any loss 

of personally identifiable information. 

PII is “information which can be used to distinguish or trace an individual’s identity, such as their name, social 

security number, biometric records, etc., alone, or when combined with other personal or identifying information 

which is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, etc.”

(Ref.: OMB Memorandum 07-16) Other specific examples of PII include, but are not limited to:

(a) Personal identification number, such as passport number, driver’s license number, taxpayer identification 

number, or financial account or credit card number;

(b) Address information, such as street address or personal email address; and,

(c) Personal characteristics, including photographic image (especially of face or other distinguishing 

characteristic), fingerprints, handwriting, or other biometric image or template data (e.g., retina scans, voice 

signature, facial geometry).

All employees working on this contract must:

 Be familiar with current information on security, privacy, and confidentiality as they relate to the 

requirements of this contract.

 Obtain pre-screening authorization before using sensitive or critical applications pending a final suitability 

determination as applicable to the specifications.

 Lock or logoff their workstation/terminal prior to leaving it unattended.

 Act in an ethical, informed, and trustworthy manner.

 Protect sensitive electronic records.

 Be alert to threats and vulnerabilities to their systems.

 Are prohibited from having any mobile devices or cameras in sensitive areas that contain any confidential 

materials. This includes areas where shredding and waste management occurs.

Managers at the contractor’s facility working on this contract must also: 

 Monitor use of mainframes, PCs, LANs, and networked facilities to ensure compliance with national and 

local policies, as well as the Privacy Act statement. 

 Ensure that employee screening for sensitive positions within their department has occurred prior to any 

individual being authorized access to sensitive or critical applications. 
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 Implement, maintain, and enforce the security standards and procedures as they appear in this contract and 

as outlined by the contractor. 

 Contact the security officer within 24 hours whenever a systems security violation is discovered or 

suspected. 

Applicability:

The responsibility to protect personally identifiable information applies during the entire term of this contract and 

all option year terms, if exercised. All contractors must secure and retain written acknowledgement from their 

employees stating they understand these policy provisions and their duty to safeguard personally identifiable 

information. These policy provisions include, but are not limited to, the following:

 Employees are required to have locking file cabinets or desk drawers for storage of confidential material, if 

applicable.

 Material is not to be taken from the contractor’s facility without express permission from the Government.

 Employees must safeguard and protect all Government records from theft and damage while being 

transported to and from contractor’s facility.

The following list provides examples of situations where PII is not properly safeguarded:

 Leaving an unprotected computer containing Government information in a non-secure space (e.g., leaving 

the computer unattended in a public place, in an unlocked room, or in an unlocked vehicle).

 Leaving an unattended file containing Government information in a non-secure area (e.g., leaving the file in 

a breakroom or on an employee’s desk).

 Storing electronic files containing Government information on a computer or access device (flash drive, CD, 

etc.) that other people have access to (not password-protected).

This list does not encompass all failures to safeguard personally identifiable information but is intended to act as an 

alert to the contractor’s employees to situations that must be avoided. Misfeasance occurs when an employee is 

authorized to access Government information that contains sensitive or personally identifiable information and, due 

to the employee’s failure to exercise due care, the information is lost, stolen, or inadvertently released.

Whenever the contractor’s employee has doubts about a specific situation involving their responsibilities for 

safeguarding PII, they should consult GPO and/or SSA.

SECURITY AND SUITABILITY REQUIREMENTS FOR GOVERNMENT PRINTING (NOV 2018):

NOTE: For the purposes of this contract, the Contracting Officer’s Representative (COR) or Contracting Officer’s 

Technical Representative (COTR) is the SSA representative/Program Lead. The terms “vendor” and “contractor” 

are used interchangeably throughout this contract. Additionally, the terms “business days” and “workdays” are 

used interchangeably throughout this contract.

(a) Suitability Process

The background investigation and adjudication processes are compliant with 5 CFR 731 or equivalent. Any 

new vendor personnel (i.e., those who have not previously received a suitability determination under this 

contract) requiring access to an SSA facility, site, information, or system, must complete and submit, through 

the COR-COTR, the documents listed in (a)(1) at least 30 workdays prior to the date vendor personnel are to 

begin work. The suitability process cannot begin until the vendor submits, and SSA receives, accurate and 

complete documents.
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(1) Suitability Document Submission

a. Immediately upon award, the Company Point of Contact (CPOC) must provide to the Center for 

Suitability and Personnel Security (CSPS) and a copy to the Contracting Officer’s Representative 

(COR) for all vendor personnel requesting a suitability determination using a secured/encrypted email* 

with a password sent separately to dchr.ope.suitability@ssa.gov:

(i) An e-QIP applicant listing including the names of all vendor personnel requesting suitability;

(ii) Completed Optional Form (OF) 306, Declaration for Federal Employment (see Exhibit F);

(iii)Work authorization for non-United States (U.S.) born applicants, if applicable.

b. The e-QIP applicant listing must include the vendor name, the Social Security Administration (SSA) 

vendor number, the CPOC’s name, the CPOC’s contact information, the COR’s name, the COR’s 

contact information, and the full name, Social Security Number, date of birth, place of birth (must show 

city and state if born in the U.S. OR city and country if born outside of the U.S.), and a valid email 

address for all vendor personnel requesting suitability. All spelling of names, email addresses, places, 

and numbers must be accurate and legible.

(2) e-QIP Application 

a. Once SSA receives all completed documents, listed in (a)(1), the Center for Suitability and Personnel 

Security (CSPS) will initiate the e-QIP process using the e-QIP applicant listing. CSPS will email the 

e-QIP notification to the CPOC and COR inviting vendor personnel to the e-QIP website to 

electronically complete the background investigation form (Standard Form (SF) 85P, Questionnaire for 

Public Trust Positions). (See Exhibit G.)

b. Vendor personnel will have up to 10 business days to complete the e-QIP application. The 10-day 

timeframe begins the day CSPS sends the invitation to the CPOC and COR. Vendor personnel must 

electronically sign the signature pages before releasing the application in e-QIP. Signature pages 

include the Certification, Release, and Medical Release pages for the SF 85P. Find information about 

the e-QIP process in the e-QIP Quick Reference Guide for e-QIP Applicants at https://nbib.opm.gov/eqip-background-investigations/.

c. If vendor personnel need assistance with e-QIP logon and navigation, they can call the e-QIP Hotline 

at 1-844-874-9940.

(3) Fingerprinting 

a. The e-QIP notification email also provides vendor personnel with instructions to obtain electronic 

fingerprinting services. Vendor personnel must report for fingerprint services immediately upon 

completion and release of the e-QIP application and within 10 business days from the day CSPS sends 

the invitation.

b. If vendor personnel cannot report to the designated fingerprint locations (in the notification email), 

CSPS will accept completed Field Division (FD) 258 fingerprint cards. (See Exhibit H.) The COR can 

provide the FD 258, if required. Vendor personnel must complete all fields on the FD 258. Incomplete 

fields may delay suitability processing.

c. If the vendor needs to mail completed FD 258 fingerprint cards, the vendor can send them, via certified 

mail, along with a completed Vendor Personnel Suitability Cover Sheet to: Social Security 

Administration Center for Suitability and Personnel Security, Attn: Suitability Program Officer, 6401 

Security Boulevard, 2246 Annex Building, Baltimore, MD 21235.
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(4) Status Check

If vendor personnel have completed each of the steps in (e) in their entirety and do not receive a suitability

determination within 15 business days of their last submission, call 1-844-874-9940 to determine suitability 

status.

(b) Suitability Determination

(1) CSPS uses a Federal Bureau of Investigation fingerprint check as part of the basis for making a suitability 

determination. 

This determination is final unless information obtained during the remainder of the full background 

investigation, conducted by the Office of Personnel Management, is such that SSA would find the vendor 

personnel unsuitable to continue performing under this contract. CSPS will notify the CPOC and the COR 

of the results of these determinations.

(2) SSA will not allow vendor personnel access to a facility, site, information, or system until CSPS issues a 

favorable suitability determination. A suitability determination letter issued by CSPS is valid only for 

performance on the vendor specified in the letter.

(3) If personnel have been cleared at a previous contractor’s facility and are to perform work under a new 

vendor, the CPOC must submit a fully completed, legible Contractor Personnel Rollover Request Form to 

the COR. (See Exhibit I.) CSPS will notify the CPOC, COR, and Contracting Officer (CO) of suitability 

to work under the new vendor.

(c) Vendor Personnel Previously Cleared by SSA or Another Federal Agency

If vendor personnel previously received a suitability determination from SSA or another Federal agency, the CPOC 

should include this information next to the vendor personnel’s name on the initial applicant listing (see paragraph 

(a)(1)(b)) along with the OF 306. CSPS will review the information. If CSPS determines another suitability 

determination is not required, it will provide a letter to the CPOC and the COR indicating the vendor personnel 

were previously cleared under another Federal contract and do not need to go through the suitability determination 

process again.

(d) Unsuitable Determinations

(1) The vendor must notify the contractor personnel of any unsuitable determinations as soon as possible after 

receipt of such a determination.

(2) The vendor must submit requests for clarification for unsuitable determinations in writing within 30 

calendar days of the date of the unsuitable determination to the email mailbox or address listed below. 

Vendor personnel must file their own requests; vendor may not file requests on behalf of vendor personnel.

dchr.ope.suitclarify@ssa.gov

OR

Social Security Administration; Center for Suitability and Personnel Security, Attn: Suitability Program 

Officer, 6401 Security Boulevard, 2246 Annex Building, Baltimore, MD 21235
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(e) Vendor Notification to Government

The vendor shall notify the COR and CSPS within one business day if any vendor personnel are arrested or 

charged with a crime, or if there is any other change in the status of vendor personnel (e.g., leaves the company, 

no longer works under the vendor, the alien status changes, etc.) that could affect their suitability determination. 

The vendor must provide in the notification as much detail as possible, including, but not limited to: name(s) 

of vendor personnel whose status has changed, SSA vendor number, the type of charge(s), if applicable, date 

of arrest, the court date, jurisdiction, and, if available, the disposition of the charge(s).

Email Procedures

For the contractor’s convenience, SSA has included the following instructions to send emails with sensitive 

documentation or messages containing personally identifiable information (e.g., SSNs, etc.) securely to an SSA 

email address. Contractor is to consult their local information technology staff for assistance. If the contractor 

utilizes an alternate secure method of transmission, it is recommended that the contractor contact the recipient to 

confirm receipt.

To Encrypt a File using WinZip

i. Save the file to contractor’s hard drive.

ii. Open Windows Explorer and locate the file.

iii. Right click on the file.

iv. Select “WinZip.”

v. Select “Add to Zip File.”

vi. An Add box pops up. Near the bottom of the box is an “Options” area.

vii. Click the “Encrypt added files” checkbox.

viii. Click the “Add” button.

ix. Check the “Hide Password” checkbox if not already checked.

a. Enter a string of characters as a password composed of letters, numbers, and special characters 

(minimum 8 characters – maximum 64 characters).

b. Select the 256-Bit AES encryption radio button.

c. Click “OK.”

x. The file has been encrypted successfully, and the new Zip file can now be attached to an email.

Providing the Recipient with the Password

Send the password to the intended recipient in a separate email message prior to sending the encrypted file or after 

sending the encrypted file. Do not send the password in the same email message to which the encrypted file is 

attached.

If possible, it is recommended to provide the password to the COR-COTR by telephone or establish a predetermined 

password between the contractor and the COR-COTR.

The COR-COTR should also submit the password in a separate email from the documentation when submitting to 

^DCHR OPE Suitability. Due to the large volume of submissions, the COR-COTR must always provide the 

password to ^DCHR OPE Suitability in a separate email, even if it is a pre-established password for a contract.

Sending an Encrypted Zip File via Email

1. Compose a new message.

2. Attach the Zip File.

3. Send message.
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PREAWARD SURVEY: In order to determine the responsibility of the prime contractor or any subcontractor, the 

Government reserves the right to conduct an on-site preaward survey at the contractor’s/subcontractor’s facility or 

to require other evidence of technical, production, managerial, financial, and similar abilities to perform, prior to 

the award of a contract. As part of the financial determination, the contractor in line for award may be required to 

provide one or more of the following financial documents: 

1) Most recent profit and loss statement 

2) Most recent balance sheet(s)

3) Statement of cash flows 

4) Current official bank statement 

5) Current lines of credit (with amounts available) 

6) Letter of commitment from paper supplier(s) 

7) Letter of commitment from any subcontractor 

The documents will be reviewed to validate that adequate financial resources are available to perform the contract 

requirements. Documents submitted will be kept confidential and used only for the determination of responsibility 

by the Government. Failure to provide the requested information in the time specified by the Government may 

result in the Contracting Officer not having adequate information to reach an affirmative determination of 

responsibility.

Additionally, the preaward survey will include a review of all subcontractors involved, along with their specific 

functions, and the contractor’s/subcontractor’s backup facility, quality control/recovery program, computer system, 

mail, material, personnel, production, and security control plans as required by this specification.

The contractor must demonstrate the capability to perform the requirements of the contract at time of award. If 

award is predicated on the purchase of production and/or systems equipment, the contractor must provide purchase 

order(s) with delivery date(s) of equipment to arrive at least 90 calendar days prior to the start of live production on

December 1, 2021.

PREAWARD PRODUCTION PLANS: As part of the preaward survey, the contractor shall present, in writing, 

to the Contracting Officer within five (5) workdays of being notified to do so by the Contracting Officer or his/her 

representative, detailed plans for each of the following activities. The workday after notification to submit will be 

the first day of the schedule. If the Government requests additional information after review of plans, the contractor 

must submit updated plans within two (2) workdays of request. 

Five (5) additional workdays will be permitted to provide a Security Assessment Package as required. The 

contractor, at SSA’s discretion, may be granted five (5) additional workdays if additional information is required 

for the Security Assessment Package. The workday after notification to submit will be the first day of the schedule. 

Option Years: For each option year that may be exercised, the contractor will be required to review their production 

plans and re-submit in writing the above plans detailing any changes and/or revisions that may have occurred. The 

revised plans are subject to Government approval. The revised plans must be submitted to the Contracting Officer 

or his/her representative within five (5) workdays of notification of the option year being exercised. 

NOTE: If there are no changes/revisions, the contractor will be required to submit to the Contracting Officer or 

his/her representative a statement confirming that the current plans are still in effect. 

These proposed plans are subject to review and approval by the Government, and award will not be made prior 

to approval of same. The Government reserves the right to waive some or all of these plans.
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PLEASE NOTE: The specifications in this contract cover the workloads of this contract transmitted daily 

and weekly. As such, the four (4) workloads of this contract must not be produced at multiple facilities, and 

therefore, cannot be transferred interchangeably between multiple plant locations. Any reference in this 

contract to multiple locations/facilities refers to the primary location and the backup facility only.

If the Government, during the preaward survey, concludes that the contractor does not or cannot meet all of the 

requirements as described in this contract, the contractor will be declared non-responsive.

Due to PII issues, the Government cannot award the contract until all security requirements are met. If the contractor 

fails to meet these requirements within 60 workdays of start of live production, the contractor will be declared 

nonresponsive.

Information Sheet – If the contractor is currently producing on other GPO contracts, they must submit an

information sheet specifying how the workload(s) on this contract will fit into the pre-existing Government 

production without hampering the production/delivery schedules for all the contracts. (NOTE: This is a requirement 

of this program due to the legislated nature of certain GPO contracts.)

At a minimum, the information sheet must include a list of the contracts currently held and the production/delivery 

schedules for each of those contracts. The sheet must also specify which of those contracts would run concurrently 

with the projected schedule for this contract.

Backup Facility – The failure to deliver the products required under this specification in a timely manner would 

have an impact on the daily operations of SSA. Therefore, if for any reason(s) (act of God, labor disagreements,

national emergencies, pandemics, etc.) the contractor is unable to perform at said locations for a period longer than 

five (5) workdays, contractor must have a backup facility with the capability of producing the products required 

under this specification.

Plans for their contingency production must be prepared and submitted to the Contracting Officer as part of the 

preaward survey. These plans must include the location of the facility to be used, equipment available at the facility, 

and a timetable for the start of production at that facility.

Part of the plan must also include the transportation of Government materials from one facility to another. SSA 

has the option to install a data connection into the contractor’s backup facility.

NOTE: All terms and conditions of this contract will apply to the backup facility. Due to the time sensitive nature 

of the notices produced on this contract, the contractor must maintain the original schedule set forth in this contract. 

Quality Control Plan – The contractor shall provide and maintain, within their own organization, an independent 

quality assurance organization of sufficient size and expertise to monitor the operations performed and inspect 

the products of each operation to a degree and extent that will ensure the Government’s quality assurance, 

inspection, and acceptance provisions specified herein are met. The contractor shall perform, or have performed, 

the process controls, inspections, and tests required to substantiate that the products provided under this contract 

conform to the specifications and contract requirements. The contractor shall describe in detail their quality 

control/quality assurance and recovery plans describing how, when, and by whom the plans will be performed.

The quality control plan must also include examples and a detailed description of all quality control samples and 

their corresponding inspection reports or logs the contractor will keep to document the quality control inspections 

performed on each run. Furthermore, the plan must include the names of all quality assurance officials and describe 

their duties in relationship to the quality control plan.

The quality control plan must account for the number of pieces mailed daily and must also cover the security 

over the postage meters as well as the controls for the setting of the meters (if meters will be used).
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Quality Control Sample Plan – The plan must provide a description of how the contractor will create quality control

samples for periodic samplings to be taken during the production run, provide for backup and re-running in the 

event of an unsatisfactory sample, and contain control systems that will detect defective, missing, or mutilated 

pieces.

The plan should include the sampling interval the contractor intends to utilize. The contractor will be required to 

create two (2) control samples every 4,000 notices. The samples to be drawn from the production stream at the 

same time: 

 One (1) sample will be drawn, inspected, and retained as part of the contractor’s quality assurance records.

 One (1) sample will be drawn for the Social Security Administration and packed with the remaining samples 

associated with each task order and shipped to SSA, Printing Management Branch (see Exhibit K). 

NOTE: Mailers with low volumes (less than 4,000) will require at least one (1) set of samples to be produced. 

The plan shall detail the actions to be taken by the contractor when defects, missing, or mutilated items are 

discovered. These actions must be consistent with the requirements found in GPO Contract Terms (GPO Publication 

310.2, effective December 1, 1987 (Rev. 01-18)). 

The plan shall monitor all aspects of the job, including material handling and mail flow, to assure that the production 

and delivery of these notices meet specifications and Government requirements. This includes maintaining 100% 

accountability in the accuracy of imaging and mailing of all pieces throughout each run. The contractor must ensure 

that there are no missing or duplicate pieces. 

The contractor must maintain quality control samples, inspection reports, and records for a period of no less than 

210 calendar days subsequent to the date of the check tendered for final payment by the Government Publishing 

Office. The Government will periodically verify that the contractor is complying with the approved quality control 

plan through on-site examinations and/or requesting copies of the contractor’s quality assurance records and quality 

assurance random copies. 

Computer System Plan – This plan must include a detailed listing of the contractor’s operating software platform 

and file transfer system necessary to interface with SSA’s National File Transfer Management System (FTMS) for

electronic transmission of notice files from SSA. The plan must also include the media type on which files from

SSA will be received to the extent that operator intervention (e.g., a tape mount) is not required at SSA or the

contractor’s production facility.

The system plan shall demonstrate the contractor’s ability to provide complete hardware and software compatibility

with SSA’s existing network (see “PREPRODUCTION TESTS, Transmission Test” for additional information). 

The contractor must complete a System Plan (see Exhibit J).

Included with the Computer System Plan shall be a resume for each employee responsible for the monitoring and 

the programming of the contractor’s computer system and file transmissions. If the contractor plans to use a 

consultant, a resume must still be included. This plan must show that the programmer(s) is skilled in the handling 

and programming of Advanced Function Presentation (AFP) (Fully Composed or Mixed Mode) printing platform.

Mail Plan – This plan should include sufficient detail as to how the contractor will comply with all applicable 

U.S. Postal Service (USPS) mailing requirements as listed in the USPS Domestic and International Mail 

Manuals in effect at the time of the mailing and other USPS instructional material such as the Postal Bulletin.

The contractor must also disclose how they will achieve multi-level USPS presort postal discounts as outlined in 

the contract.
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Material Handling and Inventory Control – This plan should explain in detail how the following materials 

will be handled: incoming raw materials; work-in-progress materials; quality control inspection materials; USPS 

inspection materials; and all outgoing materials cleared for USPS pickup/delivery.

Personnel Plan – This plan should include a listing of all personnel who will be involved with this contract. For 

any new employees, the plan should include the source of these employees and a description of the training 

programs the employees will be given to familiarize them with the requirements of this program.

Production Plan – The contractor is to provide a detailed plan of the following:

(1) list of all production equipment and equipment capacities to be utilized on this contract; 

(2) the production capacity currently being utilized on this equipment;

(3) capacity that is available for these workloads; and,

(4) if new equipment is to be utilized, documentation of the purchase order, source, delivery schedule, and

installation dates are required.

The last leaf of the SSA-L732-OP1 notice within the eRPA data files contains a micro-perforated payment stub. 

(For Bilingual (Spanish/English) notices, the payment stub will be on the last leaf of both the Spanish and the 

English notices. However, the micro-perforated payment stub will not be on the same page for every notice because 

these notices have variable page counts.) The contractor will be required to identify the payment stub page(s) 

(English or Spanish/English) requiring perforation. Regarding the “select-a-perf” requirement, the contractor’s 

production plan must explain how they will handle imaging and collating the required micro-perforated sheet into 

the proper sequence of leaves. The plan must also detail how the contractor intends to meet the critical margins 

associated with the scanline. (See “PRINTING/IMAGING.”)

The contractor must disclose in their production plan their intentions for the use of any subcontractors. If a 

subcontractor will be handling SSA notices, the plan must include the same information required from the contractor 

for all items contained under “SECURITY REQUIREMENTS” and “PREAWARD SURVEY.” If a subcontractor 

for any operation is added at any time after award, the contractor must submit the subcontractor’s proposed plans 

which are subject to review and approval by the Government.

The subcontractor must be approved by the Government prior to production starting in that facility. If the 

subcontractor is not approved by the Government, then the contractor has 30 calendar days prior to production to 

submit to the Government the new subcontractor’s information.

Security Control Plan – The contractor shall maintain in operation, an effective security system where items by 

these specifications are manufactured and/or stored (awaiting distribution or disposal) to assure against theft 

and/or the product ordered falling into unauthorized hands.

Contractor is cautioned that no Government provided information shall be used for non-Government business. 

Specifically, no Government information shall be used for the benefit of a third party.

The Government retains the right to conduct on-site security reviews at any time during the term of the contract. 

The plan shall contain at a minimum:

(1) How Government files (data) will be secured to prevent disclosure to a third party. 

(2) How the disposal of waste materials will be handled.

(3) How all applicable Government-mandated security/privacy/rules and regulations as cited in this contract 

shall be adhered to by the contractor and/or subcontractor(s).
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(4) How contractors classified as Cloud Service Providers (CSP) will adhere to additional FedRAMP security 

control requirements. CSPs must have a security control assessment performed by a Third Party Assessment 

Organization (3PAO) (see Exhibit M). Additional information is also available at:

http://www.gsa.gov/portal/category/102371.

(5) The contractor shall submit a System Authorization Package as described in the “SSA External Service 

Provider Security Requirements” section. The SSP, a part of this package, documents how the solution 

implements security controls in accordance with the designated FIPS 199 security categorization and the 

Minimum Security Requirements for Federal Information and Information Systems. This SSP requires the 

use of NIST SP 800-53 Rev. 4. The SAP should be completed by either an independent assessor or another 

Federal agency.

Materials – The contractor is required to explain how all accountable materials will be handled throughout all 

phases of production. 

Production Area Plan - The contractor must provide a secure area(s) dedicated to the processing and storage of 

data for the EAD, YCER, BEVE and eRPA Notices, either a separate facility dedicated to these products, or a 

walled-in limited access area within the contractor’s existing facility. Access to the area(s) shall be limited to 

security-trained employees involved in the production of the notices. 

Part of the Production Area Plan shall include a floor plan detailing the area(s) to be used, showing existing walls, 

equipment to be used, and the printing and finishing locations.

Contractor must have, in place, a building security system that is monitored 24 hours a day, seven (7) days a week, 

and a badging/keypunch system that limits access to Government materials (data processing center/production 

facility and other areas where Government materials with PII are stored or are accessible) that is only accessible by 

approved personnel. Contractor must present this information, in detail, in the production area plan.

Disposal of Waste Materials - The contractor is required to demonstrate how all waste materials used in the 

production of sensitive SSA records (records containing PII information as identified in “SECURITY WARNING”) 

will be definitively destroyed (ex., burning, pulping, shredding, macerating, or other suitable similar means). 

Electronic Records must be definitively destroyed in a manner that prevents reconstruction. Sensitive records are 

records that are national security classified or exempted from disclosure by statue, including the Privacy Act or 

regulation. Definitively destroying the records means the material cannot be reassembled and used in an 

inappropriate manner in violation of law and regulations. 

The contractor, at a minimum, must crosscut shred all documents into squares not to exceed 1/4 inch. All documents 

to be destroyed cannot leave the security of the building and must be destroyed by the contractor at contractor’s 

printing site. The contractor must specify the method planned to dispose of the material. 

UNIQUE IDENTIFICATION NUMBER: Unique identification numbers will be used to track each individual 

notice, thereby providing 100% accountability. This enables the contractor to track each notice through completion 

of the project. The contractor will be required to create a test sample every 4,000 notices. Each AFP file must have 

a minimum of one (1) test sample. This sample must have a unique number and must be produced on each notice. 

The contractor will generate a list of the unique identifying numbers for each sample. As samples are pulled, their 

unique numbers will be marked off the list. This enables the contractor to track which samples have been produced 

and pulled and what records have been produced.

The contractor may create their own sequence number to facilitate their presorting and inserting process but must 

maintain the original SSA identification number.
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RECOVERY SYSTEM: A recovery system will be required to ensure that all defective, missing, or mutilated 

pieces detected are identified, reprinted, and replaced. The contractor’s recovery system must use the unique 

alpha/numeric identifiers assigned to each piece (including quality control samples) to aid in the recovery and 

replacement of any defective, missing, or mutilated pieces, and must be capable of tracking and/or locating any 

individual piece of mail from the time it leaves the press, up to and including when it is off-loaded at the U.S. Postal 

Service facility. An explanation of the contractor’s sequential numbering system is required to understand the audit 

trail required for each and every piece.

100% ACCOUNTABILITY OF PRODUCTION AND MAILING: Contractor must have a closed loop process* 

to determine that the data from the original print file is in the correct envelope with the correct number of pages and

inserts. Notices requiring print regeneration must be reprinted from their original print image with the original job 

ID and piece ID remaining unchanged as each mail piece continues through the inserting life cycle. This process 

will repeat itself (since subsequent reprint runs may yield damages) until all mail pieces from the original print run 

have been inserted and accounted for.

*CLOSED LOOP PROCESSING: A method for generating a plurality of mail pieces including error detection 

and reprinting capabilities. The method provides a mail handling process which tracks processing errors with the 

use of a first and second scan code which obtain information regarding each mail piece, diverts mail pieces in 

response to error detection, transmits such errors to a processor, and automatically generates a reconfigured print 

file to initiate reprints for the diverted mail pieces.

Contractor will be responsible for providing a unique identifying number that will be used to track each individual 

notice, thereby providing 100% accountability and validating the integrity of every notice produced in all phases of 

printing, inserting, and mailing and to ensure all notices received from SSA were correctly entered into the United 

States postal system.

Contractor must have all hardware, programming, and finalized reports in place to meet this requirement. The 

equipment must arrive 90 calendar days prior to the start of live production on December 1, 2021. Contractor must 

submit a sample of their proposed Audit and Summary reports with the required preaward production plans for 

approval. The Government considers grounds for the immediate default of this contract if the contractor, at any 

time, is unable to perform or found not complying with any part of this requirement.

Notice integrity must be defined as follows:

 Each notice must include all pages (and only those pages) intended for the designated recipient as contained 

in the print files received from SSA.

 The contractor’s printing process must have automated systems which can detect all sync errors, stop 

printing when detected, and identify, remove, and reprint all effected notices.

Mailing integrity must be defined as follows:

 All notices received from SSA for each file date were printed, inserted, and entered correctly into the United 

States postal system.

The contractor is responsible for providing the automated inserted notice tracking/reporting systems and processes 

required to validate that 100% of all notices received from SSA were printed, all pages for each notice with the 

correct inserts are accounted for, inserted, and mailed correctly.

The contractor’s inserting equipment must have automated systems that include notice coding and scanning 

technology capable of:
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(a) Uniquely identifying each notice and corresponding notice leaves within each individual file by mailer 

number and file date.

(b) Unique identifier to be scanned during insertion to ensure all notices and corresponding notice leaves are 

present and accounted for.

(c) Entrance Scanning: A camera system must electronically track and scan all leaves of each mail piece as 

the inserting equipment pulls them into the machine to ensure each mail piece was produced and inserted. 

If there is any variance on a mail piece or if a mail piece is not verified that all leaves are present, that piece 

and the piece prior to and immediately following must be diverted and sent back for reprint. All instances 

of variance must be logged.

(d) Touch and Toss: All spoilage, diverted, mutilated, or mail piece that is acted upon directly by a human hand 

prior to sealing must be immediately recorded, discarded, properly destroyed, and automatically 

regenerated in a new print file for reprint. Exception – Intentionally diverted pieces due to a requirement 

for a product, which cannot be intelligently inserted and requires manual insertion such as a publication, 

can be sealed, re-scanned, and placed back into production. These must be programmed diverts and sent to 

a separate bin for processing to ensure they are not mixed with other problem diverts and logged into the 

Audit system as such.

(e) Exit Scanning: A camera system must be mounted just aft of the inserting equipment. This camera system 

must read a unique code through the window of each mail piece and be capable of identifying and reporting 

all missing notices that were lost or spoiled during production for each individual file by mailer number 

and file date. This system ensures that no missing mail pieces have been inadvertently inserted into another 

mail piece. The equipment must check the mail pieces after insertion, verify that all leaves are accounted 

for, and divert any suspect product. During exit scanning, if a sequence number is missing, the notice prior 

to and immediately after must be diverted. The equipment must divert all products that exhibit missing or 

out of order sequence numbers and any other processing errors. All diverted pieces are to be automatically 

recorded and regenerated in a new print file for reprint.

(f) Reconciliation: All notices and the amount of correct finished product must be electronically accounted for 

after insertion through the use of the audit system that is independent of the inserting equipment as well as 

independent of the operator. The sequence numbers, for each file, must be reconciled, taking into account 

any spoilage, duplicate, or diverted product. If the reconciliation yields divergent results, corrective action 

must be taken to locate the mail pieces that are causing any difference between the input and outputs of the 

inserting process. Therefore, all finished mail for that sequence run must be held in an accessible area until 

this reconciliation is complete.

(g) Generate a new production file for all missing, diverted, or mutilated notices (reprint file).

(h) Contractor must generate an automated audit report from the information gathered from scanning for each 

mailer number, file date, and for each notice (manual inputs are not allowed). This audit report will contain 

detailed information for each notice as outlined above for each individual file by mailer number and file 

date. Contractor must maintain this information for a 6-month period after mailing.

(i) Audit report must contain the following information:

1. Job name

2. Mailer number, file date, and mail date(s)

3. Machine ID

4. Date of production with start and end time for each phase of the run (i.e., machine ID).

5. Start and end sequence numbers in each run

6. Status of all sequence numbers in a run
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7. Total volume in run

8. Status report for all incidents for each sequence number and cause (i.e., inserted, diverted, and reason 

for divert such as missing sequence number, missing leaves, mutilated, duplicate, pulled for inspection, 

etc.)

9. Bottom of audit report must contain total number of records for that run, quantity sent to reprint, number 

of duplicates, duplicates verified and pulled, and total completed.

10. Audit report must contain the same information for all the reprints married with this report as listed 

above showing that all pieces for each mailer number and file date are accounted for (see Exhibit L, 

“Audit and Summary Reports”).

(j) Contractor must generate a final automated 100% accountability summary report for each print order. This 

information must be generated directly from the audit report; manual inputs are not allowed. 

The summary report must contain the following (see Exhibit L):

1. Job name.

2. Print order (must show sequence numbers for each section (i.e., first pass and then reprints).

3. Sequence number range for each print order and/or mail date.

4. Volume of all sequence numbers associated with the print order and or mail date were inserted.

5. Volume of reprints that were inserted for each print order and/or mail date.

6. Volumes for each file or print order and date that each was completed.

A PDF copy of the summary report(s) and matching USPS 3607R, and/or GPO 712 form(s) must be submitted to 

SSA, Printing Management Branch (see Exhibit K), for each file date within two (2) workdays of mailing.

Contractor must submit a sample of their Audit and Summary reports (see Exhibit L) with the required preaward 

production plans for approval.

Contractor must generate an automated audit report when necessary showing the tracking of all notices throughout 

all phases of production for each mail piece. This audit report will contain all information as outlined in item (i) 

above. Contractor is required to provide any requested Summary and/or Audit reports within one (1) hour of a 

request, via email, in an MS Word, MS Excel, or PDF file.

All notice tracking/reporting data must be retained in electronic form for 210 calendar days after mailing and must 

be made available to SSA for auditing of contractor performance upon request.

The contractor must maintain quality control samples, inspection reports, and records for a period of no less than 

210 calendar days subsequent to the date of the check tendered for final payment by the Government Publishing 

Office. 

The Government will periodically verify that the contractor is complying with the approved quality control plan 

through on-site examinations and/or requesting copies of the contractor’s quality assurance records and quality 

assurance random copies.

NOTE: The Government will not as a routine matter request that the contractor produce individual pieces in transit 

within the plant; however, the contractor must demonstrate that they will have an audit trail established that has the 

ability to comply with this type of request when and if the need arises.
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REQUEST FOR NOTICES PULLS FROM PRODUCTION: Due to the sensitivity of notices in this contract, 

the Government may request that the contractor remove individual notices from the production stream. When this 

occurs, the Government will supply the contractor with a list of Social Security Numbers (SSNs) or ID Codes that 

need to be pulled. The SSNs for each notice are contained in the Mail Run Data (MRD) File (see Exhibit O).

The contractor must be able to run a sort to find and eliminate the notice from the production run. If the list is 

provided after the notice has been produced, the contractor must be capable of identifying the notice and pulling it 

from the production floor. It is anticipated that this will be an infrequent occurrence.

ON-SITE REPRESENTATIVES: One (1) or two (2) full-time Government representatives may be placed on the 

contractor’s premises on a limited basis or throughout the term of the contract. The contractor will be required to 

provide one private office of not less than 150 square feet, furnished with one desk, one swivel arm chair, telephone 

lines, internet access via wireless or Ethernet for two computers, two work tables, and two 4-drawer letter-size files 

with combination padlock and penda-flex file folders, or equal. On-site representative(s) may be stationed at the 

contractor’s facility to: provide project coordination in receipt of transmissions; verify addresses; monitor the 

printing, imaging, folding, inserting, mail processing, quality control, sample selections, and inspections; and 

monitor the packing and staging of the mail. These representatives will not have contractual authority and cannot 

make changes in the specifications or in contract terms, but will bring any and all defects detected to the attention 

of the company Quality Control Officer. The representatives must have full and unrestricted access to all production 

areas where work on this program is being performed.

POSTAWARD CONFERENCE: Unless waived by the Contracting Officer, the total requirements of the job as

indicated in these specifications will be reviewed by Government representatives with the contractor’s 

representatives at the Social Security Administration, 6401 Security Boulevard, Baltimore, MD, 21235,

immediately after award. At the Government’s option, the postaward conference may be held via teleconference.

Person(s) that the contractor deems necessary for the successful implementation of the contract must be in 

attendance.

PREPRODUCTION MEETING: A preproduction meeting covering printing, imaging, folding, inserting, and 

mailing will be held at the contractor’s facility after award of the contract to review the contractor’s production plan 

and to establish coordination of all operations. Attending this meeting will be representatives from the Government 

Publishing Office, Social Security Administration, and the U.S. Postal Service. The contractor must present and 

explain their final plan for both printing, imaging, folding, inserting, and mailing the EAD, YCER, BEVE, and 

eRPA Notices. In addition, the contractor must be prepared to present detailed production plans, including such 

items as quality assurance, projected commencement dates, equipment loading, pallet needs, etc.

The contractor shall meet with SSA and USPS representatives to present and discuss their plan for mailing. The 

preproduction meeting will include a visit to the contractor’s mailing facility where the contractor is to furnish 

specific mail.

The contractor must present documentation of the plant loading agreement and either a copy of the optional 

procedure, which has been negotiated with the USPS or a draft of the original procedure that the contractor intends 

to negotiate with the USPS for SSA approval. The contractor also needs to present SSA with a copy or a draft of 

the manifest (tracking system) to be used to accomplish the above.

ASSIGNMENT OF JACKETS, PURCHASE, TASK, AND PRINT ORDERS: A GPO jacket number will be 

assigned and a purchase order issued to the contractor to cover work performed. The purchase order will be 

supplemented by an individual daily “Task Order” for each job placed with the contractor. A print order will be 

issued weekly and will indicate the total number of task orders placed and the total number of notices produced that 

week. The print order will also indicate any other information pertinent to the particular order.
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ORDERING: Items to be furnished under the contract shall be ordered by the issuance of weekly print orders 

supplemented by daily electronic task orders. Orders may be issued under the contract from September 1, 2021

through August 31, 2022, plus for such additional period(s) as the contract is extended. All print orders and task 

orders issued hereunder are subject to the terms and conditions of the contract. The contract shall control in the 

event of conflict with any print order or task order. 

Task orders will be issued daily for purposes of the contract and shall detail the daily volume of notices required. 

A print order will be used for billing purposes, will be issued weekly, and will cover all daily task orders issued that 

week. A task order or print order shall be issued upon notification by the Government when it is electronically 

transmitted or otherwise physically furnished to the contractor in conformance with the schedule. 

REQUIREMENTS: This is a requirements contract for the items and for the period specified herein. 

Shipment/delivery of items or performance of work shall be made only as authorized by orders issued in

accordance with the clause entitled “ORDERING.” The quantities of items specified herein are estimates only

and are not purchased hereby. Except as may be otherwise provided in this contract, if the Government’s

requirements for the items set forth herein do not result in orders in the amounts or quantities described as

“estimated,” it shall not constitute the basis for an equitable price adjustment under this contract.

Except as otherwise provided in this contract, the Government shall order from the contractor all the items set forth 

which are required to be purchased by the Government activity identified on page 1.

The Government shall not be required to purchase from the contractor requirements in excess of the limit on total

orders under this contract, if any.

Orders issued during the effective period of this contract and not completed within that time shall be completed 

by the contractor within the time specified in the order, and the rights and obligations of the contractor and the 

Government respecting those orders shall be governed by the terms of this contract to the same extent as if 

completed during the effective period of this contract.

If shipment/delivery of any quantity of an item covered by the contract is required by reason of urgency prior to 

the earliest date that shipment/delivery may be specified under this contract, and if the contractor will not accept 

an order providing for the accelerated shipment/delivery, the Government may procure this requirement from 

another source.

The Government may issue orders which provide for shipment/delivery to or performance at multiple 

destinations.

Subject to any limitations elsewhere in this contract, the contractor shall furnish to the Government all items set 

forth herein which are called for by print orders issued in accordance with the “ORDERING” clause of this contract.

PRIVACY ACT NOTIFICATION: This procurement action requires the contractor to do one or more of the 

following: design, develop, or operate a system of records on individuals to accomplish an agency function in 

accordance with the Privacy Act of 1974, Public Law 93-579, December 31, 1974 (5 U.S.C. 552a) and applicable 

agency regulations. Violation of the Act may involve the imposition of criminal penalties as stated in 5 U.S.C. 552a 

(i)(1) CRIMINAL PENALTIES. It is incumbent upon the contractor to inform its officers and employees of the 

penalties for improper disclosure imposed by the Privacy Act of 1974, 5 U.S.C. 552a, specifically, 5 U.S.C. 552a 

(i)(1) CRIMINAL PENALTIES and m(1) GOVERNMENT CONTRACTORS.
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PRIVACY ACT

(a) The contractor agrees:

(1) to comply with the Privacy Act of 1974 and the rules and regulations issued pursuant to the Act in the 

design, development, or operation of any system of records on individuals in order to accomplish an agency 

function when the contract specifically identifies (i) the system or systems of records and (ii) the work to 

be performed by the contractor in terms of any one or combination of the following: (A) design, (B) 

development, or (C) operation;

(2) to include the solicitation notification contained in this contract in every solicitation and resulting 

subcontract and in every subcontract awarded without a solicitation when the statement of work in the 

proposed subcontract requires the design, development, or operation of a system of records on individuals 

to accomplish an agency function; and

(3) to include this clause, including this paragraph (3), in all subcontracts awarded pursuant to this contract 

which require the design, development, or operation of such a system of records.

(b) In the event of violations of the Act, a civil action may be brought against the agency involved where the 

violation concerns the design, development, or operation of a system of records on individuals to accomplish 

an agency function, and criminal penalties may be imposed upon the officers or employees of the agency where 

the violation concerns the operation of a system of records on individuals to accomplish an agency function. 

For purposes of the Act when the contract is for the operation of a system of records on individuals to 

accomplish an agency function, the contractor and any employee of the contractor is considered to be an 

employee of the agency.

(c) The terms used in this clause have the following meanings:

(1) “Operation of a system of records” means performance of any of the activities associated with maintaining 

the system of records including the collection, use, and dissemination of records.

(2) “Record” means any item, collection or grouping of information about an individual that is maintained by 

an agency, including, but not limited to, his education, financial transactions, medical history, and criminal 

or employment history and that contains his name, or the identifying number, symbol, or other identifying 

particular assigned to the individual, such as a finger or voice print or a photograph.

(3) “System of records” on individuals means a group of any records under the control of any agency from 

which information is retrieved by the name of the individual or by some identifying number, symbol, or 

other identifying particular assigned to the individual;

ADDITIONAL EMAILED BID SUBMISSION PROVISIONS: The Government will not be responsible for any 

failure attributable to the transmission or receipt of the emailed bid including, but not limited to, the following:

1. Illegibility of bid.

2. Emails over 75 MB may not be received by GPO due to size limitations for receiving emails.

3. The bidder’s email provider may have different size limitations for sending email; however, bidders are 

advised not to exceed GPO’s stated limit.

4. When the email bid is received by GPO, it will remain unopened until the specified bid opening time. 

Government personnel will not validate receipt of the emailed bid prior to bid opening. GPO will use the 

prevailing time (specified as the local time zone) and the exact time that the email is received by GPO’s 

email server as the official time stamp for bid receipt at the specified location.
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PAYMENT: Submitting invoices for payment via the GPO fax gateway (if no samples are required) utilizing the 

GPO barcode coversheet program application is the most efficient method of receiving payment. Instruction for 

using this method can be found at the following web address:

http://winapps.access.gpo.gov/fms/vouchers/barcode/instructions.html. 

Invoices may also be mailed to: U.S. Government Publishing Office, Office of Financial Management, Attn: 

Comptroller, Stop: FMCE, Washington, DC 20401. 

For more information about the billing process, refer to the General Information of the Office of Finance web page 

located at: https://www.gpo.gov/how-to-work-with-us/vendors/how-to-get-paid

Contractor’s billing invoice must be itemized in accordance with the items in the “SCHEDULE OF PRICES.” 
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SECTION 2. – SPECIFICATIONS

SCOPE: These specifications cover the production of mailing packages from four (4) workloads consisting of 

English only and Bilingual (Spanish/English) personalized notices, business reply mail (BRM) envelopes, courtesy 

reply mail (CRM) envelopes, and mail-out envelopes, requiring such operations as: the receipt and processing of 

transmitted data; redevelopment of Advanced Function Presentation (AFP) (Fully Composed or Mixed Mode)

printing platform; composition; printing and imaging; binding; construction; inserting and packing; manifesting 

and/or metering; and, distribution.

TITLE: EAD, YCER, BEVE, and eRPA Notices.

The four (4) workloads are as follows:

1. EAD (Earnings After Death)

2. YCER (Young Children’s Earnings)

3. BEVE (Benefit Verification)

4. eRPA (Electronic Representative Payee Accounting System)

Future Workloads (during term of contract): During the term of this contract the Government expects to develop 

new notice workloads with the same requirements as the four (4) notice workloads described by these specifications. 

All terms and conditions in this specification will apply to these future notice workloads. It is estimated that 

approximately one (1) to three (3) new notice workloads may be added during the term of this contract.

FREQUENCY OF ORDERS: 

EAD and YCER Workloads: Electronic task order will be issued weekly (the morning after the transmission).

BEVE and eRPA Workloads: Electronic task order will be issued daily (Tuesday through Saturday).

Task orders will be issued the morning after the transmission with the volumes for notices, leaves, pages, and any 

insert required. 

A print order will be issued weekly.

Separate print orders will be issued for the composition and proofs and for the preproduction validation tests.

QUANTITY: The combined total for EAD, YCER, BEVE, and eRPA notices is approximately 7,538,240 per year. 

The Government reserves the right to increase or decrease by up to 25% of the total number of notices ordered 

annually.

NUMBER OF PAGES:

Notices: 1 to 20 printed pages (1 to 10 leaves) per notice.

All Envelopes: Face and back (after manufacturing).

TRIM SIZES:

EAD and YCER:

Notices: 8-1/2 x 11”.

White CRM Envelope: 5-3/4 x 8-3/4”, plus flap.

Window Mail-Out Envelope: 6-1/8 x 9-1/2”, plus flap.
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BEVE:

Notices: 8-1/2 x 11”.

Window Mail-Out Envelope: 4-1/8 x 9-1/2”, plus flap.

eRPA:

Notices: 8-1/2 x 11”.

White BRM Envelope: 5-3/4 x 8-3/4”, plus flap.

Green BRM Envelope: 3-7/8 x 8-7/8”, plus flap.

Window Mail-Out Envelope: 6-1/8 x 9-1/2”, plus flap.

MAKE-UP OF MAILERS: A record will be transmitted for each mailing address. The records will contain all the 

data relevant for the mailing of an associated mail piece. Unique alpha/numeric identifiers will be part of the record 

to ensure accuracy in the insertion process. All files transmitted by SSA will be physical sequential Advanced 

Function Presentation (Fully Composed or Mixed Mode) printing platform. Any alteration of the notice content in 

the file is not permitted.

FOR QUALITY CONTROL AND AUDITING PURPOSES: The contractor must not merge file dates and 

mailers during processing, printing, and mailing. Any alteration of the notice content in the file is not permitted.

The figures indicated below are estimates that are based on historical data of past production runs. The figures show 

the minimum and maximum quantities required daily, as well as the number of printed pages in a notice (notices 

are duplex printed and one-side only when an odd page is required), inserts (items that are to be inserted into the 

mail-out envelope along with the notice), and how the notice is to be folded. Exact quantities will not be known 

until each run is electronically transmitted to the contractor. NO SHORTAGES WILL BE ALLOWED.

MAKE-UP OF NOTICE MAILERS:

EAD: The EAD mailers are divided into three (3) notice categories by file names. All EAD notices consist of 1 or 

2 pages and a mail-out envelope, and may require a White CRM envelope.

Mailer 1 (EADER):

Transmission Minimum: 0

Transmission Maximum: 28,270

Leaves: 1

Printed Pages: 2

Personalized Notice (Form SSA-L4112-C1)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: White CRM Envelope

Folding: Bifold

Mailer 2 (EADEE):

Transmission Minimum: 0

Transmission Maximum: 45,597

Leaves: 1

Printed Pages: 1

Personalized Notice (Form SSA-L3044-C1)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: None

Folding: Bifold
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Mailer 3 (EADSE):

Transmission Minimum: 0

Transmission Maximum: 26

Leaves: 1

Printed Pages: 1

Personalized Notice (Form SSA-L3400-C1)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: None

Folding: Bifold

YCER: The YCER mailers are divided into three notice categories by file names. ALL YCER notices consist of 

1 or 2 pages and a mail-out envelope, and may require a White CRM envelope.

Mailer 4 (YCERER):

Transmission Minimum: 0

Transmission Maximum: 5,016

Leaves: 1

Printed Pages: 2

Personalized Notice (Form SSA-L3231-C1)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: White CRM Envelopes

Folding: Bifold

Mailer 5 (YCEREE):

Transmission Minimum: 0

Transmission Maximum: 9,239

Leaves: 1

Printed Pages: 1 or 2

Personalized Notice (Form SSA-L3232-C1)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: None

Folding: Bifold

Mailer 6 (YCERSE):

Transmission Minimum: 0

Transmission Maximum: 189

Leaves: 1

Printed Pages: 1

Personalized Notice (Form SSA-L3241-C1)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: None

Folding: Bifold

BEVE: The BEVE mailer is one notice consisting of 1 to 3 pages and a mail-out envelope (P.O. Box 31500).

Mailer 7

Transmission Minimum: 15,000

Transmission Maximum: 40,000
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Leaves: 1 or 2

Printed Pages: 1 to 3

Personalized Notice (No form number)

Mail-out Envelope (4-1/8 x 9-1/2”)

Inserts: None

Folding: Trifold

eRPA: 

The eRPA mailer consists of four (4) notice types transmitted in one file. These personalized notices are English 

ONLY (Mailer 8) and Bilingual (Spanish/English) (Mailer 9) and range from 1 to 20 pages (1 to 10 leaves). An 

occasional mailer (less than 1%) may exceed these leaf counts.

All eRPA notices require a mail-out envelope. Form SSA-L732 requires a White BRM envelope; Form SSAL732-

OP1 requires both a White and a Green BRM envelope.

The Redirect Notices and Call-In Notices DO NOT REQUIRE any BRM envelopes.

Mailer 8:

Transmission Minimum: 0

Transmission Maximum: 12,756

Leaves: 1 to 10

Printed Pages: 1 to 20

Personalized English Notice (Form SSA-L732)

Personalized English Notice (Form SSA-L732-OP1)*

Redirect English Notice (No Form Number/No Inserts) 

Call-In English Notice (No Form Number/No Inserts)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: White BRM Envelope (Form SSA-L732/ Form SSA-L732-OP1)

Green BRM Envelope (Form SSA-L732-OP1 only)

Folding: Bifold

Mailer 9:

Transmission Minimum: 0

Transmission Maximum: 221

Leaves: 1 to 10

Printed Pages: 1 to 20

Personalized Bilingual (Spanish/English) Notice (Form SSA-L732)

Personalized Bilingual (Spanish/English) Notice (Form SSA-L732-OP1)*

Call-In Bilingual (Spanish/English) Notice (No Form Number/No Inserts)

Mail-out Envelope (6-1/8 x 9-1/2”)

Inserts: White BRM Envelope (Form SSA-L732/ Form SSA-L732-OP1)

Green BRM Envelope (Form SSA-L732-OP1 only)

Folding: Bifold

New Notice Workloads:

Mailers 10, 11, and 12:

Minimum: 0

Maximum: 35,000
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Leaves: 1 to 10

Printed Pages: 1 to 20

English Notices or Bilingual (English/Spanish) Notices

Mail-out Envelope (4-1/8 x 9-1/2” or 6-1/8 x 9-1/2”)

Inserts: Variable

When required, Reply Envelope

Folding: Trifold or Bi-fold

PAYMENT STUB NOTE:

*Form SSA-L732-OP1 Payment Stub Requirement: The next to the last leaf of the English ONLY Notice and the 

next to the last leaf of both the Spanish and the English Notices of the Bilingual Notice require a full horizontal 

micro-perforation, 3-1/2” up from bottom of page, along the entire 8-1/2” length dimension. However, the microperforated payment stub will not be on the same page for every notice because these notices have variable page 

counts.) The contractor will be required to identify the payment stub page(s) (English or Spanish/English) requiring 

perforation.

NOTE: The eRPA bilingual notices require insertion of both a Spanish and English notice in one envelope. On 

occasion, an eRPA mailer (10 leaves maximum) will exceed one ounce in weight.

The payment stub page (full 8-1/2 x 11” leaf) is part of the notice itself and will be electronically transmitted.

FILE NAME MAILER DATA SET NAME

EAD Mailer 1 EERAFP.M10orderid.Ryymmdd

Mailer 2 EEEAFP.M20orderid.Ryymmdd

Mailer 3 ESEAFP.M30orderid.Ryymmdd

YCER Mailer 4 YERAFP.M40orderid.Ryymmdd

Mailer 5 YEEAFP.M50orderid.Ryymmdd

Mailer 6 YSEAFP.M60orderid.Ryymmdd

BEVE Mailer 7 BEVAFP.M70orderid.Ryymmdd

eRPA Mailer 8 (English) RPAAFP.M8orderid.Ryymmdd

Mailer 9 (Spanish/English) RPAAFP.M9orderid.Ryymmdd

Vendor – is the identifier. This is assigned when the transmission connectivity is installed.

aaaaa – is the order ID assigned by Control M at run time. This is used to build the unique identifier for the file.

yymmdd – is the year, month, and day of the file being transmitted. This is also referred to as the run date.

NEW NOTICES: The file names/dataset names for each new notice workload will be supplied to the contractor as 

they are developed.

CRM ENVELOPES:

EAD:

White CRM Envelopes (5-3/4 x 8-3/4”) 90-Calendar Day Estimated Volumes

Wilkes Barre Direct Operations Center

P.O. Box 80

Wilkes Barre, PA 18767-0080 27,883
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YCER:

White CRM Envelopes (5-3/4 x 8-3/4”) 90-Calendar Day Estimated Volumes

Wilkes Barre Direct Operations Center

P.O. Box 40

Wilkes Barre, PA 18767-0040 4,940

BRM ENVELOPES:

eRPA:

White BRM Envelopes (5-3/4 x 8-3/4”) 90-Calendar Day Estimated Volumes

Wilkes Barre Direct Operations Center

P.O. Box 8500

Wilkes Barre, PA 18767-9998 204,223

Green BRM Envelopes (3-7/8 x 8-7/8”) 90-Calendar Day Estimated Volumes

Mid-Atlantic Program Service Center

P.O. Box 3430

Philadelphia, PA 19122-9985 3,712

NOTE: The contractor must submit billing invoice for all surplus inventory within 90 calendar days of completion 

of the contract in order to receive payment.

MAIL-OUT ENVELOPES:

Bifold Size: 6-1/8 x 9-1/2” 90-Calendar Day Estimated Volumes

EAD: Wilkes Barre Direct Operations Center

P.O. Box 80

Wilkes Barre, PA 18767-0080 27,883

YCER: Wilkes Barre Direct Operations Center

P.O. Box 40

Wilkes Barre, PA 18767-0040 4,940

Trifold Size: 4-1/8 x 9-1/2” 90-Calendar Day Estimated Volumes

BEVE: Northeaster Program Service Center

P.O. Box 315100

Jamaica, NY 11431-4089 1,625,000

Bifold Size: 6-1/8 x 9-1/2” 90-Calendar Day Estimated Volumes

eRPA: Wilkes Barre Direct Operations Center

P.O. Box 8500

Wilkes Barre, PA 18767-8500 206,884
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GOVERNMENT TO FURNISH:

Manuscript copy for eight (8) envelopes, as follows:

 three (3) mail-out envelopes (6-1/8 x 9-1/2”)

 one (1) mail-out envelope (4-1/8 x 9-1/2”)

 two (2) White CRM envelopes (5-3/4 x 8-3/4”)

 one (1) White BRM envelope (5-3/4 x 8-3/4”)

 one (1) Green BRM envelopes (3-7/8 x 8-7/8”)

Camera copy for the Facing Identification Mark (FIM) and ZIP+4 Intelligent Mail Barcode (IMB) for BRM and 

CRM envelopes. 

At the Government’s option, camera copy or electronic files (PostScript format) for the recycled paper logo and 

legend may be furnished for the notices and envelopes. Electronic files will be furnished via email.

PS Form 3615, Mailing Permit Application and Customer Profile Postage and Fees Paid Mailing Indicia.

A data connection between the contractor’s specified location and the nearest available SSA network interface 

location or SSA’s National Computer Center.

Identification markings such as register marks, commercial identification marks of any kind, etc., except GPO 

imprint, form number, and revision date, carried in the furnished electronic files or furnished copy, must not print 

on the finished product.

EXHIBITS:

Exhibit A: Contractor Personnel Security Certification (Form SSA-301)

Exhibit B: SSA External Service Provider Additional Security Requirements

Exhibit C: Security Assessment Report (SAR) Template

Exhibit D: Risk Assessment Report (RAR) Template

Exhibit E: System Security Plan (SSP) Template

Exhibit F: Declaration for Federal Employment (Optional Form 306)

Exhibit G: Questionnaire for Public Trust Positions (Standard Form (SF) 85P)

Exhibit H: Fingerprint Card (FD-258)

Exhibit I: Contractor Personnel Rollover Request Form

Exhibit J: System Plan

Exhibit K: Key SSA and GPO Personnel Contact Information

Exhibit L: Audit and Summary Reports

Exhibit M: 3PAO-Obligations-and-Performance-Guide v1.0

Exhibit N: Perforated Payment Stub

Exhibit O: Mail Run Data (MRD) File 

Exhibit P: Postage Meter Activity Log

ELECTRONIC FILES: 

All files will be electronically transmitted to the contractor and contain a complete record for each notice. Any 

programming or other format changes necessitated due to the contractor’s method of production will be the full 

responsibility of the contractor and must be completed prior to SSA’s validation. All files transmitted by SSA will 

be physical sequential Advanced Function Presentation (Fully Composed or Mixed Mode). Any alteration of the 

notice content in the file is not permitted. The contractor must not merge file dates and mailers (if applicable) 

during processing, printing/imaging, and mailing.
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The contractor must not compress files in processing data for this contract.

The contractor will receive three (3) files for each print file: the Advanced Function Presentation (Fully Composed 

or Mixed Mode) printing platform, the Mail Run Data (MRD) file, and the Banner (BNR) file. The notice files for 

printing are formatted for the AFP printing platform in duplex printing (face and back). For proper processing of 

AFP, SSA supplies resources used for printing notices in AFP format. The MRD file will contain all information 

relevant to each mail piece. This would include, for each mail piece, the unique alpha/numeric identifier (the 

sequential number of the document), the number of sheets of paper, required inserts and insertion bin selection, 

recipient’s address, return address, USPS IMB, the appropriate signature, and any required inserts. The BNR file 

contains information for setting up the intelligent inserters such as file totals, number of mail packets, and bin set 

up for those items being included in the mail packets and the total required in each bin.

The contractor will receive an electronic daily task order for BEVE and eRPA and weekly task order for EAD and 

YCER in the morning after transmission with the volumes for notices, leaves, pages, and any inserts required.

Whenever the contractor makes a change in the programming, the contractor will be required to execute a selfcertification statement specifying the date of the last programming change. Prior notification of a programming 

change is required in addition to the self-certification statement for the contractor to schedule a validation test with 

SSA.

Prior to the commencement of production of orders placed under this contract, the Government will furnish 

preproduction electronic test files shortly after the postaward conference that are to be used in performing the 

various preproduction validation tests. Files will be in print image format and in ZIP Code sequence. Contractor 

will be required to sort files as necessary to obtain maximum USPS Postal discounts (i.e., leaf counts or mail 

weight).

Dataset names for the items listed below will be provided at the postaward conference or shortly thereafter:

Print Resource Library (AFP) for Transmission or email: AFP resources include page and form definitions, fonts, 

page segments, and overlays (if applicable) for page formatting.

Preproduction Press and Mail Run Test Files for Transmission: An AFP formatted print file with the 

corresponding MRD file and BNR file will be provided for each workload in the quantities required.

Revised Resource Library (AFP) for Transmission or Email (when applicable): AFP print resources, overlays, 

page segments, and non-standard fonts provided shortly after the postaward conference may change during the term 

of the contract, in which case a revised AFP resource file will be electronically transmitted to the contractor as a 

replacement.

PRINTER RESOURCES (AFP): SSA will provide the AFP (Fully Composed or Mixed Mode) resources for 

notice workloads. These resources will be provided to the contractor via transmission or email shortly after the 

postaward conference. SSA will also provide test files for transmission with samples of each workload to enable 

the start of the validation process.

The test files are to be used in the preproduction press and mail run test (see “PREPRODUCTION TESTS, 

Preproduction Press and Mail Run Test”).

These compliances relate solely to interpreting and printing files to be provided to the contractor by SSA, to ensure

that the contractor is able to print the files as provided without alteration of any kind on the part of SSA. It is solely

the contractor’s responsibility to re-develop/re-program the AFP (Fully Composed or Mixed Mode) resources and 

MRD file to ensure proper printing and inserting in their environment.
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NOTE: The AFP (Fully Composed or Mixed Mode) file contains all AFP resources, except licensed fonts, required 

to print this file.

The contractor will be responsible for maintaining the Advanced Function Presentation (AFP; Fully Composed or 

Mixed Mode) resources on each system that processes SSA’s notices. SSA will provide updated resources 

electronically, as necessary.

When the contractor receives an update to the printer resources, the contractor will be required to provide SSA with 

75 sample documents representative of the workload involved, from the test files, within five (5) workdays for 

review (see below). The contractor is to continue using existing resources while the samples are reviewed. Once the 

samples are approved, the contractor will be advised when to implement the new printer resource files into live 

production. Whenever testing is required, the contractor will be responsible for performing the test on each printer 

that processes SSA’s notices.

The sample documents must be submitted as follows:

EAD and YCER Workloads:

 Submit 25 printed samples each to: SSA, Printing Management Branch (see Exhibit K).

 Submit 50 printed samples each to: SSA, Wilkes-Barre Direct Operations Center, Attn: EAD/YCER 

Analyst, Room 341, 1150 East Mountain Drive, Wilkes-Barre, PA 18702-7997. 

eRPA Workloads:

 Submit 25 printed samples to: SSA, Printing Management Branch (see Exhibit K).

 Submit 50 printed samples to: SSA, Wilkes-Barre Direct Operations Center, Attn: eRPA Analyst, Room 

341, 1150 East Mountain Drive, Wilkes-Barre, PA 18702-7997.

SSA’s Printing Management (DMIM) will notify the contractor of these changes as soon as possible. Upon 

successful testing of the changes, SSA must transmit the new print resources (if necessary) and resume transmission 

of the notice file(s).

During the term of the contract, the Government anticipates making programmatic changes to the daily notices as 

warranted (e.g., changes in language, format, appearance, etc.). When changes occur, SSA will perform testing of 

the workload in their print facility for a short period of time. (The “Dark Days” for the contractor should only last 

a few days.) Only those affected workloads (indicated by filename) will be held back at SSA for validation and 

production. For example, if the BEVE notice workload were to be changed, SSA would test and print those notices 

only. The contractor would continue to print and mail the eRPA notice workloads. Upon successful testing of the 

changes by SSA, SSA will then transmit the new print resources (if necessary) and resume transmission of the notice 

file(s).

CONTRACTOR TO FURNISH: All materials and operations, other than those listed under “GOVERNMENT 

TO FURNISH,” necessary to produce the products in accordance with these specifications.

Contractor must have programmer(s) capable of handling AFP resources.

Secure File Transfer Protocols (SFTP) Site: Contractor is required to set up, establish, and maintain a Secure File 

Transfer Protocol site that multiple users at SSA can access for passing PDF notice validation samples containing 

PII to SSA and back. Contractor cannot send PDF notices with PII via email. 
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TRANSMISSIONS: Upon award of this contract, the Government will determine the connectivity method between 

SSA and the contractor. Internet Protocol (IP) will be the connection protocol for the transmissions. The 

connectivity method will be through the Internet using an encrypted VPN tunnel or the Government will place an 

order for a dedicated circuit under GSA’s Networx contract to be installed within 60 to 90 calendar days between 

the contractor’s location and SSA’s network interface location. Either connectivity method will be encrypted with 

the AES256 encryption algorithm. For the Internet option to be used, the contractor must have an Internet ready 

VPN IPSec capable hardware device. The Government will not be responsible for any cost associated with the VPN 

Internet connection that the contractor may incur. The connection method is at the sole discretion of the 

Government. The cost of the dedicated circuit connection will be borne by the Government. 

The Government will not be responsible for installation delays of data connections due to any external influences 

such as employee strikes, weather, supplies, etc., which conditions are beyond the control of the Government.

If a dedicated circuit is deemed necessary, SSA will provide the dedicated data connection, including a router and 

firewall, at the contractor’s specified locations. The contractor must provide adequate rack space for securing the 

router and firewall; the contractor must provide a dedicated analog dial-up line within eight (8) feet of the router. 

This dedicated analog dialup line will be used for router management and access for troubleshooting. The line must 

be in place and active prior to the installation of the circuit/router.

Upon contract award, the contractor must provide a complete delivery address with nearest cross-street, contact 

name, and phone number for installation of data transmission services and equipment. The contractor’s contact 

person must be available for delivery of services at the specified location. The Government shall not be responsible 

for incorrect or lack of address information nor for non-availability of contact persons at the delivery site.

It is the contractor’s responsibility to notify SSA when systems or data line problems arise and transmission(s) 

cannot take place. SSA’s first point of contact for systems or data line problems must be the HELP DESK at 877-

697-4978.

FILE TRANSFER MANAGEMENT SYSTEM (FTMS) REQUIREMENTS: The contractor must provide the 

capability to interface with SSA’s National FTMS for electronic transmission of designated files from SSA to the 

production facility. SSA will provide the necessary data connection into the contractor’s location. At the discretion 

of SSA, the line speed may be either increased or decreased depending on utilization. The contractor must provide, 

at their expense, the equipment and operating software platform, and the file transfer software required at their 

location.

The contractor assumes all responsibility for configuration, maintenance, and troubleshooting of their equipment 

and software. 

SSA utilizes, and the contractor must provide compatibility with, TIBCO’s Managed File Transfer Platform Server. 

The personal computers/servers must have the capability to run Managed File Transfer software with encryption 

enabled using IP protocols on Windows, UNIX (i.e., IBM’s AIX, SUN or HP), or z/OS platforms. 

SSA will not permit any private class A, B, or C IP addresses, i.e., 10.xxx.xxx.xxx type IP addresses, from external 

users on its network. At connection time to SSA, the contractor will be provided a suitable IP address for access to 

SSA’s network via a firewall. SSA will provide the necessary subnet(s) for connection at the remote site. The 

contractor will be responsible for its own name/address translation to fulfill the intended purpose of data transfers. 

SSA will provide Managed File Transfer node information to the contractor as required to accomplish file transfers. 

The contractor may determine the media type on which files from SSA will be received, to the extent that operator 

intervention (e.g., a tape mount) is not required at SSA or the contractor’s production facility. Simultaneous multiple 

transmission sessions must be possible on the contractor’s equipment. All files transmitted by SSA will be written 

as Physical Sequential or “flat” files at the contractor’s location and will be distinguished with a “run date” in the 

contractor’s file name. 
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Virtual Storage Access Method files and Generation Data Groups, supported by IBM/MVS or IBM z/OS operating 

systems, are not permitted under this contract. The contractor’s storage format must not preclude the availability of 

the Managed File Transfer Platform Server software’s Checkpoint/Restart feature. 

The contractor may not use VM/VSE/ESA on a mainframe system as this hinders automated file transmission. 

The contractor’s FTMS software must be operational for the receipt of data files 24 hours a day, seven (7) days a 

week, unless otherwise specified by the Government. The communications protocol between SSA and the 

contractor must be the Internet Protocol (IP). The contractor must specify the type Local Area Network (LAN) 

connection that will be used at the location where the SSA connection is to be installed. The contractor is responsible 

for providing complete hardware and software compatibility with SSA’s existing network. Production file transfers 

will be established according to SSA’s standard procedures for transmission control, dataset naming, and resource 

security. The contractor’s file management system must accommodate multiple file transmission sessions without 

intervention at either end. The contractor must have sufficient capacity to support the number of concurrent 

transmission file sessions as directed by SSA. 

The above will apply regardless of the number of workloads transmitted to the contractor daily. If the contractor is 

awarded multiple SSA notice workloads, there must be sufficient capacity at the contractor’s production facility to 

accept transmission of all files according to their schedules. 

Transmission of production files must be the standard, automated technique. In the event that the transmission 

network is unavailable for a time period deemed critical by the Government, the files may (at the Government’s 

option) be processed at the SSA print/mail facility. 

It is the contractor’s responsibility to notify SSA when systems or connection problems arise and transmission 

cannot take place. SSA’s first point of contact for systems or connectivity problems is the HELP DESK at (877) 

697-4889. 

All data provided by the Government or duplicates made by the contractor or their representatives and any resultant 

printouts must be accounted for and kept under strict security to prevent their release to any unauthorized persons. 

Data may not be duplicated in whole or in part for any other purpose than to create material to be used in the 

performance of this contract. 

Any duplicate data and any resultant printouts must be destroyed by the contractor. Data provided to the contractor 

must be retained for 21 workdays after mailing. 

PREPRODUCTION TESTS: Prior to the commencement of production on the contract, the contractor will be 

required to demonstrate their ability to perform the contract requirements. The Government will furnish electronic 

test files at the postaward conference, or shortly thereafter, to be used in performing a Transmission Test, 

Preproduction Validation Test, a Payment Stub Validation Test, a Preproduction Press and Mail Run Test, and a 

Systems Change/Signature Change/New Notice Files Validation Test.

Failure of the contractor to perform any of the below tests satisfactorily may be cause for default. The Government 

reserves the right to waive the requirements of any of these tests. The contractor will be notified at the postaward 

conference if any test(s) is to be waived.

The contractor will be required to have all material necessary to perform these tests. All composition and proofing 

must be completed prior to these tests, as applicable for each test (see “COMPOSITION” and “PROOFS” specified 

herein). 

Government representatives will witness all phases of the Preproduction Press and Mail Run Test. 
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When Preproduction Validation and/or Validation Tests are required, the Government will include them on a print 

order.

The contractor will be required to perform the following tests:

Transmission Test: Within one (1) week of the data connection being installed, the contractor will be required to 

receive within one (1) workday approximately 141,292 notices. Notices will be either 1 or 2 printed pages. 

The contractor will be required to perform a record count verification (broken down by data set name) the same 

workday of the complete transmission of the test files and perform the Coding Accuracy Support System (CASS) 

certifications the same workday as receipt of the complete transmission of all notice test files. Additionally, the 

contractor must provide a timeline showing how long it took to receive the test files.

The contractor will be required to run the test file through their CASS certification system to ensure that there are 

no problems with the reading of the address file. Contractor will be required to report back to SSA with the test 

results.

The contractor will be required to copy the files to their own system and provide to the SSA, Printing Management 

Branch (see Exhibit K) the exact counts received (broken down by data set name) before proceeding with any other 

processing. 

SSA will respond within one (1) workday of receipt thereof.

When the record count verification and CASS certification have been successfully completed, the contractor will 

be required to process the test files and provide SSA, within two (2) workdays, 30 sample notices from each mailer 

from the transmission test files for EAD, YCER, BEVE, and eRPA workloads. 

Contractor to submit these test samples to: SSA, Printing Management Branch (see Exhibit K).

The Government will approve, conditionally approve, or disapprove the samples from the Transmission Test within 

five (5) workdays of receipt thereof. Approval or conditional approval must not relieve the contractor from 

complying with the specifications and all other terms and conditions of the contract. A conditional approval must 

state any further action required by the contractor. A notice of disapproval must state the reasons thereof.

NOTE: If errors are found, additional samples will be required until such time as the validation produces no errors.

Preproduction Validation Test: Within five (5) workdays of receipt of test files and prior to the Preproduction 

Press and Mail Run Test, the contractor will be required to provide SSA, no less than 225 total samples of the 

completed product as specified below. 

Notices must be complete and include all variable data from the Government furnished files and inserted into mailout envelopes. Seal envelopes. 

The Validation Test Samples are to be shipped in the following manner: 

 Submit 25 printed EAD samples, 25 printed YCER samples, and 25 printed eRPA samples to: SSA, Printing 

Management Branch (see Exhibit K).

 Submit 50 printed EAD samples and 50 printed YCER samples to: SSA, Wilkes-Barre Direct Operations 

Center, Attn: EAD/YCER Analyst, Room 341, 1150 East Mountain Drive, Wilkes Barre, PA 18702-7997. 

 Submit 50 printed eRPA samples to: SSA, Wilkes-Barre Direct Operations Center, Attn: eRPA Analyst, 

Room 341, 1150 East Mountain Drive, Wilkes Barre, PA 18702-7997.
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The Government will approve, conditionally approve, or disapprove the preproduction validation test output within 

five (5) workdays of receipt thereof. Approval or conditional approval shall not relieve the contractor from 

complying with the specifications and all other terms and conditions of the contract. A conditional approval shall 

state any further action required by the contractor. A notice of disapproval shall state the reasons thereof.

If errors are found, additional samples of notices (as indicated above) will be required until such time as the 

validation produces no errors. All samples must be manufactured at the facilities and on the equipment in which the 

contract production quantities are to be manufactured.

If required due author’s alterations or contractor’s error, the contractor must submit revised samples within five (5) 

workdays of notification. The Government will approve, conditionally approve, or disapprove the preproduction 

validation test samples within three (3) workdays of receipt thereof. 

Payment Stub Validation Test (eRPA OP1 only): Within five (5) workdays of receipt of test files and prior to the 

Preproduction Press and Mail Run Test, the contractor will be required to provide 100 printed samples of Form 

SSA-L732-OP1 containing a payment stub for validation of the scanline. 

The micro-perforation on the payment stub page must be properly located and the payment stub must function 

properly when processed through the current high-speed scanning equipment owned by SSA. A form is a reject 

when its OCR print cannot be correctly deciphered on the first pass through the specified reading equipment. 

Contractor to submit samples as follows:

 Submit 50 printed samples to: SSA/Wilkes-Barre Direct Operations Center, Attn: Patrice Gallagher, Room 

341, 1150 East Mountain Drive, Wilkes Barre, PA 18702-7997.

 Submit 50 printed samples to: SSA, Printing Management Branch (Exhibit K).

The Government will approve, conditionally approve, or disapprove the preproduction validation test output within 

five (5) workdays of receipt thereof. Approval or conditional approval shall not relieve the contractor from 

complying with the specifications and all other terms and conditions of the contract. A conditional approval shall 

state any further action required by the contractor. A notice of disapproval shall state the reasons thereof.

Preproduction Press and Mail Run Test (24-Hour Test): Within five (5) workdays of receipt of test files and 

after the contractor receives the materials necessary to perform the test, the contractor will be required to 

demonstrate their ability to perform the contract requirements by performing a 24-hour preproduction press and 

mail run test utilizing the test files transmitted electronically.

The test shall occur during the regular work week of Monday through Friday (excluding Federal holidays).

The Government will issue a print order to the contractor for the Preproduction Press and Mail Run test. Upon 

successful completion of all test requirements, the contractor will be reimbursed for all applicable costs in 

accordance with the contractor’s submitted bid prices for the applicable line items in the “SCHEDULE OF 

PRICES.” If the contractor fails to meet all test requirements, they will not be reimbursed for any associated costs.

Contractor must perform the preproduction press and mail run tests in a continuous 24-hour period, as required,

that will prove to the Government representatives that the contractor can satisfactorily complete the requirements 

of this contract during live production.

The contractor will be required to have all composition, proofing, envelopes, scanning equipment, and reports for 

100% accountability of production and mailing completed, available, and ready for production prior to beginning 

the test. Notices are to be completed in accordance with contract requirements, inserted with inserts into 

envelopes, and prepared for mailing. 
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Contractor is required to provide the necessary audit and summary reports for 100% accountability of production 

and mailing within one (1) hour after the test is completed.

The contractor must produce a minimum of 56,945 notices.

During the 24-hour period, the contractor will be required to print and prepare for mailing the following quantities 

of EAD, YCER, BEVE, and eRPA notices:

EAD Mailer 1 (EADER) 4,039

Mailer 2 (EADEE 6,514

Mailer 3 (EADSE) 1

YCER Mailer 4 (YCERER) 717

Mailer 5 (YCEREE) 1,320

Mailer 6 (YCERSE) 27

BEVE Mailer 7 40,000

eRPA Mailer 8 (English) 4,253

Mailer 9 (Spanish/English) 74

TOTAL 56,945

The 24-hour period for the printing process will begin when an “O.K. to Print” is given by the Government 

representative on-site. 

The 24-hour period for the inserting and mailing process will begin within two (2) hours after the start of the 

printing to allow the contractor to print sufficient materials to begin the inserting process. 

The press run test run will incorporate all aspects of the program consisting of the receipt of transmitted data; the 

duplex printing and imaging (and simplex printing/imaging when an odd page is required) of notices; gathering; 

folding; inserting; manifesting; metering (if approved by SSA under certain circumstances); presorting; and 

preparing finished notices for delivery to the USPS. (This must include any and all reprints required during the 

course of this test.) To simulate actual production conditions, the product produced must be in accordance with all 

contract specifications and all USPS regulations. 

The contractor must perform the EAD, YCER, BEVE, and eRPA Notice Preproduction Press and Mail Run Test 

on the equipment they intend to use during live production and using their personnel. 

Samples of the preproduction press and mail run test will be brought back to SSA for validation. 

The Government will approve, conditionally approve, or disapprove the output within seven (7) workdays of 

receipt thereof. Approval or conditional approval must not relieve the contractor from complying with the 

specifications and all other terms and conditions of the contract. A conditional approval must state any further action 

required by the contractor. A notice of disapproval must state the reasons thereof.

Systems Change/Signature Change/New Notice Files Validation Test: When required, the Government will 

furnish test files for transmission that are to be used in performing a Systems Change/Signature Change/New Notice 

Files Validation Test. This test is required whenever SSA initiates a systems/programming change, a signature 

change, or when a new notice workload is developed. 

When required, contractor to submit samples within five (5) workdays of receipt of files.
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The contractor shall furnish 100 total samples of the notices with the changes (no envelopes or inserts), as follows:

 Submit 25 printed samples to: SSA, Printing Management Branch (see Exhibit K).

 Submit 25 printed EAD samples and 25 printed YCER samples to: SSA, Wilkes-Barre Direct Operations 

Center, Attn: EAD/YCER Analyst, Room 341, 1150 East Mountain Drive, Wilkes Barre, PA 18702-7997.

 Submit 25 printed eRPA samples to: SSA, Wilkes-Barre Direct Operations Center, Attn: eRPA Analyst, 

Room 341, 1150 East Mountain Drive, Wilkes Barre, PA 18702-7997.

The Government will approve, conditionally approve or disapprove the samples within seven (7) workdays of 

receipt thereof. Approval or conditional approval must not relieve the contractor from complying with the 

specifications and all other terms and conditions of the contract. A conditional approval must state any further action 

required by the contractor. A notice of disapproval must state the reasons thereof.

The Systems Change/Signature Change/New Notice Files Validation Test must occur without a break in production 

of daily notices. The Government will inform the contractor in advance when the regular daily transmissions will 

contain the systems changes.

COMPOSITION: Contractor will be required to set type for approximately 6 to 9 lines of type for eight (8)

envelopes. Helvetica or similar typeface will be utilized.

Century Schoolbook or equivalent fonts (Sonoran Serif) are to be used for producing the notices. 

SSA will not provide all required fonts to the contractor. Obtaining licensed fonts will be the responsibility of the 

contractor. SSA will provide the font part numbers to the contractor who will validate that they have the proper 

licenses for each required font.

No alternate typefaces will be allowed; however, manufacturers’ generic equivalents may be accepted (upon 

Government approval) for the above typefaces.

Intelligent Mail Barcode font will be required during the term of the contract. The contactor will be required to 

obtain the necessary font; SSA will not provide it with resources supplied.

PROOFS (Envelopes Only): One (1) press quality PDF soft proof (for content only) using the same Raster Image 

Processor (RIP) that will be used to produce the final printed product may be required. PDF proof will be evaluated 

for text flow, image position, and color breaks. Proof will not be used for color match. 

Proofs must show all margins and dimensions, indicate trim marks, and must show flap and window size/placement, 

as applicable.

SSA reserves the right to make changes to all proofs. The Government may require one or more sets of revised 

proofs before rendering an “O.K. to Print.”

If any contractor’s errors are serious enough in the opinion of GPO to require revised proofs, the revised proofs are 

to be provided at no additional expense to the Government. No extra time can be allowed for this reproofing 

operation; such operations must be accomplished within the original production schedule allotted in the 

specifications.

Contractor must not print prior to receiving and “O.K. to Print.”
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STOCK/PAPER: The specifications of all paper furnished must be in accordance with those listed herein or listed 

for the corresponding JCP Code numbers in the “Government Paper Specification Standards No. 13” dated 

September 2019.

Government Paper Specification Standards No. 13 – https://www.gpo.gov/docs/default-source/forms-andstandards-files-for-vendors/vol_13.pdf.

All paper used in each copy must be of a uniform shade.

Personalized Notices: White Optical Character Recognition (OCR) Bond, basis weight: 20 lbs. per 500 sheets, 17 

x 22”, equal to JCP Code O-25.

White BRM/CRM Envelopes (5-3/4 x 8-3/4”): White Writing Envelope, basis weight: 20 lbs. per 500 sheets, 17 x 

22”, equal to JCP Code V20. EXCEPTION: Stock must contain a minimum of 50 percent waste paper.

Green BRM Envelopes (3-7/8 x 8-7/8”): Green Writing Envelope (close match of Pantone 344), basis weight: 20 

lbs. per 500 sheets, 17 x 22”, equal to JCP Code V20. EXCEPTION: Stock must contain a minimum of 50 percent 

waste paper. NOTE: Surface Tinting of envelopes is not permitted.

Mail-Out Window Envelopes (4-1/8 x 9-1/2” and 6-1/8 x 9-1/2”): White Writing Envelope, basis weight: 24 lbs. 

per 500 sheets, 17 x 22”, equal to JCP Code V20; or at contractor’s option, White Uncoated Text, basis weight: 60 

lbs. per 500 sheets, 25 x 38”, equal to JCP Code A60.

PRINTING/IMAGING: Contractor will be required to convert furnished data from electronic transmission for 

either laser or ion deposition printing. All imaging/printing must have a minimum resolution of 600 x 600 dpi. 

NOTE: Inkjet printing is NOT allowed.

The Government reserves the right to make changes to the envelopes at any time during the term of the contract. 

Notification of a proposed change will be given with sufficient time for the contractor to allow for the change and 

submit proofs to the Government. Therefore, the contractor is not to preprint or maintain more than a 90-calendar 

day surplus/inventory of any of the components required on this contract. The Government will not be required to 

purchase from the contractor the surplus/inventory of any component remaining on hand in excess of what was 

authorized when an envelope or format/text change is implemented.

Notices: All notices are simplex (face only) and/or duplex (face and back, head-to-head), printed/imaged in black 

ink. Notices can require a combination of simplex and duplex printing/imaging. Printing and imaging consist of 

text and line matter.

On the eRPA SSA-L732-OP1 Notices, leaves print both face only and face and back. The Verification Form, 

Payment Stub, and Privacy Act Statement portions each start printing on a face page. The Payment Stub and Privacy 

Act Statements are one page each and print face only.

The eRPA notices contain client completed notices that are read by OCR equipment. The notices (front and back) 

will be read by a Kodak document Scanner 9500, 9520, 1840, or other high-speed scanner. The format for these 

notices will be incorporated in the body of the notice and must be printed as specified below to be scanned.

For the eRPA only, the alpha-numeric scan line must be printed using the OCR A font. The OCR printing must read 

continuously on an Integrated Image Based Data Capture System (IIBDCS).

ANSI X3.17 “Character Set for Optical Character Recognition (OCR A)” must apply to these specifications. The 

revisions of this standard which are effective as of the date of this contract are those which must apply.
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All Envelopes: Envelopes print face and back (after manufacture) in black ink. Printing must be in accordance 

with the requirements for the style envelope ordered. All printing must comply with all applicable U.S. Postal 

Service regulations. The envelope must accept printing without feathering or penetrating to the reverse side.

CRM Envelopes: Face of envelope to be in COURTESY REPLY FORMAT. Print FIMs and barcodes using the 

furnished camera copy. The FIMs and barcodes should be placed on the mailing piece according to the current U.S. 

Postal Service’s Domestic Mail Manual, “Barcoded Mail Pieces.”

BRM Envelopes: Face of envelope to be in BUSINESS REPLY MAIL FORMAT. Print FIMs and barcodes using 

the furnished camera copy. The FIMs and barcodes should be placed on the mailing piece according to the current 

U.S. Postal Service’s Domestic Mail Manual, “Barcoded Mail Pieces.”

NOTE: Inside of BRM envelopes must contain a clear area (no pantograph design), approximate 3-1/2 x 5/8” in 

size, behind the barcode to ensure the readability of barcode by the U.S. Postal Service equipment.

Mail-Out Envelopes: Mail-out envelopes require a security tint (lining is acceptable) printed on the inside (back -

before manufacture) in black ink. Contractor may use their own design but must guarantee that the product will 

ensure complete opacity and prevent show through of any material contained therein.

2-Dimensional Barcodes: A 2-D barcode of SSA’s choice (currently Data Matrix) must be imaged (minimum 600 x 

600 dpi) at the bottomleft on first two pages of EAD and YCER notices,

The Data Matrix barcode height and width is to be 5/8”, plus or minus 1/16”. NOTE: At least 1/8” margin (quiet

zone) is required top, bottom, left, and right of each barcode.

Data columns are to be preceded and followed by the standard Data Matrix start/stop patterns, left row indicator, and 

right row indicator. Additionally, a delimiter character (comma) must be inserted between each element. The 2-D 

barcodes will encode 114 characters including the following data elements:

In each print file on the page where a 2-D barcode should be printed, there is a 5 A NOOP record. It can be identified 

by the string “2DBCDATA” beginning in column 10. The data forthe barcode beginsin column 18 (for a total length 

of 114) and the fields are as follows:

Form Type length 4

Processing Year length 2

Page Number length 1

Sequence Number length 12 (left justified)

EIN length 9

Reported SSN length 9

Reported Name:

First Name length 11 (left justified) 

Middle Initial length 1

Last Name length 15 (left justified)

Earnings length 11 (left justified) 

Tax Year length 4

Employer Name length 35 (left justified)

NOTE: Personalized forms data to be included in the barcode will be contained in the SSA wire file transmissions.

The 2-D Data Matrix barcodes must be in accordance with the following ISO standards: ISO/IEC 16022 –

“International Symbology Specification, Data Matrix;” ISO/IEC 15418:1999 – “Symbol Data Format Semantics;” 

ISO/IEC 15434:1999 – “Symbol Data Format Syntax;” and ISO/IEC 15415 – “Print Quality Standard.”
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1-Dimensional Barcodes: A barcode of SSA’s choice (currently Code 39 - 3 of 9) must be imaged (minimum 600 

x 600 dpi) at the bottom left on each printed/imaged page on all eRPA SSA-L732 Notices, approximately 1/4 inch 

below the OCR scan line. The Code 39 (3 of 9) barcode height is to be 1/4” (plus or minus 1/16”), and the width 

is to be 5” (plus or minus 1/8”). NOTE: At least 1/8” margin (quiet zone) is required top, bottom, left, and right 

of each barcode.

The (3 of 9) barcodes must be in accordance with ANSI MH 10.8M-1983, unless otherwise specified.

NOTE: Personalized forms data to be included in the barcode will be contained in the SSA file transmissions.

All barcodes will be tested for scannability on the below specified equipment at the SSA, Wilkes-Barre Data 

Operations Center in Wilkes-Barre, PA.

The forms produced under these specifications must be guaranteed to function properly when processed through 

Kodak High Speed 9500, 9520, 1840 or other high-speed Scanners. SSA will be using Top Image Systems scanning 

software to process the images; OCR engines to do the ICR; and, an Inlite Engine to read the barcodes. Forms 

require precision spacing, printing, trimming and folding. OCR forms will be extracted from CRM/BRM using the 

following equipment: OPEX MPE 7.5 Multiple Purpose Extractor.

RECYCLED PAPER LOGO: If recycled paper is used, the recycled paper logo and legend must be printed in 

black ink on the notices and envelopes. The recycled paper logo/legend must be digitized by the contractor and 

imaged in the bottom left corner of notices aligned with the contractor’s control number on the first page of each 

notice and imaged on the back of the envelopes.

PRESS SHEET INSPECTION: Final makeready press sheets may be inspected and approved at the contractor’s

plant for the purpose of establishing specified standards for use during the actual press run. Upon approval of

the sheets, contractor is charged with maintaining those standards throughout the press run (within QATAP

tolerances when applicable) and with discarding all makeready sheets that preceded approval. When a press sheet

inspection is required, it will be specified on the individual print order See GPO Publication 315.3 (Guidelines for 

Contractors Holding Press Sheet Inspections) issued January 2015. NOTE: A press sheet inspection is for the

purpose of setting specific standards that are to be maintained throughout the entire run. It does not constitute a

prior approval of the entire run.

Press sheets must contain control bars for each color of ink on the sheet. Control bars must be placed parallel to 

the press’s ink rollers. The control bars (such as BRUNNER, GATF, GRETAG, or RIT) must show areas 

consisting of 1/8 x 1/8” minimum solid color patches; tint patches of 25, 50, and 75%; dot gain scale; and gray 

balance patches for process color (if applicable). These areas must be repeated across the entire press sheet.

Viewing Light: Press sheets will be viewed under controlled conditions with 5000 degrees Kelvin overhead 

luminaries. The viewing conditions must conform to ISO 3664-2009; a viewing booth under controlled conditions 

with 5000 degrees Kelvin overhead luminaries with neutral gray surroundings must be provided.

NOTE: Before production begins on any new workloads, a press sheet inspection may be required at the 

contractor’s plant.

MARGINS: Margins will be as indicated on the print order, furnished copy, or furnished electronic file. 

NOTE: Notices must appear exactly as approved during validation. Absolutely no deviation will be accepted.
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BINDING:

Notices: Trim four sides. 

Payment Stub: For the eRPA notices, the next to the last leaf of the English ONLY Notice and the next to the last 

leaf of both the Spanish and the English Notices of the Bilingual Notice will contain a micro-perforated payment 

stub. However, the micro-perforation will not be on the same leaf for every notice because the notices have variable 

page counts. The contractor will be required to identify the payment stub page(s) requiring perforation and ensure 

that only these pages are perforated.

Perforation - It is critical that the micro-perforation on the payment stub page must be 3-1/2” (plus or minus 1/16”) 

from the bottom of the payment stub page and run along the entire 8-1/2” dimension (see Exhibit N).

CONSTRUCTION:

White CRM Envelopes (5-3/4 x 8-3/4”): Envelope must be open side, with gummed, fold-over flap for sealing and 

contain high-cut diagonal seams or double side seams, at contractor’s option. Flap depth is at the contractor’s option 

but must meet all USPS requirements. Flap must be coated with a suitable remoistenable glue that will securely 

seal the return envelope for mailing. Adhesive must not adhere to the contents of the envelope.

White BRM Envelope (5-3/4 x 8-3/4”): Envelope must be open side, with gummed, fold-over flap for sealing and 

contain high-cut diagonal seams or double side seams, at contractor’s option. Flap depth is at the contractor’s option 

but must meet all USPS requirements. Flap must be coated with a suitable remoistenable glue that will securely seal 

the return envelope for mailing. Adhesive must not adhere to the contents of the envelope.

Green BRM Envelope (3-7/8 x 8-7/8”): Envelope must be open side, with gummed, fold-over flap for sealing and 

contain high-cut diagonal or double side seams, at contractor’s option. Flap depth is at the contractor’s option but 

must meet all USPS requirements. Flap must be coated with suitable remoistenable glue that will securely seal the 

return envelope for mailing. Adhesive must not adhere to the contents of the envelope.

EAD and YCER Mail-Out Envelope (6-1/8 x 9-1/2”): Envelope must be open side, with gummed, fold-over flap 

for sealing and contain high-cut diagonal seams or double side seams, at contractor’s option. Flap depth is at the 

contractor’s option but must meet all USPS requirements. Flap must be coated with a suitable remoistenable glue 

that will securely seal the envelope without adhering to contents, not permit resealing of the envelope, and permit 

easy opening by the recipient.

BEVE Mail-Out Envelope (4-1/8 x 9-1/2”): Envelope must be open side, with gummed, fold-over flap for sealing 

and contain high-cut diagonal seams or double side seams, at contractor’s option. Flap depth must meet USPS 

standards and flap must be coated with a suitable remoistenable glue that will securely seal the envelope without 

adhering to contents, not permit resealing of the envelope, and permit easy opening by the recipient. 

Face of envelope to contain one die-cut address window (4-1/4 x 1-3/4” in size) with slightly rounded corners. Diecut window is to be located 1/2” from the bottom edge of the envelope and 3/4” from the left edge of the envelope 

(the long dimension of the window is to be parallel to the long dimension of the envelope). Contractor has the option 

to adjust the size of the window opening (subject to Government approval), providing the visibility of the computergenerated mailing address and barcode on the notice is not obscured, and other extraneous information is not visible 

when material is inserted into the envelope. 

Window is to be covered with a suitable, low-gloss, transparent poly-type material that must be clear of smudges, 

lines, and distortions. Poly-type material must be securely affixed to the inside of the envelope so as not to interfere 

with insertion of contents. Window material must meet the current U.S. Postal Service’s readability 

standards/requirements.
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eRPA Mail-Out Envelope (6-1/8 x 9-1/2”): Envelope must be open side, with gummed, fold-over flap for sealing 

and contain high-cut diagonal seams. Flap depth must meet USPS standards and flap must be coated with a suitable 

remoistenable glue that will securely seal the envelope without adhering to contents, not permit resealing of the 

envelope, and permit easy opening by the recipient. 

Face of envelope to contain one die-cut address window (4-1/4 x 1-1/2” in size) with slightly rounded corners. Diecut window is to be located 2” from the bottom edge of the envelope and 3/4” from the left edge of the envelope 

(the long dimension of the window is to be parallel to the long dimension of the envelope). Contractor has the option 

to adjust the size of the window opening (subject to Government approval), providing the visibility of the computergenerated mailing address and barcode on the notice is not obscured, and other extraneous information is not visible 

when material is inserted into the envelope. 

Window is to be covered with a suitable, low-gloss, transparent poly-type material that must be clear of smudges, 

lines, and distortions. Poly-type material must be securely affixed to the inside of the envelope so as not to interfere 

with insertion of contents. Window material must meet the current U.S. Postal Service’s readability 

standards/requirements.

INSERTING AND PACKING: Gather all pages of a notice in numerical sequence. Notice leaves are to be nested 

together with all faces forward. Fold from a flat size of 8-1/2 x 11” down to 8-1/2 x 3-11/16” or 8-1/2 x 5-1/2”, as 

indicated, title out. 

The address on first page of notice must be visible through window of mail-out envelope. Either wraparound or 

accordion folds will be acceptable for the trifold notices.

NOTE: Bilingual Spanish/English notices consist of two parts: the first part is a Spanish notice; the second part is 

the same notice in English. The two parts must be nested together.

Gather folded notice leaves and insert into appropriate mail-out envelope with the recipient’s name and address on 

the first page facing out for visibility through envelope window.

When required, the return envelope is to be inserted behind the notice (when viewed from the window side of the 

envelope). For the eRPA bilingual notices, the Spanish notice must be in front of the corresponding English notice 

prior to folding and inserting.

It is the contractor’s responsibility to assure that only the computer-generated address and Intelligent Mail Barcode

on the notice will be visible through the window in the envelope and that only one notice, and if required, only one 

of the required return envelope(s) is inserted into each envelope. 

Seal envelopes.

Delivered Shipments – Pack suitable in shipping containers. 

Mailed Shipments – Mail each individual mailer. 

PRODUCTION INSPECTION: Production inspection(s) may be required at the contractor’s/subcontractor’s 

plant for the purpose of establishing that the receipt of transmitted files, the printing/imaging of notices, collating, 

folding, inserting, and mailing are being accomplished in accordance with contract quality attributes and 

requirements. 

A production inspection is for the purpose of setting specific standards that are to be maintained throughout the 

entire run. It does not constitute a prior approval of the entire run.

When a production inspection is required, the Government will notify the contractor.
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NOTE: Before production begins on any new workloads, a production inspection may be required at the 

contractor’s plant.

DISTRIBUTION:

 Deliver f.o.b. destination (on the first order and any order that requires a significant change to the language,

format, or appearance of a notice) 30 complete sample mailers of each notice type (along with any required 

insert(s)) inserted into mailout envelopes. DO NOT SEAL ENVELOPES. Deliver samples to: SSA, Printing 

Management Branch (see Exhibit K).

 Deliver f.o.b. destination one (1) copy of the above specified sample to: Social Security Administration, WilkesBarre Direct Operations Center (see Exhibit K).

 Deliver f.o.b. destination on the first order and any order that requires a copy change, 10 samples of each 

envelope type to: SSA, Mail and Postage Policy Team (see Exhibit K).

 Mail f.o.b. contractor’s city each individual mailer. (NOTE: The contractor is responsible for all costs incurred 

in transporting the mailers to the U.S. Postal Service facility.)

All mailing shall be made at the First Class rate.

The contractor must use SSA’s “Postage and Fees Paid First Class Mail” mailing permit. The mailing permit must 

be printed on each mail piece. 

SSA requires the use of a Permit Imprint. Orders may contain various weight pieces. The contractor must use SSA’s

“Postage and Fees Paid First Class Mail” permit imprint mailing indicia printed on each mail piece. Each mail piece

sent under this payment method must bear a permit imprint indicia showing that postage is paid.

Permit imprint indicia may be printed directly onto mail pieces. Permit imprint mailings must contain at least 200 

pieces or 50 pounds. The contractor is cautioned to use the permit imprint only for mailing material produced under 

this contract.

The contractor is strongly encouraged to use manifest mail when postal regulations allow. The contractor must have

a Manifest Mailing System (MMS) for First-Class Mail, which has been approved by USPS to document postage

charges for this mailing. Each mail piece must be identified with a unique identification number or with a keyline

containing a unique identification number and rate information about the piece. Contractor must be in accordance

with the MMS in effect at the time of mailing. The requirements for the MMS are contained in Publication 401

“USPS Guide to the Manifest Mailing System.” A copy of the USPS approval for the MMS must be presented at

the postaward conference.

Workload orders that result in mailings of less than 200 pieces or less than 50 pounds will require the contractor to

apply the appropriate postage to each piece or meter, at contractor’s option. When postage is applied to the mail

piece, the permit imprint indicia must be covered/concealed by a meter strip. The contractor will be reimbursed for

postage by submitting a properly completed U.S. Postal Service form (or equivalent) with their billing invoice.

Permit imprint may not be used if the mailing is less than 200 pieces. Instead, the mail must be metered and any

permit imprint must be covered/concealed by a meter strip. The contractor will be reimbursed for the metered

postage by submitting a properly completed Postal Service form (or equivalent). 

NOTE: All meter equipment and supplies must be borne by the contractor.
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Certificate of Conformance: When using Permit Imprint Mail the contractor must complete GPO Form 712 -

Certificate of Conformance (Rev. 10-15), and the appropriate mailing statement or statements supplied by USPS. A 

fillable GPO Form 712 Certificate of Conformance can be found at https://www.gpo.gov/how-to-work-withus/vendors/forms-and-standards. 

There is an exception in the Domestic Mail Manual (DMM) called the Minimum Volume Reduction. Contractors 

are strongly encouraged to apply for the Minimum Volume Reduction through their local BMU and USPS 

Headquarters in Washington, DC. With the Minimum Volume Reduction exception, contractors will be allowed to 

mail pieces under 200 pieces, less than 50 pounds on a permit imprint eliminating metering. 

If a Government meter is required: The contractor is responsible for the security of the SSA postage meters and 

access is to be restricted to authorized personnel only. Contractors are to place SSA postage meters in a locked 

position and place them in a secure server room or safe when not in use. The contractor is to advise all staff there 

is a penalty for the private use of official postage meters (39USC3203).

Contractors should always maintain sufficient postage on the SSA meters. The contractor should contact SSA if 

they are not sure of how much postage to load or frequency.

The contractor is required to submit spoiled postage/postage error envelope(s)/meter strip(s) and prepare a Postal 

Service Form 3533, Application for Refund of Fees, Products and Withdraw of Customer Accounts.

Forms are not obtainable from the United States Postal Service website since they contain a barcode making each 

form unique. Contractors must go to local Post Offices, postal retail units, or Bulk Mailing Units to obtain the hard 

copy version of the revised PS Form 3533. USPS will credit the postage refund to SSA through the Official Mail 

Accounting System (OMAS). SSA requires the contractor to submit a copy of Form 3533 along with the associated 

print order in which the spoilage occurred and all other postal documentation to the SSA COTR.

The contractor must have approval from SSA’s Postage Meter Accountability Team for turn-in of SSA postage 

meter(s) to the meter manufacturer (e.g., excess meter, defective meter, etc.). If the contractor requires a replacement 

postage meter, USPS credits any remaining postage to SSA through the USPS’ Official Mail Accounting System 

(OMAS), or the meter manufacturer may transfer the remaining postage from the old meter to the new meter. The 

contractor is to document the last meter reading (postage remaining amount) before the meter is checked out of 

service. The contractor may receive a PS Form 3601-C, Postage Meter Activity Report from the meter manufacturer. 

The contractor is to forward a copy of this report to SSA within three (3) workdays of the transaction.

On the first workday of each month, the contractor must load $5.00 on all SSA postage meters (including backup 

postage meters). In addition to the monthly upload, the Government reserves the right to request the contractor to 

upload additional funds at any time. These uploads are in addition to any routine meter replenishments. As a result 

of the postage uploads, the contractor may receive a Postage Meter Reset Activity Report Statement from the meter 

manufacturer. If received, the contractor should retain this documentation for 12 months.

Contractor is not to relocate SSA postage meters to any other building. Contactors are required to contact the SSA

COTR before any movement of an SSA postage meter.

The contractor is required to prepare all metered mail in accordance with the rules and regulations in USPS’s 

Domestic Mail Manual and International Mail Manual.

NOTE: Contractors should not receive invoicing for meter rentals. If the contractor receives an invoice, they are to 

contact the SSA COTR immediately.
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Contractor Sites Using “Official Government” Postage Meters with Automated Reporting Capability (Detailed 

and Limited): Postage meters with “Detailed Account Reporting” are capable of providing trend reports, postal 

class reports, summary reports, chart production, accounts, subaccounts, operator IDs, etc. These meters provide

SSA with remote tracking per print program of postage used. This is SSA’s preferred meter type. This meter type 

is ideal for use when processing multiple SSA workloads because of the account and subaccount feature. 

Contractors will be required to utilize the postage meter account feature for each SSA print program. Contractors 

may also be required to use subaccount features for each SSA program. If a contractor requires assistance with setup 

and operating the “accounting” features of the postage meters, SSA will provide a contact to assist them.

Postage meters with “Limited Account Reporting” are capable of providing SSA with remote tracking of the meter 

date, contractor/location, meter used, start funds available, any refills/refunds, number of pieces (postage applied), 

total cost, end funds available, and postage used. This meter is best suited for use when processing one single SSA 

workload. No action is necessary on the part of the contractor since SSA will be viewing postage meter usage 

remotely for the individual workload.

Contractor Sites Using an SSA Postage Meter Activity Log (Manual Process): Contractors using mailing 

equipment that cannot support a postage meter with an internal accounting feature and/or capable of remotely 

providing SSA with the detailed data it requires when producing multiple workloads will receive a compatible meter 

but will be required to complete an SSA Postage Meter Activity Log (Exhibit P).

The contractor will forward a completed SSA Postage Meter Activity Log to the appropriate SSA COTR or backup 

for each print order. If the contractor is producing multiple workloads using the same postage meter, the contractor 

is required to send the log to each SSA COTR/backup. Every field must contain an entry or an “N/A” if the field 

does not apply. SSA will return incomplete or incorrect activity logs to the contractor for correction. If a primary 

meter fails and a backup meter is needed to complete the workload, the contractor will need to document the primary 

meter log in the note field (i.e., meter failed, out of postage, etc.) and create a new activity log (documenting the 

necessary fields) to use with the backup meter.

Use of the above accounting feature or manual logs does not alter the current postal process. Contractors will

continue to forward all postal documentation as required in the contract requirements.

Domestic First-Class Letter-Size Mail: The contractor is required to prepare domestic First Class letter-size mail 

and obtain the maximum postage discount allowed by the USPS in accordance with appropriate USPS rules and 

regulations, including the USPS Domestic Mail Manual, and Postal Bulletins, in effect at the time of the mailing.

The contractor is required to prepare Domestic First Class letter-size mail pieces and obtain the maximum postage

discount allowed by USPS in accordance with the appropriate USPS rules and regulations, including USPS

Domestic Mail Manual and Postal Bulletins on Automation-Compatible First-Class Domestic Mail-Automated and

Non-automated mail discount structure in effect at the time of the mailing: a) Automation (5-digit); (b) Automation

(3-digit); (c) Automation (AADC); (d) Automation (Mixed AADC); (e) Nonautomation (Presorted); and (f) 

Nonautomation (Single Piece).

Contractor will be required to produce and use a USPS Intelligent Mail Barcode (IMB) with full service option and

achieve the maximum postage discounts available with this option. The contractor will be required to comply with

USPS requirements and place the IMB on all notices/mail pieces of this workload. The contractor is required to be

capable of achieving the postage discounts available with the Full-Service option of the IMB program.

To achieve the maximum automation compatible postal discount, the contractor is required to either presort the

notices prior to printing or sort the mail after the notices are inserted. The contractor may use a presort subcontractor

for the mailing portion of the contract. SSA has the right to inspect the subcontractor for the security of the mailing

operation and compliance with the contract. All of the pieces without a barcode must be separated and mailed as a

non-automation rate single piece mailing.
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NOTE: Mail addressed to United States territories and possessions (American Samoa, Federated States of 

Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, Puerto Rico, Virgin Islands, Wake Island, 

and Military Overseas Addresses (APO/FPO mail) is Domestic Mail, not International Mail.

Intelligent Mail Barcoding, delivery address placement, and envelopes used for the mailing are among the items

that must comply with USPS requirements for automation-compatible mail in effect at the time of the mailing.

The USPS has instituted a verification procedure called a “tap” test. This test is used to screen all mailings with 

barcoded inserts for proper barcode spacing within the envelope window. When the insert showing through the 

window is moved to any of its limits inside the envelope, the entire barcode must remain within the barcode clear 

zone. In addition, a clear space must be maintained that is at least 0.125” between the left and right edges of the 

window, and at least 0.028” clearance between the Intelligent Mail Bar code and the top and bottom edges of the 

window.

All letters in a mailing must pass the “tap” test in order to obtain the maximum postal discounts for the ordering

agency. The contractor will be responsible for payment of any additional postage resulting from a loss of postage 

discounts due to failure to pass the “tap” test because of inaccuracy or failure to conform to USPS specifications.

Contractor should be aware that USPS uses the Mail Evaluation Readability Look-up Instrument (MERLIN) to

evaluate barcodes. If MERLIN is in effect in the contractor’s geographic area, the contractor must ensure that all 

barcoded mail meets the new barcode standards. The contractor will be responsible for payment of any additional 

postage resulting from a loss of such discounts due to failure of the contractor-generated barcodes to pass the 

MERLIN test because of inaccuracy or failure to conform to USPS specifications.

The contractor is responsible for producing and providing all reporting data required for acceptance and processing 

of full- service mail required by USPS for the Intelligent Mail barcode.

International First-Class Mail: All items mailed must conform to the appropriate USPS International Mail Manual 

(IMM), Postal Bulletins, and other USPS rules and regulations in effect at the time of mailing.

If the mailing meets the qualifications for International Priority Airmail (IPA), it must be processed through IPA in 

accordance with USPS rules and regulations in effect for IPA at the time of the mailing. To maximize postage 

savings, the contractor will sort to the IPA Rate Group 1 through 15 levels.

Pieces not qualifying for the IPA Rate Group Levels of discount will be prepared at the Worldwide Non-presorted 

rate level and any remaining pieces that do not meet the IPA qualifications will be sorted by individual country 

rules according to the USPS IMM in effect at the time of the mailing.

International Mail return addresses must show as the last line of the address “UNITED STATES OF AMERICA”

or “USA” in all capital letters. All International Mail must be endorsed “PAR AVION” or “AIR MAIL” as described

in the USPS IMM. The contractor may use a rubber stamp to meet this requirement.

NOTE: International mail cannot contain a presort endorsement.

The contractor is cautioned that files listed will contain mail addressed to United States territories and possessions 

(American Samoa, Federated States of Micronesia, Guam, Marshall Islands, Northern Mariana Islands, Palau, 

Puerto Rico, Virgin Islands, Wake Island, and Military Overseas Addresses (APO/FPO mail). This mail is 

considered Domestic Mail, NOT International Mail and must be included in the discount sorting above.
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National Change of Address (NCOA) and Coding Accuracy Support System (CASS): The contractor shall run 

all addresses through NCOA and CASS software for address accuracy. The contractor cannot change the addresses, 

but if an address fails CASS or NCOA or requires a NCOA move update, the contractor shall sort those pieces into 

a separate file and mail at the non-automated presort rate or full postage rate as to avoid any USPS fines for failure 

to meet address accuracy rules imposed by USPS. If contractor fails to meet this requirement, the Government will 

not reimburse for any USPS imposed fines.

Contractor cannot at any time change the SSA supplied address prior to receipt by the USPS.

IMPORTANT: Contractor CANNOT at any time perform move updates or address corrections on the notice 

address. Notices that require a move update can be separated/diverted and sent at the full USPS first class rate. 

Contractor will be required to provide USPS postal discounts for the balance of mail pieces that pass NCOA. 

Mailing Documentation: The contractor must provide SSA with complete copies of all documents used by USPS 

to verify and accept the mail (e.g., computer records of presort ZIP+4, barcode breakdown, press runs, etc.) 

including GPO’s Form 712 (Certificate of Conformance), noted with file date and mailer number. The contractor

must place the number that is on top of the GPO Form 712 (the number that starts with “A”) in the space provided 

on the USPS mailing statements. If no space is provided on the mailing statement, place the number in the upper 

right margin of the mailing statement. 

NOTE: The contractor will use the Federal Agency Cost Code of 276-00012 on all postal mailing documents.

Within 72 hours of completion of each print order, the contractor must provide PDF copies of the mailing 

documentation, USPS 3607R, GPO Form 712, and 100% Accountability Summary reports to SSA, Printing 

Management Branch (see Exhibit K) via email. All copies must be legible and include both obverse and reverse 

side. 

The contractor will be required to forward photocopies of Postal Form 3533 (to USPS for credit), Postage Meter 

Activity Report forms, and all postage meter replenishment receipts (from the meter vendor) to SSA, Mail and 

Postage Policy Team (see Exhibit K). Furnished material and USPS validated copies of postal documentation must 

be delivered (via overnight carrier) to the SSA, Printing Management Branch (see Exhibit K). 

Upon completion of this contract, the contractor must return all furnished materials (as applicable) to: Social 

Security Administration, Attn: SSA, Cheryl Tarver, 3-B-9-D Annex Building, 6401 Security Boulevard, Baltimore, 

MD 21235-6401

All expenses incidental to picking up and returning materials (as applicable), submitting proofs, and furnishing 

sample copies must be borne by the contractor.

SCHEDULE: Adherence to this schedule must be maintained. Contractor must not start production of any job prior 

to receipt of the individual electronic task order or print order (GPO form 2511), as applicable.

When required, furnished material must be picked up from and returned to: Social Security Administration, Printing 

Management Branch (see Exhibit K).

Contractor to email PDF soft proofs to: cheryl.tarver@ssa.gov. (Email must include program and print order 

numbers plus return name and email address.)

The first task order for live production will be issued on December 1, 2021.
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Proof Schedule:

The following schedule begins the workday after notification of the availability of the print order and furnished 

material. The workday after notification will be the first workday of the schedule.

 Contractor must submit PDF soft proofs for all envelopes within seven (7) workdays of receipt of furnished 

materials. 

 Proofs will be withheld no more than five (5) workdays from their receipt at the ordering agency until the 

ordering agency provides changes/corrections/“O.K. to Print” via email. (NOTE: The first workday after 

receipt of proofs at the ordering agency is day one (1) of the hold time.)

 If necessary due to author’s alterations, contractor to submit revised proofs within five (5) workdays of 

receipt of ordering agency’s changes.

 Revised proofs will be withheld no more than three (3) workdays from their receipt at the ordering agency 

until the ordering agency provides changes/corrections/“O.K. to Print” via email. (NOTE: The first 

workday after receipt of revised proofs at the ordering agency is day one (1) of the hold time.)

Preproduction Test Schedules:

Prior to receiving transmission of live production data files, the contractor will be required to perform the below

tests. (The transmission tests will begin after the Government is notified of the availability of the system.)

In order for proper arrangements to be made, notification must be given at least three (3) workdays prior to all 

tests.

NOTE: Failure of the contractor to perform any of the below tests satisfactorily may be cause for default. The 

Government reserves the right to waive the requirements of these tests. The contractor will be notified at the 

Postaward Conference if any test(s) will be waived.

Transmission Test: 

 This test is to be performed within one (1) week of the data connection being installed.

 The contractor will be required to receive within one (1) workday approximately 141,292 notices. 

 The contractor will be required to perform a record count verification and perform the CASS certifications 

the same workday as receipt of the complete transmission of the test file and must provide SSA with the 

exact counts and the CASS certification. 

 SSA will respond within one (1) workday of receipt thereof. 

 When the record count verification has been successfully completed, the contractor will be required to 

provide SSA, Printing Management Branch (see Exhibit K) within two (2) workdays, 30 samples from 

each mailer from the Transmission Test. (See “PREPRODUCTION TESTS, Transmission Test.”)

 The Government will approve, conditionally approve, or disapprove the samples from the Transmission

Test within five (5) workdays of receipt thereof. (See “PREPRODUCTION TESTS, Transmission Test.”)
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Preproduction Validation Test: 

 Within five (5) workdays of receipt of test files and prior to the Preproduction Press and Mail Run test, the 

contractor is required to perform a Preproduction Validation Test. 

 The contractor must furnish SSA not less than 225 total printed samples, as specified (from the furnished 

test files).

 The Government will approve, conditionally approve, or disapprove the samples from the Preproduction 

Validation Test within five (5) workdays of receipt thereof. (See “PREPRODUCTION TESTS, 

Preproduction Validation Test.”)

eRPA Payment Stub Validation Test:

 Within five (5) workdays after receipt of test files and prior to the Preproduction Press and Mail Run Test, 

the contractor will be required to perform the eRPA Daily Notice Payment Stub Validation Test.

 Contractor to submit 100 printed samples of Form SSA-L732-OP1 containing a payment stub for validation 

of the scanline.

 The Government will approve, conditionally approve, or disapprove the samples from the Preproduction 

Validation Test within five (5) workdays of receipt thereof. (See “PREPRODUCTION TESTS, Payment 

Stub Validation Test (eRPA OP1 only).”)

Preproduction Press and Mail Run Test (24-Hour Test):

 Within five (5) workdays of receipt of test files and after the contractor receives the materials necessary to 

perform the test, the contractor will be required to perform a 24-hour press and mail run test on their 

equipment and using their personnel.

The test will occur during the regular work week of Monday through Friday (excluding Federal holidays).

 The contractor will be required to print and prepare for mailing 56,945 notices in a continuous 24-hour 

period. The mailers will be produced in accordance with all contract specifications and USPS regulations. 

(See “PREPRODUCTION TESTS, Preproduction Press and Mail Run Test (24-Hour Test).”)

 The Government will approve, conditionally approve, or disapprove the samples within 

seven (7) workdays of receipt thereof.

Systems Change/Signature Change/New Notice Files Validation Test:

 When required, the contractor will furnish 100 printed samples (no envelopes or inserts) within 

five (5) workdays of receipt of test files. 

 The Government will approve, conditionally approve, or disapprove the samples within 

seven (7) workdays of receipt thereof.

Production Schedule: 

Workday – The term “workday” is defined as Monday through Friday each week, excluding the days on which 

Federal Government holidays are observed. Also excluded are those days on which the Government Publishing 

Office is not open for the transaction of business, such days of national mourning, hazardous weather, etc.
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Federal Government Holidays are as follows: New Year’s Day, Martin Luther King’s Birthday, Presidents’ Day, 

Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans Day, Thanksgiving Day, and Christmas 

Day.

The contractor’s FTMS software must be operational for the receipt of data files 24 hours a day, seven (7) days a 

week, unless otherwise specified by the Government. (See “FILE TRANSFER MANAGEMENT SYSTEM 

(FTMS) REQUIREMENTS” for additional information).

Live production files will be transmitted on a daily basis Monday through Saturday for the BEVE and eRPA notices, 

except for Federal holidays in which case the data will be transmitted on the next day (i.e., when a Federal holiday 

falls on a Friday, production files will be transmitted on Saturday).

Contractor must not proceed with processing a transmission until counts are verified against the task order. If a 

discrepancy is found, the contractor must call SSA’s Scheduling Helpline immediately at 410-966-5469.

EAD and YCER: Complete production and mailing must be made within seven (7) workdays after receipt of each 

complete transmission.

BEVE and eRPA: Complete production and mailing must be made within three (3) workdays after receipt of each 

complete transmission (e.g., transmissions received on Monday must be mailed by close of business the following 

Thursday; transmissions received on Saturday must be mailed by the close of business the following Wednesday).

New Notices (Mailer X): Complete production and mailing must be made on these notices within three (3) to 

seven (7) workdays after receipt of each complete transmission as specified by the Government.

PRESS SHEET AND PRODUCTION INSPECTIONS: The contractor must notify the GPO and SSA of the 

date and time the press sheet or production inspection can be performed. In order for proper arrangements to be 

made, notification must be given at least 72 hours prior to the inspection(s). Notify the U.S. Government Publishing 

Office, Quality Control for Published Products, Washington, DC 20401 at (202) 512-0542, AND SSA (see Exhibit 

K). Telephone calls will only be accepted between the hours of 8:00 a.m. and 2:00 p.m., prevailing Eastern Time, 

Monday through Friday. NOTE: See contract clauses, paragraph 14(e) (1), Inspections and Tests in GPO Contract 

Terms (GPO Publication 310.2, effective December 1, 1987 (Rev. 01-18)). When supplies are not ready at the time 

specified by the contractor for inspection, the Contracting Officer may charge to the contractor the additional cost 

of the inspection. 

NOTE: If the backup facility is used for the production of these notices, the Government will require a press sheet

inspection. Prior to production, notification must be given at least 72 hours in advance of production startup.

The ship/deliver date indicated on the print order is the date products ordered for delivery f.o.b. destination must 

be delivered to the destinationsspecified, and products ordered for mailing f.o.b. contractor’s city must be delivered

to the U.S. Postal Service.

Unscheduled material such as shipping documents, receipts or instructions, delivery lists, labels, etc. will be 

furnished with each order or shortly thereafter. In the event such information is not received in due time, the 

contractor will not be relieved of any responsibility in meeting the shipping schedule because of failure to request 

such information.

For compliance reporting purposes, the contractor must notify the U.S. Government Publishing Office of the date 

of shipment or delivery, as applicable. Upon completion of each order, contractor must contact the Shared Support 

Services Compliance Section via email at compliance@gpo.gov. Personnel receiving email will be unable to 

respond to questions of a technical nature or to transfer any inquiries.
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SECTION 3. - DETERMINATION OF AWARD

The Government will determine the lowest bid by applying the prices offered in the “SCHEDULE OF PRICES” 

to the following units of production which are the estimated requirements to produce one (1) year’s production 

requirements under this contract. These units do not constitute, nor are they to be construed as, a guarantee of the 

volume of work which may be ordered for a like period of time.

The following item designations correspond to those listed in the “SCHEDULE OF PRICES.”

NOTE: The estimates below represent 12 months of production. However, due to the preproduction 

requirements, the first year of the contract (the base term) will have only approximately nine (9) months of live 

production.

I. 8

II. 9

III. (a) 1

(b) 1

(c) 1

IV. (a) 250

(b) 15,076

(c) 23

(d) 149

(e) 50

(f) 5,352

(g) 2,186

V. (a) 15,056

(b) 23

(c) 149

(d) 50

(e) 5,352

(f) 2,186

VI. 7,538
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SECTION 4 - SCHEDULE OF PRICES

Bids offered are f.o.b. destination for deliveries and f.o.b. contractor’s city for all mailing.

Prices must include the cost of all required materials and operations for each item listed in accordance with these 

specifications.

Bidder must make an entry in each of the spaces provided. Bids submitted with any obliteration, revision, or 

alteration of the order and manner of submitting bids may be declared nonresponsive.

An entry of NC (No Charge) must be entered if bidder intends to furnish individual items at no charge to the 

Government. 

Bids submitted with NB (No Bid), NA (Not Applicable), or blank spaces for an item may be declared nonresponsive.

The Contracting Officer reserves the right to reject any offer that contains prices for individual items of production 

(whether or not such items are included in the DETERMINATION OF AWARD) that are inconsistent or unrealistic 

in regard to other prices in the same offer or to GPO prices for the same operation if such action would be in the 

best interest of the Government.

All billing invoices submitted to the GPO shall be based on the most economical method of production. 

Fractional parts of 1,000 will be prorated at the per-1,000 rate.

Contractor’s billing invoice must be itemized in accordance with the line items in the “SCHEDULE OF PRICES.”

Cost of all required paper must be charged under Item V. “PAPER.”

I. COMPOSITION: Prices offered must include the cost of all required materials and operations necessary for 

the complete composition for each of the eight (8) envelopes in accordance with these specifications.

Envelopes..........................................................................................................per envelope......$___________

II. PROCESSING/FORMATTING FILES: The contractor will be allowed only one (1) charge per mailer for 

the term of the contract to process and/or format the AFP files, AFP Resources, and the Mail Run Data files 

supplied necessary to print and mail the package. 

Processing/Formatting Files..................................................................................per mailer......$___________

_____________

(Initials)
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III. PREPRODUCTION TESTS: Price offered must include all costs incurred in performing the Transmission 

Test, Preproduction Validation Test, and Payment Stub Validation Test (for eRPA OP1 only), as specified in

these specifications. These costs shall cover but are not limited to: machine time, personnel, all required

materials, transmissions, electronic prepress, paper, printing, imaging, collating, inserting, mail preparation, 

and any other operations necessary to produce the required quantities of the product in the time specified and

in accordance with specifications.

(a) Transmission Test............................................................................................... per test......$___________

(b) Preproduction Validation Tests.......................................................................... per test......$___________

(c) Payment Stub Validation Test (eRPA OP1 only)............................................... per test......$___________

IV. PRINTING/IMAGING, BINDING, AND CONSTRUCTION: Prices offered must be all-inclusive and 

include the cost of all materials and operations (including proofs, excluding paper) necessary for the 

printing/imaging, binding, and construction of the product listed in accordance with these specifications.

NOTE: Prices must include the cost of packing and distribution of deliveries only.

(a) *Daily Makeready/Setup Charge ..........................................................................................$___________

*Contractor will be allowed only one (1) makeready/setup charge per workday (maximum 5 per print order).

This combined charge shall include all materials and operations necessary to makeready and/or setup the

contractor’s equipment for all mailers run each day. Invoices submitted with more than one makeready/setup

charge per workday will be disallowed.

(b) Notice Leaves....................................................................................... per 1,000 leaves......$___________

(c) White CRM Envelope (5-3/4 x 8-3/4”).......................................... per 1,000 envelopes......$___________

(d) White BRM Envelope (5-3/4 x 8-3/4”).......................................... per 1,000 envelopes......$___________

(e) Green BRM Envelope (3-7/8 x 8-7/8").......................................... per 1,000 envelopes......$___________

(f) Mail-Out Envelope (4-1/8 x 9-1/2”)............................................... per 1,000 envelopes......$___________

(g) Mail-Out Envelope (6-1/8 x 9-1/2”)............................................... per 1,000 envelopes......$___________

V. PAPER: Payment for all paper supplied by the contractor under the terms of these specifications, as ordered 

on the individual task order/print order, will be based on the net number of leaves furnished for the product(s) 

ordered. The cost of any paper required for makeready or running spoilage must be included in the prices 

offered.

Computation of the net number of leaves will be based on the following:

Personalized Notices: A charge will be allowed for each page-size leaf.

All Envelopes: One leaf will be allowed for each envelope.

_____________

(Initials)
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Per 1,000 Leaves

(a) Personalized Notices: White OCR Bond (20-lb.)..................................................................$___________

(b) White CRM Envelope (5-3/4 x 8-3/4”): White Writing Envelope (20-lb.)...........................$___________

(c) White BRM Envelope (5-3/4 x 8-3/4”): White Writing Envelope (20-lb.)...........................$___________

(d) Green BRM Envelope (3-7/8 x 8-7/8”): Green Writing Envelope (20-lb.)...........................$___________

(e) Mail-Out Envelope (4-1/8 x 9-1/2”): White Writing Envelope (24-lb.);

or at contractor’s option, White Uncoated Text (60-lb.).......................................................$___________

(f) Mail-Out Envelope (6-1/8 x 9-1/2”): White Writing Envelope (24-lb.);

or at contractor’s option, White Uncoated Text (60-lb.).......................................................$___________

VI. INSERTING AND MAILING: Prices offered must include the cost of all required materials and operations 

necessary for the mailing of the notice(s) including cost of collating notice(s) (single or multiple leaves) in 

proper sequence; folding to required size in accordance with these specifications; insertion of notice(s) and 

appropriate reply envelope (if required) into appropriate mail-out envelope; and, mailing in accordance with 

these specifications.

Mailers...................................................................................................... per 1,000 mailers......$___________

LOCATION OF POST OFFICE: All mailing will be made from the__________________________________

Post Office located at Street Address _____________________________________________________________,

City____________________________, State _____________________________, Zip Code ________________

_____________

(Initials)
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SHIPMENT(S): Shipments will be made from: City __________________________, State ________________

The city(ies) indicated above will be used for evaluation of transportation charges when shipment f.o.b. contractor’s 

city is specified. If no shipping point is indicated above, it will be deemed that the bidder has selected the city and 

state shown below in the address block, and the bid will be evaluated and the contract awarded on that basis. If 

shipment is not made from evaluation point, the contractor will be responsible for any additional shipping costs 

incurred.

DISCOUNTS: Discounts are offered for payment as follows: __________ Percent, _________calendar days. See 

Article 12 “Discounts” of Solicitation Provisions in GPO Contract Terms (Publication 310.2).

AMENDMENT(S): Bidder hereby acknowledges amendment(s) number(ed) ___________________________

BID ACCEPTANCE PERIOD: In compliance with the above, the undersigned agree, if this bid is accepted 

within____________ calendar days (60 calendar days unless a different period is inserted by the bidder) from the 

date for receipt of bids, to furnish the specified items at the price set opposite each item, delivered at the designated 

points(s), in exact accordance with specifications. NOTE: Failure to provide a 60-day bid acceptance period may 

result in expiration of the bid prior to award.

BIDDER’S NAME AND SIGNATURE: Unless specific written exception is taken, the bidder, by signing and 

submitting a bid, agrees with and accepts responsibility for all certifications and representations as required by the 

solicitation and GPO Contract Terms – Publication 310.2. When responding by email, fill out and return one copy 

of all pages in “SECTION 4. – SCHEDULE OF PRICES,” including initialing/signing where indicated. Valid 

electronic signatures will be accepted in accordance with the Uniform Electronic Transactions Act, §2. Electronic 

signatures must be verifiable of the person authorized by the company to sign bids. Failure to sign the signature 

block below may result in the bid being declared non-responsive. 

Bidder ___________________________________________________________________________________

(Contractor Name) (GPO Contractor’s Code)

___________________________________________________________________________________________

(Street Address)

___________________________________________________________________________________________

(City – State – Zip Code)

By ________________________________________________________________________________________

(Printed Name, Signature, and Title of Person Authorized to Sign this Bid) (Date)

___________________________________________________________________________________________

(Person to be Contacted) (Telephone Number)

___________________________________________________________________________________________

(Email) (Fax Number)

___________________________________________________________________________________________

THIS SECTION FOR GPO USE ONLY

Certified by: __________ Date: __________ Contracting Officer: __________ Date: __________

(Initials) (Initials)

___________________________________________________________________________________________
EXHIBIT A


EXHIBIT B
Resource Page: SSA External Service Provider Security Guidance Page 1

EXHIBIT B

SSA External Service Provider Additional Security Requirements

DSPP Home

All External Service Providers (ESP) are subject to the following security requirements:

 All ESPs are subjected to SSA’s Security Authorization Process, which will entail security testing and

evaluation of the in-place security controls. For more information, see NIST SP 800-37, Revision 2 - Risk

Management Framework for Information Systems and Organizations - A System Life Cycle Approach for

Security and Privacy, December 2018.  ESPs must follow NIST SP 800-53 Revision 4 Recommended Security Controls for Federal Information

Systems and Organizations for protecting Low or Moderate impact level information as categorized by FIPS

199 for the information system. Note: Systems that contain Personally Identifiable Information (PII) are

considered “Moderate”.

 ESPs must document all deployed (applicable) and planned controls for an information system in a System

Security Plan that is in NIST-compliant format. SSA will provide the SSP template to be completed.

 ESPs classified as Cloud Service Providers (CSP) must adhere to additional FedRAMP security control

requirements. Further information may be found at: http://www.gsa.gov/portal/category/102371. As

part of these requirements, CSPs must have a security control assessment performed by a Third Party

Assessment Organization (3PAO).

 Upon request from SSA, the ESP shall provide the following network security information and

documentation for review and audit purposes:  All information security control artifacts required to support the Security Assessment and

Authorization (SA&A) process.  Intrusion Detection Systems (IDS) configuration.  Network firewall configuration.  Server and network device patching schedules and compliance.  Server, network device, and security logs.  Detailed hardware inventory including servers, network devices, and storage.

ESPs are required to adhere to NIST 800-53 Rev 4 security control framework based on their assigned categorization.

The following sections outline additional security controls and SSA organizational defined parameters for NIST 800- 53, Rev 4. Security requirements below are applicable to low and moderately categorized systems unless otherwise

designated. For additional information or supplement guidance for these controls, refer to Appendix F - SECURITY

CONTROL CATALOG in NIST 800-53, Rev 4.
Resource Page: SSA External Service Provider Security Guidance Page 2

Account Management Requirements

The purpose of the following is to address requirements for account and session management for External Service

Providers (ESPs). SSA Additional Requirements for ESPs:

 AC-2 - ESPs must employ individual account types on external service provider systems. The use of group,

anonymous or temporary accounts is strictly prohibited.

 AC-2 - ESPs must demonstrate the implementation of an approval process that describes how system

accounts are created, deleted, disabled, or modified. The process should account for roles in the system

and the appropriate authorizations to grant access. Public-facing systems may use a registration process in

place of the approval process.

 AC-2(3) - A deactivation process is required to manage inactive accounts. The process must describe how

the system identifies and deactivates inactive accounts that have not been in use for 90 days or more. ESPs

must automatically disable inactive accounts after 90 days and then remove these disabled accounts after

1 year.

 AC-2(4) - ESPs must provide the capability to produce a record of all account management activities that

occur on the system and develop an automated method to submit these records in the form of a report to

SSA.

 AC-6 - ESP administrator accounts and privileged user accounts must be customized to only allow access to

specific roles and functions on the system. ESP must provide a list of these functions to the Contract Officer

Technical Representative (COTR). (Moderate and High categorized systems only).

 AC-7 - ESPs must enforce a limit of 3 consecutive invalid login attempts by a user during a 20-minute period

and automatically lock the account/node for 30 minutes when the maximum number of unsuccessful

attempts is exceeded. The account shall remain locked for 30 minutes. (Moderate and High categorized

systems only).

 AC-8 - ESPs providing services to SSA internal users must display the internally used and approved warning

banner.

 The SSA internal banner is as follows:  Only authorized users can access the system.  The system is a U.S. Government computer system subject to Federal law.  Unauthorized attempts to access or modify any part of SSA’s systems are prohibited and

subject to disciplinary, civil action or criminal prosecution.

If the system is serving the public as its user base, the system must display a warning banner containing

language that is appropriate to the application. The SSA COTR must approve the public warning banner

language prior to implementation.

 AC-11 - ESPs must enforce termination of user sessions after 30 minutes of inactivity. Users must

authenticate again after sessions are terminated in order to continue using the application. (Moderate and

High categorized systems only).

 AC-17(4) - ESPs must restrict remote access to approved administrative functions and accounts.
Resource Page: SSA External Service Provider Security Guidance Page 3

Awareness and Training Requirements

The purpose of the following is to address requirements for awareness and training for External Service Providers

(ESPs).

SSA Additional Requirements for ESPs:

 AT-2 - ESP contractors and their employees or sub-contractors must complete SSA provided security

awareness training at least annually.

 AT-3 - ESPs must provide role-based training to all employees who fulfill special roles or duties in regards

to SSA data or systems.

 AT-4 - ESPs must retain and produce records of role based training completions for 3 years.

Auditing Requirements

The purpose of the following is to address requirements for auditing for External Service Providers (ESPs).

SSA Additional Requirements for ESPs:

 AU-2 - ESPs must maintain an audit log of transactions create, modify, or delete SSA information.

 AU-2 - ESPs must maintain an audit log of the following events: Logon/logoff events, account management,

privilege or role changes, and administrator activity.  AU-5 - ESPs must report any failure of audit processing that occurs to the SSA COTR within 24 hours.

 AU-6 - ESPs must review and analyze information system audit record for indications of inappropriate or

unusual activity and report those findings to SSA COTR within 24 hours. ESPs must support monitoring and

review of the system for unusual or inappropriate activity daily. This activity must be provided to the COTR

immediately for review.

 AU-6 - ESPs must provide user and transaction log reports to SSA when requested.  AU-7(1) - ESPs must allow for scoping of audit criteria for efficient reporting capability.

 AU-11 - ESPs must retain online audit logs for 90 days.  AU-11 - ESPs must retain audit records for seven (7) years.

Security Assessments and Authorization Requirements

The purpose of the following is to address requirements for security assessments and authorization for External

Service Providers (ESPs).

SSA Additional Requirements for ESPs:

 CA-2 - ESPs must develop an assessment plan that includes:

o Annual assessment of a subset of controls
Resource Page: SSA External Service Provider Security Guidance Page 4

o Triennial comprehensive assessment (full scope)

o Assessments as needed when a significant change occurs on the system.

 CA-2 - ESP and COTR must define what a significant change is and require a new assessment whenever a

significant change occurs. Significant change is defined in NIST Special Publication 800-37 Revision 1,

Appendix F.

 CA-3 - The contractor shall document in the SSA security plan, all connections to contractor resources made

to external information systems, and applications. Examples of connections would include: connections to

subcontractor sites, connections used for remote administration, connections made to contractor’s

company/corporate networks, etc. These connections shall be reviewed and monitored on an ongoing

basis, at least annually to determine the need for ongoing use by the contractor management. (Moderately

categorized systems only).

 CA-5 - For any security reports issued to the contractor, including internal independent reviews, the

contractor is responsible for developing a POA&M that identifies corrective actions and/or mitigating

controls for any identified vulnerabilities. Contractors shall report to COTR POA&M progress at least

monthly. In addition, the contractor must provide artifacts to update POA&M items at least 7 days prior to

milestone completion date to ensure SSA has sufficient time to review.

 CA-7 - ESP must monitoring the effectiveness of its security controls on a continual basis and take

appropriate corrective actions as necessary to ensure SSA data is protected from unauthorized access,

modification or disclosure.

Configuration Management Requirements

The purpose of the following is to address requirements for configuration management for External Service

Providers.

SSA Additional Requirements for ESPs:

 CM-2(3) - ESPs must define and deploy an approved device configuration on each device used to provide

services to SSA at least annually.  CM-6 - ESPs must periodically scan the device configuration of each device used to provide services to SSA

and identify deviations from the approved device configuration. Deviations shall be logged and corrected

within 24 hours. The ESP shall submit device scan reports to SSA upon request.

 CM-8 - ESPs must maintain an inventory all IT assets that store, process, or transmit SSA data and provide

to SSA upon request.  CM-9 - The contractor shall maintain a configuration management plan that addresses the roles,

responsibilities, processes, and procedures to manage inventory throughout the lifecycle.

Contingency Planning Requirements

The purpose of the following is to address requirements for contingency planning for External Service Providers.

SSA Additional Requirements for ESPs:
Resource Page: SSA External Service Provider Security Guidance Page 5

 CP-2 - ESP must submit a contingency plan that will support and meet the SSA supplied recovery objectives

and must be maintained, reviewed and, if necessary updated at least annually.

 CP-9 - ESPs must encrypt all Media used for backup and archiving purposes using Federal Information

Processing Standard (FIPS) 140-2 compliant solutions. (Moderate and High categorized systems only).

Identification and Authentication Requirements

The purpose of the following is to address requirements for identification and authentication for External Service

Providers (ESPs).

SSA Additional Requirements for ESPs:

 IA-2(12) - Identity, Authorization and Access Management (IdAAM) - The External Service Providers must

seamlessly integrate with the SSA’s Federation Service. This service is based on oAuth and SAML (Security

Assertion Markup Language) 2.0 standards and enables SSA to meet its two factor authentication

requirements as specified in Homeland Security Presidential Directive (HSPD)-12, dated August 12, 2004.

This service enables SSA to leverage an internal Microsoft’s Active Directory to create a single SSA-Wide

directory of all users. Currently, SSA users are required to authenticate using their SSA HSPD-12 PIV Smart

Card at the workstation. In certain acceptable instances, users can revert to user name and password, while

the Department is transitioning to HSPD-12 PIV Smart Card Authentication. The External Service Providers

must support both authentications methods.

 IA-6 - ESPs must mask all fields on a system that has a logon screen that requires credentials, to prevent

unauthorized exposure.

 IA-7 - The ESP must encrypt credentials used for e-authentication. The encryption solution must be

compliant with FIPS 140-2. (Moderate and High categorized systems only).

Incident Response Requirements

The purpose of the following is to address requirements for incident response for External Service Providers.

SSA Additional Requirements for ESPs:

 IR-6 - ESPs will receive the incident response capability timeframe and reporting requirements from the SSA

COTR.  IR-6 - ESPs Incident Response plan must require all security incidents of US CERT categories 1,2,3,4 and 6

must be reported to SSA COTR.  IR-7 - ESPs are responsible for notifying the appropriate SSA COTR when there is a security incident that has

been categorized 1,2,3,4 or 6 per US CERT regulations. The COTR is authorized to issue orders to take down

external systems or components to perform IR, forensics, further loss of data, etc.

Maintenance Requirements

The purpose of the following is to address requirements for maintenance for External Service Providers.
Resource Page: SSA External Service Provider Security Guidance Page 6

SSA Additional Requirements for ESPs:

 MA-2 - ESP must retain records of maintenance activities performed on IT devices used to provide services

to SSA. Maintenance activity logs must be made available upon request.

 MA-2 - IT equipment and media used to provide services to SSA must be sanitized prior to removal from

the ESP’s facility for maintenance or disposal purposes. The ESP must maintain a log as evidence that the

IT equipment or media was sanitized prior to removal. Logs must be made available upon request. Refer

to NIST SP 800-88 for more information on media sanitization.

Media Protection Requirements

The purpose of the following is to address requirements for media protection for External Service Providers.

SSA Additional Requirements for ESPs:

 MP-2 - Removable media used to store SSA data must be encrypted using a FIPS 140-2 compliant encryption

solution.

 MP-3 - ESP must label or mark (human readable) all media containing PII or other sensitive SSA data as “SSA

Confidential Unclassified Information”. (Moderate and High categorized systems only).

 MP-4 - ESP must have a documented process describing how IT equipment and media are controlled to

ensure the security and confidentiality of SSA data.

 MP-5 - ESP must maintain chain of custody for IT equipment and media during transport outside of

controlled-access facilities. Authorized personnel must perform transport of media outside of controlled

areas.

Planning Requirements

The purpose of the following is to address requirements for the planning for External Service Providers (ESPs).

SSA Additional Requirements for ESPs:

 PL-2 - ESP must develop a System Security Plan (SSP) compliant with NIST SP 800-18. The SSP shall be

submitted to the SSA COTR.  PL-2 - ESP must conduct an annual security review of the solution used to provide services to SSA. The

System Security Plan (SSP) must be updated to reflect changes affecting the security of SSA data.

 PL-4 - The SSA COTR will provide the SSA Rules of Behavior (within the SSA Information System Security

Handbook) for ESP systems that support internal users providing services to SSA. The rules of behavior

ensure users are familiar with information security, privacy, and confidentiality practices.

Personnel Security Requirements

The purpose of the following is to address requirements for personnel security for External Service Providers.

SSA Additional Requirements for ESPs:
Resource Page: SSA External Service Provider Security Guidance Page 7

 PS-4 - ESP must terminate employee and sub-contractor access to the solution used to provide services to

SSA immediately upon reassignment or separation.

 PS-6 - ESP personnel who are granted access to IT equipment, media or data used to provide services to

SSA must agree and sign a non-disclosure agreement prohibiting unauthorized disclosure of SSA data

encountered in the performance of their duties.

 PS-7 - ESP sub-contractors are bound to the same security requirements as employees.

 PS-8 - ESP must inform the SSA project officer of any violation of security requirements within 24 hours.

Risk Assessment Requirements

The purpose of the following is to address requirements for risk assessment for External Service Providers (ESPs).

SSA Additional Requirements for ESPs:

 RA-3 - ESPs shall conduct a risk assessment to assess the risk and magnitude of harm that could result from

the unauthorized access, use, disclosure, disruption, modification, or destruction of sensitive SSA

information. The risk assessment should be reviewed annually and updated every three years or when a

significant change occurs.

 RA-5 - ESP must scan IT equipment used to provide services to SSA for security vulnerabilities at least

monthly. The contractor must use a commercially available scanning tool. The scanning must include

vulnerabilities identified in DHS national vulnerability database. Vulnerability scan reports must be retained

for 12 months and submitted to the SSA COTR upon request.

System and Communication Requirements

The purpose of the following is to address requirements for system and communications for External Service

Providers (ESPs).

SSA Additional Requirements for ESPs:

 SC-4 - ESP must logically or physically segregate SSA data from that of other customer if a multi-tenant

environment is used to provide services to SSA. (Moderate and High categorized systems only).

 SC-7(1) - ESPs shall physically allocate publicly accessible information system components to separate

subnetworks with separate physical network interfaces.

 SC-7(4) - ESPs must provide traffic flow policy for each managed interface to SSA COTR for review and

approval prior to implementation.

 SC-8 - ESP must encrypt PII and other sensitive SSA data when stored on persistent storage devices, or when

transmitted over approved system interconnections, using a FIPS 140-2 compliant encryption solution

(Moderate and High categorized systems only).

 SC-10 - ESPs must terminate user sessions automatically after 15 minutes of inactivity. (Moderate and High

categorized systems only).

 SC-15 - ESPs use of collaborative computing devices (e.g., networked whiteboards, cameras, and

microphones) on systems hosting /processing/ shall have their remote activation capability

removed/disabled.
Resource Page: SSA External Service Provider Security Guidance Page 8

 SC-17 - For all ESPs, who manage information systems, the information system shall utilize automated

mechanisms with supporting procedures in place for digital certificate generation, installation, and

distribution. Subscriber key pairs are generated and stored using FIPS 140-2 Security Level 2 or higher

cryptographic modules. The same public/private key pair is not to be used for both encryption and digital

signature. Private keys are protected using, at a minimum, a strong password. A certificate is revoked if the

associated private key is compromised; management requests revocation; or the certificate is no longer

needed. (Moderate and High categorized systems only).

 SC-18 - Mobile code is software that is executed from a host machine to run scripts on a client machine,

including animation scripts, movies, etc. Mobile code is a powerful computing tool that can introduce risks

to the user’s information system. Whenever an ESP is developing or deploying the mobile code technology,

this shall be identified in the ESP’s security plan to SSA. Contractors, who use mobile code, shall be subject

to a source code review by SSA personnel to ensure that there is no potential risk in introducing malicious

code into the contractor/user’s environment. (Moderate and High categorized systems only).

System and Information Integrity Requirements

The purpose of the following is to address requirements for system and information integrity for External Service

Providers.

SSA Additional Requirements for ESPs:

 S1-2 - ESPs will remediate discovered flaws in the information system according to a process that is

approved by the COTR.  SI-3 - ESP must submit alerts on malicious code detection and actions performed on malicious code to the

SSA COTR for review.

 SI-4 - The ESP shall employ tools and techniques to monitor events on the information system to detect

attacks, vulnerabilities, and detect, deter, and report on unauthorized use of the information system.

Whenever there is an elevated security level, the monitoring efforts shall be increased as necessary to

enable deterrence, detection, and reporting to take place so that corrective actions shall be made to the

networked environment.

 SI-5 - ESPs must receive advisories (from US CERT) on a regular basis and take appropriate actions as

necessary.

 SI-11 - The information system shall identify security relevant error conditions and handle error conditions

in an expeditious manner. (Moderate and High categorized systems only).
EXHIBIT C
UNCLASSIFIED // FOR OFFICIAL USE ONLY 

UNCLASSIFIED // FOR OFFICIAL USE ONLY 

TEMPLATE VERSION (V1.3 FY17) - REMOVE BEFORE PUBLISHING

Security Assessment Report 

Social Security Administration 

(SSA) 

<System Name> (<Acronym>)

Security Categorization: <Enter Categorization>

<DRAFT/FINAL> Version <x.x>

<Month DD, YYYY>

Prepared by 

8229 Boone Blvd., Suite 750 

Vienna, VA 22182 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY ii 

<INSTRUCTIONS: Orange, bracketed text indicates instructions on how a section should be completed or 

sample text, which should be replaced with project specific information or removed. Ensure sample text is 

turned from orange to black where necessary (e.g., headings shall be changed to the standard heading 

color), and all instructions are removed (including this paragraph). Remove the template ID (e.g., TMP V1.3 

FY17) from the footer before publishing. All black text shall remain unchanged.> 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY iii 

Assessment Summary 

This document describes the Federal Information Security Modernization Act (FISMA) Security Assessment

Report (SAR) for Social Security Administration (SSA). The primary purpose of this document is to deliver

the independent security assessment findings for <System Name> (hereafter known as <System 

Acronym>). These findings will lead to the initiation of corrective actions or for making risk-based 

decisions. This independent security assessment supports the U.S. Government’s mandate that all 

U.S. Federal information systems comply with FISMA of 2014. 

The assessment took place between <MM DD, YYYY> and <MM DD, YYYY>. The independent 

security assessment followed the approved the Security Assessment Plan (SAP). All deviations from the 

approved SAP are located in Table 7. 

The table below represents the aggregate risk identified from the independent security assessment. 

Table 1: Executive Summary of Risks 

 NOTE: Total is the sum of high, moderate, and low risks with operationally required 

risks being represented as a subset of this total. 

Risk Category Total % of Total Risks 

High <# high risks> <% of total risks> 

Moderate <# moderate risks> <% of total risks> 

Low <# low risks> <% of total risks> 

Total Risks <Sum of all H, M, L 

risks> 

100% 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY iv 

Document Revision History 

Version Date Description Author 

1.0 <10/02/2015> Initial release Coalfire 

<1.1> <10/26/2015> <Final template updates FY17> Coalfire 

<1.2> <10/24/2017> <Template updates for FY17> Coalfire 

 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY v 

Table of Contents 

1 INTRODUCTION ....................................................................................................................... 1

1.1 Applicable Laws and Regulations ............................................................................................... 1

1.2 Applicable Standards and Guidance ........................................................................................... 1

1.3 Purpose ....................................................................................................................................... 2

2 SCOPE ................................................................................................................................... 3

2.1 Applicable Security Controls ....................................................................................................... 3

2.2 System Name/Title ...................................................................................................................... 3

2.3 Assessment Documentation ....................................................................................................... 4

2.4 Location of Components Tested ................................................................................................. 4

2.5 Subsystems, Users and Interfaces ............................................................................................. 4

2.6 Assessment Inventory ................................................................................................................. 5

3 SYSTEM OVERVIEW ................................................................................................................ 6

3.1 Security Categorization ............................................................................................................... 6

3.2 System Description and Purpose ................................................................................................ 6

4 ASSESSMENT METHODOLOGY ................................................................................................. 7

4.1 Perform Tests .............................................................................................................................. 7

4.1.1 Assessment Deviations ............................................................................................................. 7

4.2 Identification of Vulnerabilities ..................................................................................................... 7

4.3 Consideration of Threats ............................................................................................................. 8

4.4 Perform Risk Analysis ............................................................................................................... 14

5 SECURITY ASSESSMENT RESULTS ........................................................................................ 16

5.1 Security Assessment Summary ................................................................................................ 17

6 NON-CONFORMING CONTROLS .............................................................................................. 18

6.1 Risks Corrected During Testing ................................................................................................ 18

6.2 Risks with Mitigating Factors ..................................................................................................... 18

6.3 Risks Remaining Due to Operational Requirements ................................................................ 18

7 RISKS KNOWN FOR INTERCONNECTED SYSTEMS ................................................................... 20

8 RECOMMENDATIONS ............................................................................................................. 20

APPENDIX A. ACRONYMS AND TERMS ...................................................................................... 21

APPENDIX B. SECURITY RISK TRACEABILITY MATRIX (SRTM) .................................................. 24

APPENDIX C. INFRASTRUCTURE SCAN RESULTS ....................................................................... 25

Infrastructure Scans: Inventory of Items Scanned .............................................................................. 25

Infrastructure Scans: Raw Scan Results ............................................................................................ 25

Infrastructure Scans: False Positive Reports ...................................................................................... 25

APPENDIX D. DATABASE SCAN RESULTS ................................................................................. 26

Database Scans: Inventory of Databases Scanned ........................................................................... 26

Database Scans: False Positive Reports ........................................................................................... 26

APPENDIX E. WEB APPLICATION SCAN RESULTS...................................................................... 27

Web Application Scans: Inventory of Web Applications Scanned ...................................................... 27

Web Application Scans: False Positive Reports ................................................................................. 27

APPENDIX F. ASSESSMENT RESULTS ....................................................................................... 28
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

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APPENDIX G. PENETRATION TEST REPORT ............................................................................... 29

APPENDIX H. SECURITY ASSESSMENT REPORT SIGNATURE ...................................................... 30

 

List of Tables 

Table 1: Executive Summary of Risks .......................................................................................................... iii

Table 2: Identified Security Controls Assessed ............................................................................................ 3

Table 3: Information System Name and Title ................................................................................................ 3

Table 4: Location of Components ................................................................................................................. 4

Table 5: Users and Interfaces ....................................................................................................................... 5

Table 6: Hardware and Software Inventory .................................................................................................. 5

Table 7: List of Assessment Deviations ........................................................................................................ 7

Table 8: Threat Categories and Type Identifiers........................................................................................... 8

Table 9: Potential Threats ............................................................................................................................. 9

Table 10: Likelihood Definitions from NIST 800-30 Rev. 1 Publication ....................................................... 14

Table 11: Impact Definitions from NIST 800-30 Rev. 1 Publication ............................................................. 14

Table 12: Risk Exposure Ratings from NIST 800-30 Rev. 1 Publication .................................................... 15

Table 13: Risk Exposure ............................................................................................................................. 18

Table 14: Summary of Risks Corrected During Testing ............................................................................. 18

Table 15: Summary of Risks with Mitigating Factors .................................................................................. 18

Table 16: Summary of Risks Remaining Due to Operational Factors ........................................................ 19

Table 17: Risks from Interconnected Systems ........................................................................................... 20

Table 18: Acronyms and Terms .................................................................................................................. 21

Table 19: Security Test Procedure Workbook ............................................................................................ 24

Table 20: Inventory of Items Scanned ........................................................................................................ 25

Table 21: Raw Scan Results ....................................................................................................................... 25

Table 22: Infrastructure Scans: False Positive Reports .............................................................................. 25

Table 23: Inventory of Databases Scanned ................................................................................................ 26

Table 24: Database Scans: False Positive Reports ................................................................................... 26

Table 25: Inventory of Web Applications Scanned ..................................................................................... 27

Table 26: Web Application Scans: False Positive Reports ......................................................................... 27

Table 27: Summary of System Security Risks from FISMA Testing ........................................................... 28

Table 28: SAR Signatures ........................................................................................................................... 30
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 1 

1 Introduction 

This SAR document for <System Acronym> is required by the National Institute of Standards and 

Technology (NIST) 800-53 Revision 4 (Rev 4) document. This SAR contains unbiased and factual 

security findings by an independent security assessment team. This SAR contains the <System Acronym>

system specific security controls tested as per the Security Assessment Plan (SAP) approved by SSA Office 

of Information Security (OIS), the <System Acronym> Security Authorization Manager (SAM), and the 

Coalfire (formally Veris Group) Project Manager (PM). The implementation status of these controls identify 

the residual risk (risk remaining after controls have been implemented). These controls are required per 

NIST 800-53 Rev. 4 to address known information system vulnerabilities. The results are in support of SSA 

Security Authorization program goals, efforts, and activities necessary to achieve compliance with FISMA 

security requirements. 

1.1 Applicable Laws and Regulations 

• Computer Fraud and Abuse Act [Public Law (PL) 99-474, 18 U.S. Code (USC) 1030] 

• E-Authentication Guidance for Federal Agencies [Office of Management and Budget (OMB) M-04-

04] 

• FISMA of 2014 [PL 113-283] 

• Freedom of Information Act (FOIA) As Amended in 2002 [PL 104-232, 5 USC 552] 

• Guidance on Inter-Agency Sharing of Personal Data – Protecting Personal Privacy [OMB M-01-05] 

• Homeland Security Presidential Directive(HSPD)-7, Critical Infrastructure Identification, 

Prioritization and Protection [HSPD-7] 

• Internal Control Systems [OMB Circular A-123] 

• Management of Federal Information Resources [OMB Circular A-130] 

• Management’s Responsibility for Internal Control [OMB Circular A-123, Revised 12/21/2004] 

• Privacy Act of 1974 as amended [5 USC 552a] 

• Protection of Sensitive Agency Information [OMB M-06-16] 

• Records Management by Federal Agencies [44 USC 31] 

• Responsibilities for the Maintenance of Records About Individuals by Federal Agencies [OMB 

Circular A-108, as amended] 

• Security of Federal Automated Information Systems [OMB Circular A-130, Appendix III] 

1.2 Applicable Standards and Guidance 

• A NIST Definition of Cloud Computing [NIST SP 800-145] 

• Computer Security Incident Handling Guide [NIST SP 800-61, Revision 2] 

• Contingency Planning Guide for Federal Information Systems [NIST SP 800-34, Revision 1] 

• Engineering Principles for Information Technology Security (A Baseline for Achieving Security) 

[NIST SP 800-27, Revision A] 

• Assessing Security and Privacy Controls in Federal Information Systems and Organizations [NIST 

SP 800-53A, Revision 4] 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 2 

• Security and Privacy Controls for Federal Information Systems and Organizations [NIST SP 800-

53, Revision 4] 

• Guide for Developing Security Plans for Federal Information Systems [NIST SP 800-18, Revision 

1] 

• Guide for Applying the Risk Management Framework to Federal Information Systems: A Security 

Life Cycle Approach [NIST SP 800-37, Revision 1] 

• Guide for Mapping Types of Information and Information Systems to Security Categories [NIST SP 

800-60, Revision 1] 

• Guide for Security-Focused Configuration Management of Information Systems [NIST SP 800-128] 

• Information Security Continuous Monitoring for Federal Information Systems and Organizations 

[NIST SP 800-137] 

• Managing Information Security Risk: Organization, Mission, and Information System View [NIST 

SP 800-39] 

• Minimum Security Requirements for Federal Information and Information Systems [FIPS 

Publication 200] 

• Personal Identity Verification (PIV) of Federal Employees and Contractors [FIPS Publication 201-

2] 

• Recommended Security Controls for Federal Information Systems [NIST SP 800-53, Revision 4] 

• Guide for Conducting Risk Assessments [NIST SP 800-30, Revision 1] 

• Security Considerations in the System Development Life Cycle [NIST SP 800-64, Revision 2] 

• Security Requirements for Cryptographic Modules [Federal Information Processing Standard 

(FIPS) Publication 140-2] 

• Standards for Security Categorization of Federal Information and Information Systems [FIPS 

Publication 199] 

• Technical Guide to Information Security Testing and Assessment [NIST SP 800-115] 

1.3 Purpose 

The purpose of this document is to provide the System Owner (SO) and the SSA Authorization Official (AO)

with a detailed level of the residual risk for <System Acronym>. An independent security assessment team 

conducted a test for each system specific security control implemented by SSA stakeholders. These 

tests include a combination of interviews, document examinations, and actual technical testing of controls 

when applicable. These controls each had implementation statements listed in the <System Acronym>

System Security Plan (SSP). These statements identified how the controls are in place and the 

assessment team tested the controls based on that criteria. Additionally, the testing ensures the controls 

are in are in compliance with the FISMA baseline security control requirements as defined in NIST 800-53 

Rev 4. FISMA mandates that all Federal Agencies will comply with the NIST 800-53 Rev. 4 standards. 

Assessors from the independent security assessment team are members of contracted Coalfire Federal 

Services (formally Veris Group). 

The system specific security controls for this assessment are in section 2.1 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 3 

2 Scope 

2.1 Applicable Security Controls 

The applicable security controls as listed in the <System Acronym> SAP are in Table 2 of this <System 

Acronym> SAR. The security control assessment authorized by OIS and the <System Acronym> SAM 

gives authority to the Coalfire Independent Security Assessment team to assess the listed controls. 

Table 2: Identified Security Controls Assessed 

Security Control Family Security Control 

Access Control AC-2, AC-2(2), AC-2(3), AC-2(4) 

Awareness and Training 

Audit and Accountability AU-7(1) 

Security Assessment and Authorization CA-5, CA-6 

Configuration Management CM-9 

Contingency Planning 

Identification and Authentication IA-2, IA-(3), IA-5, IA-5(1) 

Planning PL-2, PL-2(3), PL-8 

Personnel Security PS-4, PS-5 

Risk Assessment RA-2, RA-3 

System and Services Acquisition SA-3, SA-4(9), SA-5, SA-8, SA-9, SA-9(2), SA-11 

System and Communications Protection SC-4, SC-39 

System and Information Integrity SI-10, SI-11, SI-16 

2.2 System Name/Title 

The <System Acronym> system unique identifier and system acronyms are in Table 3. Due to the 

number of applications located within <System Acronym>, <only two of the subsystems> fall within the 

scope of this assessment. The authority to use a representative sample is located within NIST 800-53 

Rev 4 Guide for Assessing the Security Controls in Federal Information Systems and Organizations. 

Table 3: Information System Name and Title 

Information System Name: <System Name> 

Information System Acronym: <System Acronym> 

Information System Identifier <System Identifier> 

Security Categorization: (High, Moderate, Low) <Categorization> 

PII data: (Yes/No) <Yes/No> 

e-Authentication Application: (Yes/No) <Yes/No> 

Production Data Used In Development/Test 

Environment (Yes/No) 

<Yes/No> 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 4 

Federal Tax Information (Yes/No) <Yes/No> 

2.3 Assessment Documentation 

Documentation used by the independent assessment team to perform the assessment of the <System 

Acronym> subsystems include the following: 

• <System Acronym> System Security Plan (SSP) 

• <System Acronym> Security Assessment Plan (SAP) 

• Security Operation Division (SOC) Nessus scanner with McAfee, McAfee ePolicy 

Orchestrator (EPO) instance scan statistic reports 

• SSA Information Security Policy (ISP) 

• The <System Acronym> Boundary Scope Memo (BSM) 

• The <System Acronym> Information System Contingency Plan (ISCP) 

• The <System Acronym> Federal Information Processing Standards Publication (FIPS) 199 

2.4 Location of Components Tested 

The physical locations of all the different functional components supporting the testing of the <System 

Acronym> information system is in Table 4. 

Table 4: Location of Components 

System Physical Location and Addresses 

Production Environment Site 

Name 

Address Description of Components 

<EXAMPLE: National Computer 

Center (NCC)>

6401 Security Blvd 

Baltimore, MD 21235 

Production Environment (i.e., 

hardware ) 

(Primary Support) 

Development/Test 

Environment Site Name 

Address Description of Components 

<EXAMPLE: National Support 

Center (NSC)>

3500 Campus Drive, Suite 106 

Urbana, MD 21704 

Development and Testing

Environment (Integration 

Testing) 

Disaster Recovery 

Environment Site Name 

Address Description of Components 

<EXAMPLE: Secondary Support 

Center (SSC)>

3004 Tower Blvd 

Durham, NC 27707 

Production Environment (i.e., 

hardware) 

(Secondary/Failover Support) 

Contractor Owned 

Environment Site Name 

Address Description of Components 

 

2.5 Subsystems, Users and Interfaces 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

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The <System Acronym> system contains the following subsystems, users and interfaces that were tested 

as part of this assessment. They are contained within the embedded Error! Reference source not found.. 

<Complete the embedded spreadsheet with system specific information.>

Table 5: Users and Interfaces 

T2 Internet - Users 

and Interfaces.doc

<Embed the applicable system’s Users and Interface, EXAMPLE attached.>

2.6 Assessment Inventory 

The <System Acronym> hardware and software inventories provided by the SO’s are in Table 6. 

<Complete the embedded spreadsheet with system specific information.> 

Table 6: Hardware and Software Inventory 

T2 Internet - 

HW-SW Inventory.xl

<Embed the applicable system’s Hardware and Software Inventory, EXAMPLE attached.> 

 NOTE: Any changes to the scope of the Authorization Boundary after the Boundary 

Scope Meeting and finalization of the Boundary Scope Memo (BSM) may impact the 

overall Independent Verification and Validation (IV&V) schedule. 
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3 System Overview 

3.1 Security Categorization 

The FIPS 199 Security Categorization of a Federal Information and Information System publication

determines the risk impact level of data vulnerability exploitation. The identified impact level sets the

security control baseline that needs to be tested. The categorization for <System Acronym> determined 

by the FIPS 199 publication is a Moderate baseline. The NIST 800-53 Rev 4. <Moderate> baseline of 

controls are assessed during the security assessment. 

3.2 System Description and Purpose 

<In the sections below, insert a general description of the information system. Use a description that is 

consistent with the description found in the SSP. The description must only differ from the description in 

the SSP if additional information is going to be included that is not available in the SSP or if the description 

in the SSP is not accurate.> 
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Version <X.X>

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4 Assessment Methodology 

A summary of the assessment methodologies used to conduct the security assessment for the <System 

Acronym> subsystems are in the following steps: 

 Perform tests on the listed controls in the <System Acronym> SAP and record the results 

 Identify vulnerabilities related to <System Acronym>

 Identify known threats and determine which threats are associated with the cited vulnerabilities 

 Analyze risks based on vulnerabilities and associated threats after mitigating controls 

are implemented 

 Recommend corrective actions for controls that are not satisfied (other than satisfied) 

 Document all security assessment results, which include identified unmitigated risks, 

mitigated risks, and recommend corrective actions. 

4.1 Perform Tests 

Coalfire Federal Services performed security tests on the <System Acronym> subsystems, which 

concluded on <MM DD, YYYY>. The results of the tests are documented within the Security Risk

Traceability Matrix (SRTM) in Appendix B. The SRTM serves as input to this SAR. 

4.1.1 Assessment Deviations 

Table 7 contains any deviations from the SAP if applicable. Coalfire Federal Services did not deviate from

the testing plan. 

Table 7: List of Assessment Deviations 

Deviation ID Deviation Description Justification 

 

4.2 Identification of Vulnerabilities 

Coalfire Federal Services conducts an assessment to identify vulnerabilities for <System 

Acronym> subsystems. These vulnerabilities should have controls in place to mitigate the risk of 

exploitation. 

A vulnerability is an inherent weakness in an information system that can be exploited by a threat or 

threat agent, resulting in an undesirable impact on the protection of the confidentiality, integrity, or 

availability of the system (application and associated data). A vulnerability may be due to a design 

flaw or error in a configuration that makes the network or a host on the network, susceptible to malicious 

attacks from local or remote users. Vulnerabilities can exist in multiple areas of the system or facilities, 

such as in firewalls, application servers, Web servers, operating systems, or fire suppression systems. 

Whether or not a vulnerability has the potential to be exploited by a threat depends on a number of 

variables including (but not limited to): 

• The strength of the security controls in place 

• The ease at which a human actor could purposefully launch an attack 

• The probability of an environmental event or disruption in a given local area 
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An environmental disruption is usually unique to a geographic location. Depending on the level of the risk

exposure, the successful exploitation of a vulnerability can vary from disclosure of information about the

host to a complete compromise of the host. Risk exposure to organizational operations can affect the

business mission, functions, and/or reputation of the organization. 

4.3 Consideration of Threats 

A threat is an adversarial force or phenomenon that could affect the availability, integrity, or confidentiality

of an information system, its networks, and the facility that houses the hardware and software. A threat

agent is an element that provides the delivery mechanism for a threat. An entity that initiates the launch of

a threat agent is referred to as a threat actor. 

A threat actor might purposefully launch a threat agent (e.g., a terrorist igniting a bomb). A threat actor

could also be a trusted employee that acts as an agent by making an unintentional human error (e.g., a

trusted employee clicks on a phishing email that downloads malware). Threat agents may also be

environmental in nature with no purposeful intent (e.g., a hurricane). Threat agents working alone, or in

concert, exploit vulnerabilities to create incidents. FISMA categorizes threats using a threat origination

taxonomy of purposeful (P), unintentional (U), or environmental (E) type threats as described in Table 8. 

Table 8: Threat Categories and Type Identifiers 

Threat Origination Category Type Identifier 

Threats launched purposefully P 

Threats created by unintentional human or machine error U 

Threats caused by environmental agents or disruptions E 

Threat actors for a variety of reasons launch purposeful threats and the reasons may never be fully known.

Curiosity, monetary gain, political gain, social activism, revenge or many other driving forces could motivate

threat actors. It is possible that some threats could have more than one threat origination category. 

Some threat types are more likely to occur than others are. FISMA considers threat types to help 

determine the likelihood that a vulnerability could be exploited. The threat table shown in 

Table 9 describes typical threats to information systems; these threats have been considered for <System 

Acronym>.
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Table 9: Potential Threats 

ID Threat Name Type Identifier Description Typical Impact to 

Confidentiality Inte

T-1. Alteration U, P, E Alteration of data, files, or records. ModiT-2. Audit 

Compromise P 

An unauthorized user gains access to the audit trail and could cause audit records to be deleted or modified, or prevents future audit records from being recorded, thus masking a security relevant event. 

Modior destr

T-3. Bomb P An intentional explosion. 

Modior destr

T-4. Communications 

Failure U, E Cut fiber optic lines, trees falling on telephone lines. 

T-5. Compromising 

Emanations P 

Eavesdropping can occur via electronic media directed against large scale electronic facilities that do not process classified National Security Information. 

Disclosure 

T-6. Cyber Brute 

Force P 

Unauthorized user could gain access to the information systems by random or systematic guessing of passwords, possibly supported by password cracking utilities. 

Disclosure 

Modior destr

T-7. Data Disclosure 

Attack P 

An attacker uses techniques that could result in the disclosure of sensitive information by exploiting weaknesses in system design or configuration. 

Disclosure 

T-8. Data Entry Error U 

Human inattention, lack of knowledge, and failure to cross-check system activities could contribute to errors becoming integrated and ingrained in automated systems. 

 Modi

T-9. Denial of Service 

Attack P 

An adversary uses techniques to attack a single target rendering it unable to respond; could cause denial of service for users of the targeted information systems. 
So

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ID Threat Name Type Identifier Description Typical Impact to 

Confidentiality Inte

T-10. Distributed Denial 

of Service Attack P 

An adversary uses multiple compromised information systems to attack a single target; could cause denial of service for users of the targeted information systems. 

T-11. Earthquake E 

Seismic activity can damage the information system or its facility. Refer to the following document for earthquake probability maps http://pubs.usgs.gov/of/2008/1128/pdf/OF08-

1128_v1.1.pdf . 

 Dest

T-12. Electromagnetic 

Interference E, P 

Disruption of electronic and wire transmissions could be caused by high frequency (HF), very high frequency (VHF), and ultra-high frequency (UHF) communications devices (jamming) or sun spots. 

T-13. Espionage P The illegal, covert act of copying, reproducing, recording, photographing or intercepting sensitive 

information. 

Disclosure Modi

T-14. Fire E, P Fire can be caused by arson, electrical problems, lightning, chemical agents, or other unrelated proximity 

fires. 

 Dest

T-15. Floods E Water damage caused by flood hazards can be caused by proximity to local flood plains. Flood maps and base 

flood elevation must be considered. 

 Dest

T-16. Fraud P 

Intentional deception regarding data or information about an information system could compromise the confidentiality, integrity, or availability of an information system. 

Disclosure 

Modior destr

T-17. 

Hardware or Equipment Failure 

E Hardware or equipment may fail due to a variety of 

reasons. 

T-18. Hardware 

Tampering P An unauthorized modification to hardware that alters the proper functioning of equipment in a manner that Modi
So

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ID Threat Name Type Identifier Description Typical Impact to 

Confidentiality Inte

degrades the security functionality provided by the asset. 

T-19. Hurricane E A category 1, 2, 3, 4, or 5 land falling hurricane could impact the facilities that house the information systems. DestT-20. Malicious 

Software P Software that damages a system such a virus, Trojan, or worm. Modi

or destr

T-21. Phishing Attack P 

Adversary attempts to acquire sensitive information such as usernames, passwords, or SSNs, by pretending to be communications from a legitimate/trustworthy source. Typical attacks occur via email, instant messaging, or comparable means; commonly directing users to Web sites that appear to be legitimate sites, while actually stealing the entered information. 

Disclosure 

Modior destr

T-22. Power 

Interruptions E 

Power interruptions may be due to any number of reasons such as electrical grid failures, generator failures, uninterruptable power supply (UPS) failures (e.g. spike, surge, brownout, or blackout). 

T-23. Procedural Error U An error in procedures could result in unintended 

consequences. 

Disclosure 

Modior destr

T-24. Procedural 

Violations P Violations of standard procedures. Disclosure 

Modior destr

T-25. Resource 

Exhaustion U 

An errant (buggy) process may create a situation that 

exhausts critical resources preventing access to services. 
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ID Threat Name Type Identifier Description Typical Impact to 

Confidentiality Inte

T-26. Sabotage P Underhanded interference with work. 

Modior destr

T-27. Scavenging P Searching through disposal containers (e.g., dumpsters) to acquire unauthorized data. Disclosure T-28. Severe Weather E 

Naturally occurring forces of nature could disrupt the operation of an information system by freezing, sleet, hail, heat, lightning, thunderstorms, tornados, or snowfall. 

 Dest

T-29. Social 

Engineering P 

An attacker manipulates people into performing actions, divulging confidential information, or providing access to computer systems or facilities. 

Disclosure 

T-30. Software 

Tampering P 

Unauthorized modification of software (e.g., files, programs, database records) that alters the proper operational functions. 

Modior destr

T-31. Terrorist P An individual performing a deliberate violent act could use a variety of agents to damage the information 

system, its facility, and/or its operations. 

Modior destr

T-32. Theft P An adversary could steal elements of the hardware. T-33. Time and State P 

An attacker exploits weaknesses in timing or state of functions to perform actions that would otherwise be prevented (e.g., race conditions, manipulation of user state). 

Disclosure Modi

T-34. Transportation 

Accidents E 

Transportation accidents include train derailments, river barge accidents, trucking accidents, and airline 

accidents. Local transportation accidents typically occur when airports, sea ports, railroad tracks, and major trucking routes occur in close proximity to systems facilities. Likelihood of HAZMAT cargo must 

 Dest
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ID Threat Name Type Identifier Description Typical Impact to 

Confidentiality Inte

be determined when considering the probability of local transportation accidents. 

T-35. Unauthorized 

Facility Access P 

An unauthorized individual accesses a facility which may result in comprises of confidentiality, integrity, or availability. 

Disclosure 

Modior destr

T-36. Unauthorized 

Systems Access P An unauthorized user accesses a system or data. Disclosure 

Modior destr

T-37. Volcanic Activity E 

A crack, perforation, or vent in the earth’s crust followed by molten lava, steam, gases, and ash forcefully ejected into the atmosphere. For a list of volcanoes in the U.S. see: http://volcanoes.usgs.gov/about/volcanoes/volcanolist.

php . 

 Dest
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4.4 Perform Risk Analysis 

NIST identifies risk assessment as the first process in the risk management methodology. Organizations

use the risk assessment to determine the extent of the potential threat and the risk associated with an

information system. NIST defines Risk as “a function of the likelihood of a given threat-source’s exercising

a particular vulnerability and the resulting impact of the adverse event on the organization”. The outcome

of performing risk analysis yields risk exposure metrics that can be used to make risk-based decisions. 

The FISMA risk analysis process is a qualitative risk analysis. In qualitative risk analysis, the risk level of

exploiting a threat may be subjective and the justification for each risk is explained in terms of probability.

The following tables have probabilities associated with the likelihood and the impact level of the risk. For

example, when a system is easy to exploit, it has a “Very High” likelihood that a threat could exploit the

vulnerability. Likelihood definitions and probabilities are in Table 10. 

Note: The likelihood levels should not be confused or used interchangeably with the security categorization

of the system even though they use the some of the same terminology. The security categorization is

determined by the sensitivity of the data residing on the information system and is in the FIPS 199

publication. 

Table 10: Likelihood Definitions from NIST 800-30 Rev. 1 Publication 

Likelihood 

Probability Level 

Description 

Very Low If the threat event is initiated or occurs, it is almost certain to have adverse impacts. 

Low If the threat event is initiated or occurs, it is unlikely to have adverse impacts. 

Moderate If the threat event is initiated or occurs, it is somewhat likely to have adverse

impacts. 

High If the threat event is initiated or occurs, it is highly likely to have adverse impacts. 

Very High If the threat event is initiated or occurs, it is almost certain to have adverse impacts. 

Impact refers to the magnitude of potential harm to the information system (or its data) by successful

vulnerability exploitation. Definitions for the impact are in Table 11. Since exploitation has not yet occurred,

these values are perception values based on available information system information if the exploitation of

a vulnerability can cause significant loss to a system (or its data) then the impact is “Very High”. 

Table 11: Impact Definitions from NIST 800-30 Rev. 1 Publication 

Impact 

Probability 

Description 

Very Low The threat event could be expected to have a negligible adverse effect on

organizational operations, organizational assets, individuals other organizations, or 

the Nation. 

Low The threat event could be expected to have a limited adverse effect on

organizational operations, organizational assets, individuals other organizations, or 

the Nation. A limited adverse effect means that, for example, the threat event might: 

(i) cause a degradation in mission capability to an extent and duration that the 

organization is able to perform its primary functions, but the effectiveness of the 

functions is noticeably reduced; (ii) result in minor damage to organizational assets; 

(iii) result in minor financial loss; or (iv) result in minor harm to individuals 
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Moderate The threat event could be expected to have a serious adverse effect on

organizational operations, organizational assets, individuals other organizations, or 

the Nation. A serious adverse effect means that, for example, the threat event might: 

(i) cause a significant degradation in mission capability to an extent and duration 

that the organization is able to perform its primary functions, but the effectiveness 

of the functions is significantly reduced; (ii) result in significant damage to 

organizational assets; (iii) result in significant financial loss; or (iv) result in 

significant harm to individuals that does not involve loss of life or serious lifethreatening injuries. 

High The threat event could be expected to have a severe or catastrophic adverse

effect on organizational operations, organizational assets, individuals, other

organizations, or the Nation. A severe or catastrophic adverse effect means that, for 

example, the threat event might: (i) cause a severe degradation in or loss of mission 

capability to an extent and duration that the organization is not able to perform 

one or more of its primary functions; (ii) result in major damage to organizational 

assets; (iii) result in major financial loss; or (iv) result in severe or catastrophic harm 

to individuals involving loss of life or serious life-threatening injuries. 

Very High The threat event could be expected to have multiple severe or catastrophic

adverse effects on organizational operations, organizational assets, individuals,

other organizations, or the Nation. 

The combination of the Likelihood Probability and the Impact Probability creates the risk exposure. The risk

exposure matrix shown in Table 12 presents the same likelihood and impact severity ratings as those found

in NIST SP 800-30 Rev. 1 Risk Management Guide for Information Technology Systems. 

Table 12: Risk Exposure Ratings from NIST 800-30 Rev. 1 Publication 

Likelihood Impact 

Very Low Low Moderate High Very High 

Very High Very Low Low Moderate High Very High 

High Very Low Low Moderate High Very High 

Moderate Very Low Low Moderate Moderate High 

Low Very Low Low Low Low Moderate 

Very Low Very Low Very Low Very Low Very Low Very Low 

Using Table 12 as a reference, Coalfire Federal Services reviewed all identified vulnerabilities and assigned

a risk exposure located in the <System Acronym> SRTM in Appendix B. 

Documenting the results of security control testing creates a record of the security posture for the system

at a given moment in time. The record can be used by the AO to make risk-based decision and to create

plans of action to mitigate unacceptable residual risks. 

FISMA requires that a Plan of Action and Milestones (POA&M) be developed. The POA&M is a mitigation

plan designed to address specific residual security risks and includes information on costing, resources,

and target dates for remediation efforts resolving the identified security weaknesses. The plan is utilized as

the primary mechanism for tracking all the residual risks and other issues. SSA will leverage the SAR to

create a POA&M for <System Acronym>. 
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5 Security Assessment Results 

This section describes all security risks found during assessment. The following elements for each security

risk are reported. 

• Identifier 

• Name 

• Source of Discovery 

• Description 

• Affected internet protocol (IP) Address/Hostname/Database 

• Applicable Threats 

• Likelihood (before mitigating controls/factors) 

• Impact (before mitigating controls/factors) 

• Risk Exposure (before mitigating controls/factors) 

• Risk Statement 

• Mitigating Controls/Factors 

• Likelihood (after mitigating controls/factors) 

• Impact (after mitigating controls/factors) 

• Risk Exposure (after mitigating controls/factors) 

• Recommendation 

Below is a description of the SAR security risk elements. 

• Identifier: All weaknesses are assigned a vulnerability identifier (ID) in the form of V#-Security 

Control ID. For example, the first vulnerability listed would be reported as V1-AC-2(2) if the 

vulnerability is for control ID AC-2(2). If there are multiple vulnerabilities for the same security 

control ID, the first part of the vulnerability ID must be incremented, for example V1-AC-2(2), V2-

AC-2(2). 

• Name: A short, unique name for each vulnerability. 

• Source of Discovery: The source of discovery refers to the method that was used to discover the 

vulnerability (e.g., web application scanner, manual testing, security test procedure workbook, 

interview, document review). References must be made to scan reports, security test case 

procedure IDs, staff that were interviewed, manual test results, and document names. All scans 

reports are attached in Appendix C, Appendix D, Appendix E, and Appendix F. Results of manual 

tests can be found in Appendix G. If the source of discovery is from one of the security test 

procedure workbooks, a reference must point to the workbook name, the sheet number, and the 

cell number. Workbook tests results are found in Appendix B. If the source of discovery is from 

an interview, the date of the interview and the people who were present at the interview are named. 

If the source of discovery is from a document, the document must be named. 
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• Description: All security weaknesses must be described in enough detail to be reproduced by the 

stakeholder, the Information System Security Officer (ISSO), or the AO. If a test was performed 

manually, the exact manual procedure and any relevant screenshots must be included. If a test 

was performed using a tool or scanner, a description of the reported scan results for that 

vulnerability must be included along with the vulnerability identifier (e.g., Common Vulnerabilities 

and Exposures (CVE), Common Vulnerability Scoring System (CVSS), Nessus Plugin ID) and 

screenshots of the particular vulnerability being described. If the tool or scanner reports a severity 

level, that level must be reported in this section. Any relevant login information and role information 

must be included for vulnerabilities discovered with scanners or automated tools. If any security 

weaknesses affect a database transaction, a discussion of atomicity violations must be included. 

• Affected IP Address/Hostname(s)/Database: For each reported vulnerability, all affected IP 

addresses/hostnames/databases must be included. If multiple hosts/databases have the same 

vulnerability, list all affected hosts/databases. 

• Applicable Threats: The applicable threats describe the unique threats that have the ability to 

exploit the security vulnerability. (Use threat numbers from Error! Reference source not found..) 

• Likelihood (before mitigating controls/factors): Very High, High, Moderate, Low, or Very Low 

(see Error! Reference source not found.). 

• Impact (before mitigating controls/factors): Very High, High, Moderate, Low, or Very Low (see 

Error! Reference source not found.). 

• Risk Exposure (before mitigating controls/factors): Very High, High, Moderate, Low, or Very 

Low (see Error! Reference source not found.). 

• Risk Statement: Provide a risk statement that describes the risk to the business. (See examples 

in Error! Reference source not found.). Also indicate whether the affected machine(s) is/are 

internally or externally facing. 

• Mitigating Controls/Factors: Describe any applicable mitigating controls/factors that could 

downgrade the likelihood or risk exposure. Also indicate whether the affected machine(s) is/are 

internally or externally facing. Include a full description of any mitigating factors and/or 

compensating controls if the risk is an operational requirement. 

• Likelihood (after mitigating controls/factors): Moderate or Low (see Error! Reference source 

not found.) after mitigating control/factors have been identified and considered. 

• Impact (after mitigating controls/factors): Moderate or Low (see Error! Reference source not 

found.) after mitigating control/factors have been identified and considered. 

• Risk Exposure (after mitigating controls/factors): Moderate or Low (see Error! Reference 

source not found.) after mitigating controls/factors have been identified and considered. 

• Recommendation: The recommendation describes how the vulnerability should be resolved. 

Indicate if there are multiple ways that the vulnerability could be resolved or recommendation for 

acceptance of operational requirement. 

5.1 Security Assessment Summary 

<Two (2) vulnerabilities, (0 high, zero moderate, 2 low)> have been discovered as part of the manual 

security assessment testing. Vulnerability scans provided did not provide enough information to provide 

analysis of scan vulnerability to assessment result. 
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The vulnerabilities summary is contained in the following embedded file: 

Table 13: Risk Exposure 

T2 Risk Exposure 

Table.xlsx

<Embed applicable system’s Risk Exposure table, EXAMPLE attached.> 

6 Non-conforming Controls 

In some cases, the initial risk exposure to the system has been adjusted due to either corrections that 

occurred during testing or to other mitigating factors. Additional detail is provided in the following sections. 

6.1 Risks Corrected During Testing 

Any risks that were discovered during the testing of the <System Acronym> subsystems and subsequently 

mitigated prior to authorization are listed in Table 14. Coalfire Federal Services verified risks corrected 

during testing. The verification method used to determine correction is noted in the right-hand column of 

Table 14. 

Table 14: Summary of Risks Corrected During Testing 

Identifier Description Source of 

Discovery 

Initial Risk 

Exposure 

Remediation 

Description 

Date of 

Remediation 

Verification 

Statement/Testing 

Procedures 

 

6.2 Risks with Mitigating Factors 

Risks that have had their severity levels changed due to mitigating factors are summarized in Table 15.

The factors used to justify changing the initial risk exposure rating are noted in the right-hand column of the

table. See Table 13 for more information on these risks. 

Table 15: Summary of Risks with Mitigating Factors 

Identifier Description Source of 

Discovery 

Initial Risk 

Exposure 

Current Risk 

Exposure 

Description of 

Mitigating 

Factors 

 

6.3 Risks Remaining Due to Operational Requirements 

Risks that reside in the <system acronym> that cannot be corrected due to operational constraints are 

summarized in Error! Reference source not found.. An explanation of the operational constraints and 

risks are included in Error! Reference source not found. as well as in the appropriate security assessment 

test cases and SSP. Because these risks will not be corrected, they are not tracked in the POA&M. See 

Error! Reference source not found.for more information on these risks. 
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Table 16: Summary of Risks Remaining Due to Operational Factors 

Identifier Description Source of Discovery Current Risk Exposure Operational 

Requirements 

Rationale 

 
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7 Risks Known for Interconnected Systems 

Inherent relationships between the system and other interconnected systems may affect the overall system

security posture. A summary of the risks known for systems that connect to <System Acronym> is provided 

in Table 17. 

Table 17: Risks from Interconnected Systems 

System Authorization 

Date/Status 

Date of POA&M Control Family 

Identifier 

 

8 Recommendations 

<System Acronym> subsystem risks that were discovered during the assessment have an impact on 

the security posture of the SSA Federal Agency as a whole. These risks must be mitigated and Coalfire 

Federal Services has made recommendations in the Risk Exposure section, Table 14. These

recommendations should be addressed by the SAM, system owners, OIS, and other stakeholders that have

a responsibility for the controlling the overall risk of <System Acronym>. 

 
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Appendix A. Acronyms and Terms 

Acronyms and terms used throughout this SAR are defined in Table 18. 

Table 18: Acronyms and Terms 

Acronym/Term SAR Acronym Definitions

AC Associate Commissioner 

AC Access Control 

AO Authorizing Official 

ARB Architecture Review Board 

ART Analysis and Reporting Tool 

AU Audit and Accountability 

BRI Benefit Rate Increase 

BSM Boundary Scope Memo 

CA Security Assessment and Authorization 

CCB Configuration Control Board 

CIC Customer Information Control System 

CM Configuration Management 

CMP Contingency Management Plan 

COTR Contract Officer’s Technical Representative 

CSAM Cyber Security Assessment & Management 

CSO Component Security Officer 

CVE Common Vulnerabilities and Exposures 

CVSS Common Vulnerability Scoring System 

DCS Deputy Commissioner for Systems 

DSPP Division of Security Policy & PII 

EPECS Electronic Personal Enrollment Credential System 

EPO ePolicy Orchestrator 

FIPS Federal Information Processing Standard 

FISMA Federal Information Security Modernization Act 

FOIA Freedom of Information Act 

HRMIS Human Resources Management Information System 

HRODS Human Resources Operational Data Store 

HSPD Homeland Security Presidential Directive 

IA Identification and Authentication 

ID Identification 
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IP Internet Protocol 

ISCP Information System Contingency Plan 

ISO Information Security Officers

ISP Information Security Policy

ISSO Information System Security Officer 

LIS Low Income Subsidy 

NIST National Institute of Standards and Technology 

NSC National Support Center 

OIS Office of Information Security 

OMB Office of Management and Budget 

OSOHE Office of Systems Operations and Hardware Engineering

OTSO Office of Telecommunications and Systems Operations 

PAM Payment Application Modernization 

PCCB Project Configuration Control Board

PIN Personal Identification Number

PIV Personal Identification Verification 

PL Public Law 

PL (Control) Planning 

PM Program Manager 

POA&M Plan of Action and Milestones 

PRIDE Project Resource Guide 

PS (Control) Personnel Security 

P, U, E Purposeful, Unintentional, Environmental 

SA System and Services Acquisition 

SAM Security Authorization Manager 

SAP Security Assessment Plan 

SARA Security Administration Report Application (User Guide)

SAR Security Assessment Report

SC Systems and Communications Protection 

SDLC System Development Life Cycle 

SI System and Information Integrity 

SMACS Security Management Access Control Systems

SO System Owner

SOC Security Operation Division 
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SP Special Publication 

SRC System Release Certificate

SRTM Security Requirements Traceability Matrix

SSA Social Security Administration 

SSC Secondary Support Center 

SSP System Security Plan 

SVR Security Violations Report

Threat An adversarial force or phenomenon that could affect the availability,

integrity, or confidentiality of an information system, its networks, and the

facility that houses the hardware and software.

Threat Actor An entity that initiates the launch of a threat agent is referred to as a threat

actor. 

Threat Agent An element that provides the delivery mechanism for a threat. 

UPS uninterruptable power supply 

USC United States Code 

Vulnerability An inherent weakness in an information system that can be exploited by a

threat or threat agent, resulting in an undesirable impact in the protection

of the confidentiality, integrity, or availability of the system (application and

associated data). 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 24 

Appendix B. Security Risk Traceability Matrix (SRTM) 

The Security Risk Traceability Matrix (SRTM) with test results and test procedures are within the following

embedded document in Table 19. 

Table 19: Security Test Procedure Workbook 

T2 SRTM 

Worksheet.xlsx

<Embed the applicable system’s Security Risk Traceability Matrix (SRTM), EXAMPLE attached.>
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 25 

Appendix C. Infrastructure Scan Results 

The Nessus scanner along with the McAfee ePolicy Orchestrator (EPO) deployed by the SOC was used to

scan SSA servers. Associated Windows Database servers that have the EPO agent deployed within the

<System Acronym > boundary were scanned. The other <System Acronym> servers did not have 

any vulnerability scanning tools available, which allowed for scanning of mainframe or storage hardware, 

and therefore were not scanned. 

Infrastructure Scans: Inventory of Items Scanned 

Table 20 provides an inventory of infrastructure items scanned during this assessment. 

Table 20: Inventory of Items Scanned 

T2 Scanned 

Inventory Items.xlsx

<Embed the applicable system’s Inventory of Items Scanned, EXAMPLE attached.>

Infrastructure Scans: Raw Scan Results 

Table 21 has the <System Acronym> raw scan results: 

Table 21: Raw Scan Results 

T2 Raw Scan 

Results.xlsx

<Embed the applicable system’s Raw Scan Results, EXAMPLE attached.>

Infrastructure Scans: False Positive Reports 

Table 22 provides a list of false positive reports collected during infrastructure scans if applicable. 

Table 22: Infrastructure Scans: False Positive Reports 

ID# IP Address Scanner Severity Level Finding False Positive 

Explanation 

 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 26 

Appendix D. Database Scan Results 

Database scan results are included in this appendix. 

Database Scans: Inventory of Databases Scanned 

Table 23 provides an inventory of any databases scanned during this assessment if applicable. 

Table 23: Inventory of Databases Scanned 

IP Address Hostname Software and Version Function Comment 

 

Database Scans: False Positive Reports 

Table 24 provides a list of false positive reports collected during database scans if applicable. 

Table 24: Database Scans: False Positive Reports 

ID# IP Address Scanner Severity Level Finding False Positive 

Explanation 

 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 27 

Appendix E. Web Application Scan Results 

Web application scan results are included in this appendix. 

Web Application Scans: Inventory of Web Applications 

Scanned 

Table 25 provides an inventory of all web applications scanned during this assessment if applicable. 

Table 25: Inventory of Web Applications Scanned 

Login URL IP Address of Login Host Function Comments 

 

Web Application Scans: False Positive Reports 

Table 26 provides a list of false positive reports collected during web application scans if applicable. 

Table 26: Web Application Scans: False Positive Reports 

ID# IP Address Scanner Severity Level Finding False Positive 

Explanation 

 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 28 

Appendix F. Assessment Results 

Assessment results are summarized in Table 27. 

Table 27: Summary of System Security Risks from FISMA Testing 

Risk Level Assessment Test Cases Total 

High <# high risks> <% of total risks> 

Moderate <# moderate risks> <% of total risks> 

Low <# low risks> <% of total risks> 

Operationally 

Required 

<# operationally required 

high risks> 

<% of total risks> 

Total <Sum of all H, M, L risks> 100%

 NOTE: Total is the sum of high, moderate, and low risks with operationally required 

risks being represented as a subset of this total. 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 29 

Appendix G. Penetration Test Report 

<Update the text below to reflect actual penetration test results for this assessment. Embed the penetration 

test report as appropriate.> 

Coalfire Federal Services is not authorized as per the Statement of Work (SOW) to perform a formal

Penetration Test for the <System Acronym> Batch and Internet Services subsystems. Therefore, no data 

from a penetration test is available for this assessment. 
Social Security Administration 

<System Name> 

Security Assessment Report (SAR) 

Version <X.X>

TMP V1.3 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 30 

Appendix H. Security Assessment Report Signature 

Table 28: SAR Signatures 

Acceptance and Signature 

I have read the above Security Assessment Report prepared by the third party assessment organization,

Coalfire Federal Services. I acknowledge the assessment was completed as per the <System 

Acronym> SAP and understand the findings detailed herein. 

Security Authorization Manager/ 

<SAM>: 

OIS Division of Compliance and 

Assessments Director: 

<DD> 
EXHIBIT D
UNCLASSIFIED // FOR OFFICIAL USE ONLY 

UNCLASSIFIED // FOR OFFICIAL USE ONLY 

Social Security Administration (SSA) 

Security Categorization: <Enter Categorization>

Risk Assessment Report (RAR)

FOR 

<System Name> (<Acronym>) 

<DRAFT/FINAL> Version <x.x>

<Month DD, YYYY>

Prepared by 

Office of Information Security
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY ii 

<INSTRUCTIONS: Orange, bracketed text indicates instructions on how a section should be 

completed or sample text, which should be replaced with project specific information or removed. 

Ensure sample text is turned from orange to black where necessary (e.g., headings shall be 

changed to the standard heading color), and all instructions are removed (including this paragraph). 

All black text shall remain unchanged.>
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY iii 

Document Revision History 

Revision 

History Date Summary of Changes Author 

1.0 <Month DD, YYYY> Initial release <name>

<x.x> <Month DD, YYYY> <description> <name>

<x.x> <Month DD, YYYY> <description> <name>
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY iv 

Table of Contents 

1 RISK ASSESSMENT REPORT (RAR) BACKGROUND ...................................................... 6

2 RAR EXECUTIVE SUMMARY FOR <SYSTEM NAME> ...................................................... 6

3 <SYSTEM NAME> SYSTEM PURPOSE .............................................................................. 6

3.1 System Name/Title/Unique Identifier ........................................................................................... 6

3.2 Responsible Organization ............................................................................................................ 7

3.3 Security Categorization ................................................................................................................ 8

4 RISK ASSESSMENT APPROACH ....................................................................................... 8

4.1 Risk Assessment Purpose ........................................................................................................... 8

4.2 Risk Assessment Objective ......................................................................................................... 8

4.3 Risk Assessment Scope .............................................................................................................. 9

4.4 Limitations .................................................................................................................................... 9

4.5 Risk Assessors ............................................................................................................................ 9

4.6 Results ....................................................................................................................................... 10

4.7 Recommendation ....................................................................................................................... 11

5 SUMMARY OF FINDINGS .................................................................................................. 12

APPENDIX A. REFERENCE DOCUMENTS .......................................................................... 15
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY v 

List of Tables 

Table 1: <SYSTEM ACRONYM> Points of Contact ..................................................................................... 7

Table 2: <System Name> Security Categorization ....................................................................................... 8

Table 3: Assessment Team Points of Contact ......................................................................................... 9

Table 4: Overall Risk Level ......................................................................................................................... 10

Table 5: <SYSTEM ACRONYM> Results Summary .................................................................................. 12

Table 6: Acronym List ................................................................................................................................. 14
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 6

1 Risk Assessment Report (RAR) Background 

The Office of Management and Budget (OMB) directive requires the Social Security Administration (SSA) 

to assess and re-authorize its major information technology (IT) systems at least once every three years 

and in the event of a major change, when that change occurs. This information must be reported in the 

annual Federal Information Security Modernization Act (FISMA) report to OMB and Congress during the 

fourth quarter (Q4) of each year. OMB has directed Chief Information Officers (CIO) of Federal agencies to 

follow the guidance found in the National Institute of Standards and Technology (NIST) Special Publication 

(SP) 800-37 Revision 1, Guide for Applying the Risk Management Framework to Federal Information 

Systems, to assess and re-authorize their information systems. This security authorization process contains 

subordinate efforts including performing risk-based reviews of the systems, developing/updating system 

security plans (SSP), and assessing and testing the security controls implemented for SSA’s information 

systems. 

2 RAR Executive Summary for <System Name> The Office of Information Security (OIS) contracted with Coalfire Federal Services, a third party assessment 

organization (3PAO), to conduct a system specific risk assessment on <system name> (<ACRONYM>). 

The acting Director of the Division of Compliance and Assessments, and the Security Authorization 

Manager (SAM) of <SYSTEM ACRONYM> approved the controls selected for this risk assessment. Thirtytwo (32) controls were tested over eleven (11) different NIST 800-53 Rev 4 control families. These controls 

were selected out of the <system categorization> baseline due to <SYSTEM ACRONYM> being 

categorized as a <system categorization> system as per the FIPS 199. During the assessment, there were 

<55 manual tests conducted, 62 interviews, and 84 document examinations>. Each of these is a 

requirement of a specific control. At the conclusion of the assessment, two controls were identified as “not 

implemented”. It should be noted that these controls have since been identified as common and should be 

added to the common control list. The controls that were not implemented, identified as PS4 (personnel 

termination), and PS 5 (personnel transfer), requires the SSA Information Security Policy (ISP) to document 

specific exit interview security debrief policies and procedures and the defined time period in which these 

must be carried out. Please refer to Table 5 for specific details. The likelihood of these vulnerabilities being 

exploited combined with the potential system impact is considered an overall LOW risk to the system. It is 

recommended that the <system name> assigned representative from the Security Assessment and 

Authorization Branch (SAAB) work with the System Authorization Manager (SAM) to mitigate these risks. 

Due to the overall identified risk being LOW, it is recommended that this be considered an acceptable risk 

and the system be given an authority to operate (ATO) for the next three years. 

3 <system name> System Purpose 

The <system name> (<ACRONYM>) system, has a <system categorization> Security Categorization. The 

boundaries are designed to aid SSA in the accomplishment of its mission to provide cost-effective and 

reliable services to other Federal agencies, and the public at large. 

<Insert detailed information> 

Coalfire Federal Services’ objective is to provide IT Independent Verification and Validation (IV&V) Support 

Services for <SYSTEM ACRONYM>. 

3.1 System Name/Title/Unique Identifier 

System/Application Name: <system name> (<SYSTEM ACRONYM>)

Unique Identifier : <016-00-SSA/DCS-M-001> 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 7

3.2 Responsible Organization 

Table 1: <SYSTEM ACRONYM> Points of Contact 

Title II Batch 

POCs.xlsx

Title II Internet 

Applications POCs.xlsx

<Embed the applicable system’s POCs, EXAMPLE attached.>
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 8

3.3 Security Categorization 

This authorization boundary has been categorized as <system categorization> risk according to FIPS 

199. Refer to Table 5 below for supporting documentation regarding the determination of the 

application’s security categorization. 

Table 2: <System Name> Security Categorization 

Information Type Confidentiality Integrity Availability 

Accounting 

Mission Area: Financial Management 

Explanation: Selected risk values derived from NIST SP-800-

60, and FIPS 199, considering SSA business case.

L M L

Payments 

Mission Area: Financial Management 

Explanation: Selected risk values derived from NIST SP-800-

60, and FIPS 199, considering SSA business case.

L M L

Reporting & Information 

Mission Area: Financial Management 

Explanation: Based on the protection requirements for 

confidentiality, integrity and availability, the overall system 

sensitivity is <SYSTEM CATEGORIZATION>. The loss, 

misuse or unauthorized access to Agency data can be 

expected to have a serious adverse effect on SSA operations 

and assets.

L M L

Entitlement Event Information 

Mission Area: General Government 

Explanation: Selected risk values derived from NIST SP-800-

60, and FIPS 199, considering SSA business case.

M M M

Personal Identity and Authentication 

Mission Area: General Government

M M M

Information Sharing 

Mission Area: Information and Technology Management 

Explanation: Selected risk values derived from NIST SP-800-

60, and FIPS 199, considering SSA business case.

N/A N/A N/A

Overall M M M 

4 Risk Assessment Approach 

4.1 Risk Assessment Purpose 

The purpose of this Risk Assessment Report (RAR) is to summarize the residual risk identified during the 

security assessment of <SYSTEM ACRONYM>. Risk is a factor derived from a vulnerability that can be 

exploited and the likelihood that it will be exploited. Please see Appendix A for the NIST 800-60 Volume II 

publication for the definition of risk. 

4.2 Risk Assessment Objective 

The objective of the risk assessment is to identify any controls that are not fully implemented as required 

by FISMA. Controls that are not implemented pose a measureable risk to SSA and that risk must be 

mitigated in a timely manner based on the level or risk the non-implemented control creates. For example, 

a low risk may only require an update to a policy or a POA&M that the system’s SAM must execute. Another 

example is a High risk that must have immediate action taken by the SAM and other stakeholders in order 

to prevent a threat actor(s) from exploiting the discovered risk. 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 9

4.3 Risk Assessment Scope 

The previous system specific risk assessment was conducted on <SYSTEM ACRONYM> in <date>. The 

residual risk was identified and submitted to the SSA’s CIO. This submission was in accordance with OMB 

and FISMA guidelines to present the risk level of <SYSTEM ACRONYM> and ask for the ATO <SYSTEM 

ACRONYM> for the next three years. The CIO granted the ATO on <Month DD, YYYY> and allowed 

<SYSTEM ACRONYM> to operate from <Month DD, YYYY> to <Month DD, YYYY>. 

A new risk assessment is required by OMB and FISMA in order to identify the current residual risk and any 

risks associated with controls that are not fully implemented. The assessed controls were selected based 

on the <SYSTEM ACRONYM> Security Assessment Plan (SAP) approved by the OIS Director and the 

<SYSTEM ACRONYM> SAM. 

In addition to the controls selected, SSA uses the Nessus scanner along with the McAfee ePolicy 

Orchestrator (EPO) deployed by the SOC to look for signature based vulnerabilities in accordance with the 

SSA ISP. Associated Windows Database servers that have the EPO agent deployed within the <SYSTEM 

ACRONYM> boundary were scanned. The other <SYSTEM ACRONYM> servers did not have any 

vulnerability scanning tools available that could scan mainframe or storage hardware, and therefore were 

not scanned. 

The risk assessment was performed in accordance with all applicable laws, regulations, rules and orders 

of all governmental agencies and authorities. A complete list of referenced publications and regulations can 

be found in Appendix A. All risks associated with <SYSTEM ACRONYM> that were identified during the 

assessment and the potential impact of those risks are documented in this RAR. 

The RAR complies with the following SSA guidance: 

 SSA ISP

4.4 Limitations 

The <SYSTEM ACRONYM> subsystems, which reside within the National Support Center (NSC), rely on 

the Office of Systems Operations and Hardware Engineering (OSOHE) for hardware, software, and 

maintenance support. Additionally, user access and user profile provisioning for <SYSTEM ACRONYM>

subsystems residing on the mainframe, are provided by CA Top Secret, and managed by the Office of 

Systems Operations and Hardware Engineering (OSOHE), not by <SYSTEM ACRONYM>. Therefore, 

some access controls specific to <SYSTEM ACRONYM> are tested during an enterprise level common 

control assessment, and not during the <SYSTEM ACRONYM> system specific assessment reported 

within this RAR. 

This assessment was limited to the 32 system specific controls as listed in the approved SAP. 

4.5 Risk Assessors 

The participants in this risk assessment included the following Coalfire Federal Services personnel: 

Table 3: Assessment Team Points of Contact 

Name Role Contact Information 

<TJ Crews> Program Manager <Tj.crews@ssa.gov> 

<Kenneth Free> Lead Assessor (Senior Analyst) <kenneth.free@ssa.gov> 

<Gregory Bonham> Junior Assessor <gregory.bonham@ssa.gov> 

<Thomas G. Volpe, Sr.> Lead Assessor (Surge Support) <Thomas.G.Volpe@ssa.gov> 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 10

The following techniques and NIST/FIPS publications were used to gather information relevant to the 

<SYSTEM ACRONYM>: 

 NIST SP 800-60 Volume II Revision 1/ and FIPS 199. The Risk Assessment (RA) Team utilized 

the <SYSTEM ACRONYM> Security Categorization, dated February 16, 2017 to determine 

associated system security categorization for the <SYSTEM ACRONYM>. System security 

categorization determines which recommended set of minimum (baseline) security controls from 

NIST SP 800-53 Revision 4 must be implemented. 

 NIST SP 800-53 Revision 4. The RA Team utilized NIST SP 800-53 Revision 4 to determine the 

recommended set of minimum-security controls. The security controls (management, operational, 

and technical safeguards or countermeasures) were reviewed to ensure they adequately protect 

the confidentiality, integrity, and availability of the <SYSTEM ACRONYM>, and that the selected 

security controls have been implemented, or there is a plan for future implementation. 

 Interviews. Interviews were conducted on-site with the SAM, System Administrator, and Database 

Administrator by the RA Team to collect useful information about the <SYSTEM ACRONYM>. 

Follow-up communications were conducted via email and by telephone to collect additional 

information about the <SYSTEM ACRONYM>. 

 Examination/Document Reviews. The RA Team reviewed documentation from the SSA for 

<SYSTEM ACRONYM>, such as policy and implementation guidance. POA&M, and the prior 

Security Assessment and Authorization (SA&A) Package, including the previous SSP, Risk 

Assessment, and the Security Control Assessment (SCA) Plan were reviewed. 

 Testing of Systems. Testing and Evaluation of security controls for <SYSTEM ACRONYM> was 

based on System Specific and Hybrid security controls defined by the OIS Rev4 SSA Control 

Inheritance Structure Worksheet with a <SYSTEM CATEGORIZATION> Baseline. Using the NIST 

Guidance from NIST SP 800-53A Revision 4, the RA Team tested and evaluated these controls for 

specified conditions that compare actual with expected behavior, the results of which are used to 

support the determination of security control existence, functionality, correctness, completeness, 

and potential for improvement over time. 

4.6 Results 

The overall risk level of the <SYSTEM ACRONYM> was determined to be Low, which is the combination 

of the likelihood of identified threats being able to exploit known system vulnerabilities and the potential the 

impact to <SYSTEM ACRONYM>. 

Low risk indicates that corrective actions are needed and a plan must be developed to incorporate these 

actions within a reasonable period of time. The preliminary review of security measures for the protection 

of the <SYSTEM ACRONYM> identified two low threat-vulnerability pairs (risks) in the overall risk 

assessment as summarized below in Table 2. 

Table 4: Overall Risk Level 

Risk Rating Control Category

Management Operational Technical Total 

Very High 0 0 0 0 

High 0 0 0 0 

Moderate 0 0 0 0 

Low 2 0 0 2 

Very Low 0 0 0 0 

Total 2 0 0 2 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 11

4.7 Recommendation 

It is the recommendation from the Office of Information Security that an issuance of an Authority to Operate 

(ATO) for <system name> (<ACRONYM>) be given. This recommendation comes from the assessment 

findings from the 3PAO that conducted a system specific security assessment. The overall security 

categorization of <SYSTEM ACRONYM> is <system categorization> and the findings have an overall risk 

of LOW. 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 12

5 Summary of Findings 

Table 5: <SYSTEM ACRONYM> Results Summary

Item 

No. 

Finding 

(In Order by Control 

Family) 

Threat Source Likelihood 

Level 

Impact 

Level 

Risk 

Level 

Recommended 

Corrective 

Action(s) 

V-1 PS-4.c.1 

PS-4.c.2 

Personnel 

Termination 

SSA ISP does not 

define the security 

debrief topics or policy 

to discuss with 

separating employees. 

In addition, the SSA 

ISP has no policy, 

guidelines for including 

the security debrief 

actions, or SSA specific 

information security 

topics during the exit 

interview as defined in 

PS-4.c.1 and PS-4.c.2. 

Insider Threat with 

Intent (e.g., Poorly 

Trained, 

Disgruntled, 

Malicious, 

Negligent, 

Dishonest, or 

Terminated 

Employees) 

Insider Threat 

without Intent or 

Knowledge 

Computer 

Crime/Hackers 

Espionage (e.g., 

Companies, 

Foreign 

Governments, or 

Other Government 

Interests) 

Low Low Low This is an agency 

requirement that 

must be reflected in 

the SSA ISP and is 

the responsibility of 

Division of Security 

Customer Service 

(DSCS). The 

Security 

Authorization 

Manager (SAM) is 

not responsible for 

updating policy. The 

SSA ISP should be 

updated to include a 

requirement that 

employees sign a 

Non-Disclosure 

Agreement (NDA), 

and have a security 

debrief to discuss 

the importance of 

not disclosing 

knowledge of 

specifics pertaining 

to the SSA 

information system 

environment. The 

ISP section 2.1.1.3 

should be updated 

to reflect this. In 

addition, section 

2.1.1.3 should be 

updated to reflect 

that a security 

debrief must be 

included as part of 

the exit interview. 

Exit interview 

guidance is currently 

located here: 

http://personnel.ba.s

sa.gov/OPE/cpps/exi

tprocedures.html 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 13

Item 

No. 

Finding 

(In Order by Control 

Family) 

Threat Source Likelihood 

Level 

Impact 

Level 

Risk 

Level 

Recommended 

Corrective 

Action(s) 

V-2 PS-5.b.1 

PS-5.b.2 

Personnel Transfer 

SSA ISP does not 

define what security 

actions are to be taken 

when an employee is 

transferred or 

reassigned. The SSA 

ISP also does not 

specify the time period 

in which security 

actions that are defined 

in must occur. 

Insider Threat with 

Intent (e.g., Poorly 

Trained, 

Disgruntled, 

Malicious, 

Negligent, 

Dishonest, or 

Terminated 

Employees) 

Insider Threat 

without Intent or 

Knowledge 

Low Low Low This is an agency 

requirement that 

must be reflected in 

the SSA ISP and is 

the responsibility of 

DSCS. The ISP 

section 2.4 should 

be updated to define 

what security actions 

need to occur, in 

what period of time 

and what personnel 

or role is to be 

identified to be 

notified when an 

employee is 

transferred or 

reassigned. 

Authority To Operate (ATO) 

Recommendation 

Acceptance and Signature 

As the Security Authorization Manager (SAM) for <system name>, I hereby certify that this Risk 

Assessment Report provides an accurate representation of the system and its subsystems that were 

assessed. I also certify that it is my recommendation based on the findings that the SSA Chief 

Information Officer (CIO) grant an Authority to Operate (ATO) for <system name> for the next three (3) 

years. 

Security Authorization Manager: 

<name> 

As the Acting Director of the Division of Compliance and Authorization (DCA) in the Office of Information 

Security (OIS), I hereby certify that this Risk Assessment Report provides an accurate representation of 

the system and its subsystems that were assessed. I also certify that it is my recommendation based on 

the findings that the SSA Chief Information Officer (CIO) grant an Authority to Operate (ATO) for <system 

name> for the next three (3) years. 

Division of Compliance and 

Assessments Director 

Steven Harkness 

(Acting)
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 14

Table 6: Acronym List 

Acronym Definition 

AO Authorizing Official 

BSM Boundary Scope Memorandum 

CET Customer Engagement Tool 

CICS Customer Information Control System 

CIO Chief Information Officer 

CSO Component Security Officer 

DCA Division of Compliance and Authorization 

DCS Deputy Commissioner for Systems 

EPO McAfee ePolicy Orchestrator 

FIPS Federal Information Processing Standard 

FISMA Federal Information Security Modernization Act 

FOUO For Official Use Only 

ISA Interconnection Security Agreement 

ISP Information Security Policy 

IT Information Technology 

IV&V Independent Verification and Validation 

L2TP Layer 2 Tunneling Protocol 

LAN Local Area Network 

LIS Low Income Subsidy 

MKS Mortise Kern Systems 

MOA Memorandum of Agreement 

MOU Memorandum of Understanding 

NDA Non-disclosure Agreement 

NSC National Support Center 

NIST National Institute of Standards and Technology 

OIS Office of Information Security 

OMB Office of Management and Budget 

OSOHE Office of Systems Operations and Hardware Engineering 

OTSO Office of Telecommunications and System Operations 

PII Personally Identifiable Information 

POA&M Plan of Action and Milestones 

PSC Program Service Centers 

RA Risk Assessment or Risk Assessor 
Social Security Administration 

<System Name> 

Risk Assessment Report (RAR) 

Version <x.x>

 UNCLASSIFIED // FOR OFFICIAL USE ONLY 15

Acronym Definition 

RAR Risk Assessment Report 

RSDI Retirement, Survivor, or Disability Insurance 

SA&A Security Assessment and Authorization 

SAM Security Authorization Manager 

SAP System Assessment Plan 

SBU Sensitive But Unclassified 

SCA Security Control Assessment 

SO System Owner 

SP Special Publication 

SSA Social Security Administration 

SSP System Security Plan 

VPN Virtual Private Network 

3PAO Third Party assessment Organization 

 

APPENDIX A. REFERENCE DOCUMENTS 

The following documents were reviewed during the risk assessment process of the SSA’s security 

controls: 

 Federal Information Processing Standard (FIPS) 199 

 NIST Special Publication 800-30 Rev. 1, “Guide for Conducting Risk Assessments” 

 Office of Management and Budget (OMB) Circular A-130. 

 NIST Special Publication 800-39 

 NIST Special Publication 800-60 Revision 1, Volumes 1&2 

 NIST Special Publication 800-53 Revision 4 

 SSA Information Security Policy (ISP) 
EXHIBIT E
UNCLASSIFIED // FOR OFFICIAL USE ONLY 

UNCLASSIFIED // FOR OFFICIAL USE ONLY 

TEMPLATE VERSION (V2.2 FY17) 

Social Security Administration (SSA) 

Security Categorization: <Enter Categorization>

 NOTE: The Security Categorization for the system may not be available at the time of

the development of this document if the system is a newly developed system or has

undergone a major change which has augmented the data types processed by the

system. Additional information on completing the security categorization of the

information system can be found on the DSPP website at:

http://sharepoint.ba.ssa.gov/DCS/OIS/DSPP/Veris%20TO14%20IVV%20and%20OA/

Forms/AllItems.aspx?RootFolder=%2fDCS%2fOIS%2fDSPP%2fVeris%20TO14%20I

VV%20and%20OA%2fIVV%2fTEMPLATES%2fOIS%20TEMPLATES%20FY16&Fol

derCTID=0x0120003BC3DC1169B0CE47BB662BC248F5B5EE.

<Document Name> 

FOR 

<Externally Hosted Information System Name> 

<(Acronym)> 

<DRAFT/FINAL> Version <X.X> 

<Month DD, YYYY> 

Prepared by 

[COMPANY LOGO] 

[COMPANY STREET ADDRESS] 

[COMPANY CITY, STATE ZIP]
Social Security Administration 

<System Name><System Acronym> 

<Document Name> 

Version <X.X>

TMP V2.2 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY ii

Document Revision History 

Revision 

Number Revision Date Page Number Revision Summary Name of Reviewer 

V[X.X] MM/DD/YYYY All/Page 

No. [E.g. Initial Draft, Annual Review, etc.] 

[Company/Agency 

Name: Contact 

Name] 

 

 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

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TMP V1.2 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY iii 

PREFACE

To carry out its wide-ranging responsibilities, the Social Security Administration (SSA), and its employees 

and managers have access to diverse and complex automated information systems, which includes, file 

servers, local and wide area networks (LANs/WANs) running on various platforms, and 

telecommunications systems. The components and offices within the SSA depend on the confidentiality, 

integrity, and availability (as defined by the Federal Information Processing Standard (FIPS) 199) of these 

systems and their data in order to accomplish day-to-day operations. 

In accordance with Office of Management and Budget (OMB) Circular A-130, Appendix III, all federal 

systems have value and require some level of protection. The generic term “system” is used to mean 

either a general support system or a major application. (See NIST Special Publication 800-18, Guide for 

Developing Security Plans for Federal Information Systems for additional information). 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

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EXECUTIVE SUMMARY

The SSA relies on its information technology (IT) systems, including the [Enter SYSTEM NAME 

(Acronym)], to accomplish its undertaking of providing cost-effective and reliable services to the SSA, 

other Federal agencies, and the public at large. Since this externally hosted information system is part of 

an SSA security authorization boundary, it is subject to meet some or all of the SSA specific security 

requirements depending upon the information it processes and the services it provides for the SSA. 

[Provide an EXECUTIVE SUMMARY and overview of the information system. This summary should 

describe what the information system is, what its importance is to SSA, who is in the user audience, and 

any additional subsystems that is encompassed in the system.] 

The purpose of this system security plan is to provide an overview of the security requirements of the 

[ENTER SYSTEM NAME HERE] system and describe the controls in place or planned for meeting those 

requirements. The system security plan also delineates responsibilities and expected behavior of all 

individuals who access the system. 

The SSP documents the structured process of planning adequate, cost-effective security protection for a 

system. It shall reflect input from various managers/stakeholders with responsibilities concerning the 

system from the hosting company and from the SSA component for which the system provides services. 

 [Note: This SSP template shall be used to document an external hosted Information 

Systems that “IS” associated with one of the existing SSA Security Authorization 

Boundaries. 

As part of the development of this SSP document, the external system ISO or designee along with the 

SSA SAM and the Office of Information Security (OIS) will need to follow the instructions to determine 

which new application/system/sub-system should be included or associated with SSA. See section 1.1 

below for more details related to this process.]  DELETE THESE INSTRUCTIONS UPON 

COMPLETION 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

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SYSTEM SECURITY PLAN AGREEMENT SUMMARY

This SSP documents a formal agreement among the organizational officials approving the security 

controls designed to meet the security requirements for the [SYSTEM NAME]. These officials are the 

SSA System Owner (SO), (External Contractor) Information System Security Officer (ISSO), SSA 

Security Authorization Manager (SAM) and the SSA Authorizing Official (AO). 

Each organizational official has signed this agreement summary for the reasons identified below and has 

concurred with the security category of this Controlled Unclassified Information (CUI) system to be 

[LOW/MODERATE]. See Executive Order 13556 for more information on CUI. 

 [Check the box below that is applicable  DELETE] 

Initiation of the System Security Plan (including FIPS 199 security categorization)1

Annual Update of the System Security Plan (no significant changes) 

Acceptance and Signature 

As the Designated Representative(s) for <System Name>, I hereby certify that the <System 

Acronym> System Security Plan described in this document provides an accurate representation 

of the <System Acronym> and its subsystems. 

SSA Security Authorization Manager 

[ENTER NAME OF SAM  DELETE 

<Insert digital signature> 

SSA DSP Director 

[ENTER NAME OF DSP DIRECTOR] 

DELETE 

<Insert digital signature> 

 

1 When there are no significant changes, the System Owner, Information System Security Officer and SSA Security Authorization Manager must sign 

the agreement summary for an annual update. The Authorizing Official is not required to sign if there are no significant changes affecting the 

security posture of the system requiring reauthorization. Reauthorization is addressed via a formal memorandum approving the security plan and 

authorizing the system to operate for a specified period of time.
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

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Table of Contents 

1 INFORMATION SYSTEM IDENTIFICATION ....................................................................... 1

1.1 DETERMINATION OF SYSTEM .......................................................................................................... 1

1.2 RESPONSIBLE ORGANIZATION ......................................................................................................... 1

1.3 INFORMATION SYSTEM CATEGORIZATION ........................................................................................ 1

1.4 GENERAL DESCRIPTION OF INFORMATION SENSITIVITY .................................................................... 2

1.5 IMPACT LEVEL FOR INFORMATION TYPES ......................................................................................... 2

1.6 SYSTEM POINTS OF CONTACT ........................................................................................................ 3

1.7 ASSIGNMENT OF SECURITY RESPONSIBILITY ................................................................................... 4

1.8 SYSTEM OPERATIONAL STATUS ...................................................................................................... 4

1.9 INFORMATION SYSTEM TYPE ........................................................................................................... 4

1.10 SECURITY STATUS ......................................................................................................................... 5

1.11 GENERAL DESCRIPTION AND PURPOSE ........................................................................................... 5

1.12 DATA TYPES .................................................................................................................................. 5

1.13 INFORMATION SYSTEM BOUNDARY .................................................................................................. 6

1.14 SYSTEM ARCHITECTURE/ENVIRONMENT .......................................................................................... 6

1.15 SECURITY AUTHORIZATION BOUNDARY ........................................................................................... 6

1.16 SYSTEM INVENTORY ....................................................................................................................... 6

1.17 SYSTEM INTERCONNECTIONS.......................................................................................................... 7

2 [SYSTEM ACRONYM] NIST SP 800-53 - REV 4 MINIMUM SECURITY CONTROLS ....... 8

2.1 SECURITY CONTROLS .................................................................................................................... 8

2.1.1 Access Control (AC) ................................................................................................................ 8

2.1.1.1 AC-1 Access Control Policy and Procedures .......................................................................... 8

2.1.1.2 AC-2 Account Management .................................................................................................... 9

2.1.1.3 AC-3 Access Enforcement .................................................................................................... 11

2.1.1.4 AC-4 Information Flow Enforcement ..................................................................................... 12

2.1.1.5 AC-5 Separation of Duties ..................................................................................................... 13

2.1.1.6 AC-6 Least Privilege .............................................................................................................. 13

2.1.1.7 AC-7 Unsuccessful Logon Attempts ..................................................................................... 16

2.1.1.8 AC-8 System Use Notification ............................................................................................... 16

2.1.1.9 AC-11 Session Lock .............................................................................................................. 17

2.1.1.10 AC-12 Session Termination .................................................................................................. 18

2.1.1.11 AC-14 Permitted Actions without Identification or Authentication ......................................... 19

2.1.1.12 AC-17 Remote Access .......................................................................................................... 20

2.1.1.13 AC-18 Wireless Access ......................................................................................................... 22

2.1.1.14 AC-19 Access Control for Mobile Devices ............................................................................ 23

2.1.1.15 AC-20 Use of External Information Systems ......................................................................... 24

2.1.1.16 AC-21 Information Sharing .................................................................................................... 26

2.1.1.17 AC-22 Publicly Accessible Content ....................................................................................... 26

2.1.2 Awareness and Training (AT) ................................................................................................ 27

2.1.2.1 AT-1 Security Awareness and Training Policy and Procedures ........................................... 27

2.1.2.2 AT-2 Security Awareness Training ........................................................................................ 28

2.1.2.3 AT-3 Role-Based Security Training ....................................................................................... 29

2.1.2.4 AT-4 Security Training Records ............................................................................................ 30

2.1.3 Audit and Accountability (AU) ................................................................................................ 30
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2.1.3.1 AU-1 Audit and Accountability Policy and Procedures.......................................................... 30

2.1.3.2 AU-2 Audit Events ................................................................................................................. 31

2.1.3.3 AU-3 Content of Audit Records ............................................................................................. 32

2.1.3.4 AU-4 Audit Storage ............................................................................................................... 33

2.1.3.5 AU-5 Response to Audit Processing Failures ....................................................................... 34

2.1.3.6 AU-6 Audit Review, Analysis, and Reporting ........................................................................ 34

2.1.3.7 AU-7 Audit Reduction and Report Generation ...................................................................... 36

2.1.3.8 AU-8 Time Stamps ................................................................................................................ 37

2.1.3.9 AU-9 Protection of Audit Information ..................................................................................... 38

2.1.3.10 AU-11 Audit Record Retention .............................................................................................. 39

2.1.3.11 AU-12 Audit Generation ........................................................................................................ 40

2.1.4 Security Assessment and Authorization (CA) ....................................................................... 40

2.1.4.1 CA-1 Security Assessment and Authorization Policies and Procedures .............................. 41

2.1.4.2 CA-2 Security Assessments .................................................................................................. 41

2.1.4.3 CA-3 System Interconnections .............................................................................................. 43

2.1.4.4 CA-5 Plan of Action and Milestones ...................................................................................... 44

2.1.4.5 CA-6 Security Authorization .................................................................................................. 44

2.1.4.6 CA-7 Continuous Monitoring ................................................................................................. 45

2.1.4.7 CA-9 Internal System Connections ....................................................................................... 46

2.1.5 Configuration Management (CM) .......................................................................................... 47

2.1.5.1 CM-1 Configuration Management Policy and Procedures .................................................... 47

2.1.5.2 CM-2 Baseline Configuration ................................................................................................ 48

2.1.5.3 CM-3 Configuration Change Control ..................................................................................... 50

2.1.5.4 CM-4 Security Impact Analysis ............................................................................................. 51

2.1.5.5 CM-5 Access Restrictions for Change .................................................................................. 52

2.1.5.6 CM-6 Configuration Settings ................................................................................................. 52

2.1.5.7 CM-7 Least Functionality ....................................................................................................... 53

2.1.5.8 CM-8 Information System Component Inventory .................................................................. 55

2.1.5.9 CM-9 Configuration Management Plan ................................................................................. 57

2.1.5.10 CM-10 Software Usage Restrictions ..................................................................................... 58

2.1.5.11 CM-11 User-Installed Software ............................................................................................. 58

2.1.6 Contingency Planning (CP) ................................................................................................... 59

2.1.6.1 CP-1 Contingency Planning Policy and Procedures ............................................................. 59

2.1.6.2 CP-2 Contingency Plan ......................................................................................................... 60

2.1.6.3 CP-3 Contingency Training ................................................................................................... 62

2.1.6.4 CP-4 Contingency Plan Testing ............................................................................................ 63

2.1.6.5 CP-6 Alternate Storage Site .................................................................................................. 64

2.1.6.6 CP-7 Alternate Processing Site ............................................................................................. 65

2.1.6.7 CP-8 Telecommunications Services ..................................................................................... 67

2.1.6.8 CP-9 Information System Backup ......................................................................................... 69

2.1.6.9 CP-10 Information System Recovery and Reconstitution ..................................................... 70

2.1.7 Identification and Authentication (IA) .................................................................................... 71

2.1.7.1 IA-1 Identification and Authentication Policy and Procedures .............................................. 71

2.1.7.2 IA-2 Identification and Authentication .................................................................................... 72

2.1.7.3 IA-3 Device Identification and Authentication ........................................................................ 75

2.1.7.4 IA-4 Identifier Management ................................................................................................... 76

2.1.7.5 IA-5 Authenticator Management............................................................................................ 76

2.1.7.6 IA-6 Authenticator Feedback ................................................................................................. 79

2.1.7.7 IA-7 Cryptographic Module Authentication ............................................................................ 80

2.1.7.8 IA-8 Identification and Authentication (Non-Organizational Users) ....................................... 80

2.1.8 Incident Response (IR) .......................................................................................................... 82

2.1.8.1 IR-1 Incident Response Policy and Procedures .................................................................... 83

2.1.8.2 IR-2 Incident Response Training ........................................................................................... 83

2.1.8.3 IR-3 Incident Response Testing ............................................................................................ 84
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2.1.8.4 IR-4 Incident Handling ........................................................................................................... 85

2.1.8.5 IR-5 Incident Monitoring ........................................................................................................ 86

2.1.8.6 IR-6 Incident Reporting ......................................................................................................... 87

2.1.8.7 IR-7 Incident Response Assistance ...................................................................................... 88

2.1.8.8 IR-8 Incident Response Plan ................................................................................................. 89

2.1.9 Maintenance (MA) ................................................................................................................. 89

2.1.9.1 MA-1 System Maintenance Policy and Procedures .............................................................. 90

2.1.9.2 MA-2 Controlled Maintenance ............................................................................................... 90

2.1.9.3 MA-3 Maintenance Tools ...................................................................................................... 91

2.1.9.4 MA-4 Nonlocal Maintenance ................................................................................................. 92

2.1.9.5 MA-5 Maintenance Personnel ............................................................................................... 93

2.1.9.6 MA-6 Timely Maintenance ..................................................................................................... 94

2.1.10 Media Protection (MP) ........................................................................................................... 95

2.1.10.1 MP-1 Media Protection Policy and Procedures ..................................................................... 95

2.1.10.2 MP-2 Media Access .............................................................................................................. 95

2.1.10.3 MP-3 Media Marking ............................................................................................................. 96

2.1.10.4 MP-4 Media Storage ............................................................................................................. 97

2.1.10.5 MP-5 Media Transport ........................................................................................................... 97

2.1.10.6 MP-6 Media Sanitization ....................................................................................................... 98

2.1.10.7 MP-7 Media Use .................................................................................................................... 99

2.1.11 Physical and Environmental Protection (PE) ...................................................................... 100

2.1.11.1 PE-1 Physical and Environmental Protection Policy and Procedures ................................ 100

2.1.11.2 PE-2 Physical Access Authorizations ................................................................................. 101

2.1.11.3 PE-3 Physical Access Control ............................................................................................. 102

2.1.11.4 PE-4 Access Control for Transmission Medium .................................................................. 102

2.1.11.5 PE-5 Access Control for Output Devices ............................................................................ 103

2.1.11.6 PE-6 Monitoring Physical Access........................................................................................ 104

2.1.11.7 PE-8 Visitor Access Records .............................................................................................. 105

2.1.11.8 PE-9 Power Equipment and Cabling ................................................................................... 105

2.1.11.9 PE-10 Emergency Shutoff ................................................................................................... 106

2.1.11.10 PE-11 Emergency Power .................................................................................................... 107

2.1.11.11 PE-12 Emergency Lighting .................................................................................................. 107

2.1.11.12 PE-13 Fire Protection .......................................................................................................... 108

2.1.11.13 PE-14 Temperature and Humidity Controls ........................................................................ 109

2.1.11.14 PE-15 Water Damage Protection ........................................................................................ 110

2.1.11.15 PE-16 Delivery and Removal .............................................................................................. 110

2.1.11.16 PE-17 Alternate Work Site .................................................................................................. 111

2.1.12 Planning (PL) ....................................................................................................................... 112

2.1.12.1 PL-1 Security Planning Policy and Procedures ................................................................... 112

2.1.12.2 PL-2 System Security Plan .................................................................................................. 113

2.1.12.3 PL-4 Rules of Behavior ....................................................................................................... 114

2.1.12.4 PL-8 Information Security Architecture ............................................................................... 115

2.1.13 Personnel Security (PS) ...................................................................................................... 116

2.1.13.1 PS-1 Personnel Security Policy and Procedures ................................................................ 116

2.1.13.2 PS-2 Position Risk Designation ........................................................................................... 117

2.1.13.3 PS-3 Personnel Screening .................................................................................................. 117

2.1.13.4 PS-4 Personnel Termination ............................................................................................... 118

2.1.13.5 PS-5 Personnel Transfer ..................................................................................................... 119

2.1.13.6 PS-6 Access Agreements ................................................................................................... 119

2.1.13.7 PS-7 Third-Party Personnel Security .................................................................................. 120

2.1.13.8 PS-8 Personnel Sanctions .................................................................................................. 121

2.1.14 Risk Assessment (RA) ........................................................................................................ 121

2.1.14.1 RA-1 Risk Assessment Policy and Procedures .................................................................. 122

2.1.14.2 RA-2 Security Categorization .............................................................................................. 122
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2.1.14.3 RA-3 Risk Assessment ........................................................................................................ 123

2.1.14.4 RA-5 Vulnerability Scanning ................................................................................................ 124

2.1.15 System and Services Acquisition ........................................................................................ 126

2.1.15.1 SA-1 System and Services Acquisition Policy and Procedures .......................................... 126

2.1.15.2 SA-2 Allocation of Resources .............................................................................................. 127

2.1.15.3 SA-3 System Development Life Cycle ................................................................................ 127

2.1.15.4 SA-4 Acquisition Process .................................................................................................... 128

2.1.15.5 SA-5 Information System Documentation ........................................................................... 130

2.1.15.6 SA-8 Security Engineering Principles ................................................................................. 131

2.1.15.7 SA-9 External Information System Services ....................................................................... 132

2.1.15.8 SA-10 Developer Configuration Management .................................................................... 133

2.1.15.9 SA-11 Developer Security Testing and Evaluation ............................................................. 134

2.1.16 System and Communications Protection ............................................................................ 135

2.1.16.1 SC-1 System and Communications Protection Policy and Procedures .............................. 135

2.1.16.2 SC-2 Application Partitioning ............................................................................................... 136

2.1.16.3 SC-4 Information in Shared Resources .............................................................................. 136

2.1.16.4 SC-5 Denial of Service Protection ....................................................................................... 137

2.1.16.5 SC-7 Boundary Protection ................................................................................................... 137

2.1.16.6 SC-8 Transmission Confidentiality and Integrity ................................................................. 140

2.1.16.7 SC-10 Network Disconnect ................................................................................................. 141

2.1.16.8 SC-12 Cryptographic Key Establishment and Management ............................................... 142

2.1.16.9 SC-13 Cryptographic Protection .......................................................................................... 142

2.1.16.10 SC-15 Collaborative Computing Devices ............................................................................ 143

2.1.16.11 SC-17 Public Key Infrastructure Certificates ....................................................................... 144

2.1.16.12 SC-18 Mobile Code ............................................................................................................. 144

2.1.16.13 SC-19 Voice Over Internet Protocol .................................................................................... 145

2.1.16.14 SC-20 Secure Name / Address Resolution Service (Authoritative Source) ........................ 146

2.1.16.15 SC-21 Secure Name / Address Resolution Service (Recursive or Caching Resolver) ...... 146

2.1.16.16 SC-22 Architecture and Provisioning for Name / Address Resolution Service ................... 147

2.1.16.17 SC-23 Session Authenticity ................................................................................................. 148

2.1.16.18 SC-28 Protection of Information at Rest ............................................................................. 148

2.1.16.19 SC-39 Process Isolation ...................................................................................................... 149

2.1.17 System and Information Integrity......................................................................................... 149

2.1.17.1 SI-1 System and Information Integrity Policy and Procedures ............................................ 149

2.1.17.2 SI-2 Flaw Remediation ........................................................................................................ 150

2.1.17.3 SI-3 Malicious Code Protection ........................................................................................... 151

2.1.17.4 SI-4 Information System Monitoring .................................................................................... 153

2.1.17.5 SI-5 Security Alerts, Advisories, and Directives .................................................................. 155

2.1.17.6 SI-7 Software, Firmware, and Information Integrity ............................................................. 156

2.1.17.7 SI-8 Spam Protection .......................................................................................................... 157

2.1.17.8 SI-10 Information Input Validation ....................................................................................... 159

2.1.17.9 SI-11 Error Handling ............................................................................................................ 159

2.1.17.10 SI-12 Information Handling and Retention .......................................................................... 160

2.1.17.11 SI-16 Memory Protection ..................................................................................................... 161

3 APPENDIX LISTING ......................................................................................................... 162

3.1 REQUIRED APPENDICES ............................................................................................................. 162

3.2 SYSTEM SPECIFIC APPENDICES .................................................................................................. 162

3.3 ACRONYM LIST .......................................................................................................................... 163

3.4 DEFINITIONS/GLOSSARY ............................................................................................................. 165

3.5 APPLICABLE LAWS AND REFERENCES ......................................................................................... 169
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LIST OF FIGURES 

Figure 1: [System Acronym] Architecture Diagram ....................................................................................... 6

Figure 2: [System Acronym] Accreditation Boundary ................................................................................... 6

LIST OF TABLES 

Table 1: System Name/Identifier ................................................................................................................... 1

Table 2: Responsible Organization ............................................................................................................... 1

Table 3: Security Categorization ................................................................................................................... 1

Table 4: Impact Level for Information Types ................................................................................................. 3

Table 5: <System Name> Points of Contact ................................................................................................. 3

Table 6: [System Acronym] (Contractor) Information System Security Officer (ISSO) ................................. 4

Table 7: SSA Security Authorization Manager (SAM) ................................................................................. 4

Table 8: Information System Operational Status .......................................................................................... 4

Table 9: Information System Type ................................................................................................................ 5

Table 10: NIST SP 800-60 Vol 2. Information Data Types ........................................................................... 5

Table 11: Inventory: List of Technologies ..................................................................................................... 6

Table 12: [System Acronym] System Interconnections ................................................................................ 7
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1 Information System Identification 

1.1 Determination of System 

Table 1: System Name/Identifier 

System Name/Title: System ID No: 

<System name: external information system 

name> ( short name-subsystem short name)

1.2 Responsible Organization 

Table 2: Responsible Organization 

Organization Address 

 

1.3 Information System Categorization 

Security categorizations are to be performed as the first step in the security authorization process as 

required by Federal Information Processing Standard (FIPS) 199 in order to select appropriate system 

security controls to be addressed throughout the rest of the security authorization. FIPS 199 categories 

are derived according to the potential impact on the agency that would occur if its Confidentiality, 

Integrity, or Availability were compromised. FIPS 199 category definitions are as follows: 

 High Impact: The loss of confidentiality, integrity, or availability could be expected to have a 

severe or catastrophic adverse effect on organizational operations, organizational assets, or 

individuals. 

 Moderate Impact: The loss of confidentiality, integrity, or availability could be expected to have 

a serious adverse effect on organizational operations, organizational assets, or individuals. (At 

SSA, the highest security categorization is currently Moderate) 

 Low Impact: The loss of confidentiality, integrity, or availability could be expected to have a 

limited adverse effect on organizational operations, organizational assets, or individuals. 

Based on the system categorization of this externally hosted system the [SYSTEM ACRONYM] system 

has been categorized as a [LOW/MODERATE] system according to FIPS 199. 

 [Enter an “X” in the applicable section]  DELETE 

Table 3: Security Categorization 

Low 

Moderate 
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1.4 General Description of Information Sensitivity 

Sensitive information is defined by the Computer Security Act (section 552a of Title 5, United States 

Code) as any information, the loss, misuse, or unauthorized access to or modification of which could 

adversely affect the national interest or the conduct of federal programs, or the privacy to which 

individuals are entitled. The National Institute of Standards and Technology (NIST) Special Publication 

800-122 Guide to Protecting the Confidentiality of Personally Identifiable Information (PII) further defines 

the requirements for Personal Identity Information (PII) which SSA follows with regard to protecting its 

sensitive PII. 

FIPS 199 defines security categories for information systems based on potential impact on organizations, 

assets, or individuals should there be a breach of security—that is, a loss of confidentiality, integrity, or 

availability. FIPS 199 security categories play an important part in defining information system security 

boundaries by partitioning the agency's information systems according to the criticality or sensitivity of the 

information and information systems and the importance of those systems in accomplishing the agency's 

mission. This is particularly important when there are various FIPS 199 impact levels contained in one 

information system. The FIPS 199 requirement to secure an information system to the high watermark or 

highest impact level must be applied when grouping minor applications/subsystems with varying FIPS 

199 impact levels into a single general support system or major application unless there is adequate 

boundary protection, e.g., firewalls and encryption, around those subsystems or applications with the 

highest impact level. Additionally, there must be assurance that the shared resources, i.e., networks, 

communications, and physical access within the whole general support system or major application, are 

protected adequately for the highest impact level. Having the ability to isolate the high impact systems will 

not only result in more secure systems, but will also reduce the amount of resources required to secure 

many applications/systems that do not require that level of security. NIST SP 800-53 provides three 

security control baselines, i.e., low, moderate, and high (high is not addressed by this SSP), that are 

associated with the three FIPS 199 impact levels; as the impact level increases, so do the minimum 

assurance requirements. For reporting purposes, i.e., FISMA annual report, when an information system 

has varying FIPS 199 impact levels, that system is categorized at the highest impact level on that 

information system. 

1.5 Impact Level for Information Types 

The following tables identify the information types that are input, stored, processed, and/or output from 

[System Acronym]. The selection of the information types is based on guidance provided by OMB 

Federal Enterprise Architecture Program Management Office Business Reference Model 2.0 

(http://www.whitehouse.gov/omb/e-gov/fea), and the FIPS 199, Standards for Security Categorization of 

Federal Information and Information Systems, and NIST Special Publication (SP) 800-60, Guide for 

Mapping Types of Information and Information Systems to Security Categories. SP 800-60 includes two 

volumes: Volume I is a basic guideline and Volume II contains appendices. Users should review the 

guidelines provided in Volume I, then refer to only the material from the appendices that is applicable. 

NIST SP 800-60 is available for download at http://csrc.nist.gov/publications/. 

The potential impact is LOW if— 

The loss of confidentiality, integrity, or availability could be expected to have a limited adverse 

effect on organizational operations, organizational assets, or individuals. 

A limited adverse effect means that, for example, the loss of confidentiality, integrity, or availability 

might: (i) cause a degradation in mission capability to an extent and duration that the organization 

is able to perform its primary functions, but the effectiveness of the functions is noticeably 

reduced; (ii) result in minor damage to organizational assets; (iii) result in minor financial loss; or 

(iv) result in minor harm to individuals. 

The potential impact is MODERATE if— 
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The loss of confidentiality, integrity, or availability could be expected to have a serious adverse 

effect on organizational operations, organizational assets, or individuals. 

A serious adverse effect means that, for example, the loss of confidentiality, integrity, or 

availability might: (i) cause a significant degradation in mission capability to an extent and 

duration that the organization is able to perform its primary functions, but the effectiveness of the 

functions is significantly reduced; (ii) result in significant damage to organizational assets; (iii) 

result in significant financial loss; or (iv) result in significant harm to individuals that does not 

involve loss of life or serious life threatening injuries. 

The potential impact is HIGH if— 

The loss of confidentiality, integrity, or availability could be expected to have a severe or 

catastrophic adverse effect on organizational operations, organizational assets, or individuals. 

A severe or catastrophic adverse effect means that, for example, the loss of confidentiality, 

integrity, or availability might: (i) cause a severe degradation in or loss of mission capability to an 

extent and duration that the organization is not able to perform one or more of its primary 

functions; (ii) result in major damage to organizational assets; (iii) result in major financial loss; or 

(iv) result in severe or catastrophic harm to individuals involving loss of life or serious life 

threatening injuries. 

 [List the different information types per NIST SP 800-60 and indicate provisional impact level. Add or 

modify information types if necessary]. This information can be copy/pasted from the SSA Parent 

System FIPS199 Security Categorization Review documentation, Section 4.  DELETE THESE 

INSTRUCTIONS UPON COMPLETION 

Table 4: Impact Level for Information Types 

NIST Information 

Type 

NIST 

SP 800-60, 

Volume II 

Reference 

NIST Recommended Provisional Impact Levels 

System Owner 

Selected Impact Levels Comments 

Confidentiality Integrity Availability Confidentiality Integrity Availability 

EXAMPLE: 

Personal 

Identity and 

Authentication 

Information 

Type

C.2.8.9 M M M M M M None

 

1.6 System Points of Contact 

<Complete the attached spreadsheet with system specific information.> 

Table 5: <System Name> Points of Contact 

SSP-Point of 

Contacts.xlsx
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1.7 Assignment of Security Responsibility 

Table 6: [System Acronym] (Contractor) Information System Security Officer (ISSO) 

Name: 

Title: 

Agency: 

Address: 

Telephone: 

Email: 

Responsibility: Individual with assigned responsibility for maintaining the appropriate operational 

security posture for an information system or program. Information System Security 

Officer (ISSO). 

Table 7: SSA Security Authorization Manager (SAM) 

Name: 

Title: 

Agency: 

Address: 

Telephone: 

Email: 

Responsibility: SSA Security Authorization Manager 

1.8 System Operational Status 

The [SYSTEM ACRONYM] and its component systems are in the [INITIATION, 

ACQUISITION/DEVELOPMENT, IMPLEMENATION, OPERATIONAL/MAINTENANCE] phase of their 

System Development Life Cycles (SDLC). 

 [Enter an “X” in the applicable section]  DELETE 

Table 8: Information System Operational Status 

Initiation Development Implementation Operational 

 

1.9 Information system Type 

 [Enter an “X” in the applicable section below]  DELETE 
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Table 9: Information System Type 

Subsystem/Application Major Application General Support System 

 

1.10 Security Status 

[SECURTIY AUTHORIZATION ACRONYM/ EXTERNAL INFORMATION SYSTEM ACRONYM] received 

a full Authority to Operate (ATO) on [Enter DATE of ATO]. 

1.11 General Description and Purpose 

 [This section should contain a detailed general description and overall purpose for the information 

system. It should identify the system's purpose, capabilities, users, arrangements for hosting, 

connection and/or interface to SSA, and information data flow; discuss the hardware, software and 

firmware implemented in support of the information system]  DELETE 

1.12 Data Types 

Table 10: NIST SP 800-60 Vol 2. Information Data Types 

NIST 

Information 

Type 

NIST SP 800-60, Volume II 

Reference Data Type Description 

EXAMPLE: 

Personal 

Identity 

Information 

Type

C.2.8.9 Personal identity and authentication information includes that 

information necessary to ensure that all persons who are 

potentially entitled to receive any federal benefit are 

enumerated and identified so that Federal agencies can 

have reasonable assurance that they are paying or 

communicating with the right individuals. This information 

include individual citizen’s Social Security Numbers, names, 

dates of birth, places of birth, parents’ names, etc. 

 

 

 
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1.13 Information System Boundary 

The [SYSTEM ACRONYM] system architecture, environment and agreement boundary is described 

below. 

1.14 System Architecture/Environment 

[Provide a description of the information system architecture/environment, explaining where and by whom 

it is hosted, whether it is a web-based (or cloud, etc.) application, what Software (SW) it is utilizing, what 

SW sits on the front end, back end, OS, how many users access the system, describe user interfaces, 

and designate whether connectivity to SSA and/or the outside is through VPN or WAN, etc.]  DELETE 

 [INSERT a diagram of the information system architecture, including its connections/interfaces/other 

relationships to SSA].  DELETE 

Figure 1: [System Acronym] Architecture Diagram 

1.15 Security Authorization Boundary 

[Provide information of where the information system is located; where backups and restores are 

conducted, and specifically where databases are housed. Provide an explanation of where the servers 

are located (company facility, datacenter, etc.), personnel, public access or not, how the systems are 

connected, how remote users can connect and how in and outbound internet connections are secured 

and maintained].  DELETE 

 [INSERT a diagram of the information security authorization boundary showing its 

connections/interfaces/other relationships to SSA.] DELETE

Figure 2: [System Acronym] Accreditation Boundary

1.16 System Inventory 

The hardware (HW) and software (SW) components included in the externally hosted, non-SSA [System 

Acronym] boundary are listed in the tables below. <System acronym> consists of multiple technologies. 

Table 11 contains a listing of technologies (hardware, software, technologies and platforms) that reside 

within the <system acronym> authorization boundary. Technology is listed per system and subsystem: 

<Complete the embedded spreadsheet with system specific information.> 

Table 11: Inventory: List of Technologies 
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Table 6_Inventory - 

List of Technologies - 

 NOTE: Any changes to the scope of the Authorization Boundary after the Boundary 

Scope Meeting and finalization of the BSM may impact the overall IV&V schedule. 

1.17 System Interconnections 

The externally hosted [SYSTEM ACRONYM] requires that written agreements (e.g., Memorandums of 

Understanding (MOUs), Memorandums of Agreement (MOAs), Interconnection Security Agreements 

(ISAs), etc., on the security controls to be enforced on interconnecting systems and must be obtained 

prior to connecting and/or sharing sensitive data/information. Table 18 shows the status of these 

agreements between [SYSTEM ACRONYM] and the external systems that share its information. 

[SYSTEM ACRONYM] [Has /does not have] external communications requiring MOUs or ISAs. 

Table 12: [System Acronym] System Interconnections 

Information 

System 

Organization Type 

(GSS/MA) 

Agreement 

(ISA/MOU/MOA) 

Date FIPS 199 

Category 

C&A 

Status 

DAA 

N/A N/A N/A N/A N/A N/A N/A N/A 

 
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2 [System Acronym] NIST SP 800-53 - Rev 4 

MINIMUM SECURITY CONTROLS 

The minimum security control baseline for [LOW/MODERATE]-impact systems from NIST SP 800-53 

Revision 4 is documented below. Specifically, this section provides a description of how all the minimumsecurity controls in the baseline are being implemented, planned, and compensated or how they will be 

implemented in the future. The table contains: (1) the NIST SP Publication and revision number (2) the 

security control family and specific control with applicable enhancements; (3) if the security control is a 

common control, hybrid or system specific (4) the implementation statement; how the security control is 

being implemented or how it will be implemented (5) the implementation status to determine whether the 

control is in place, not in place, compensated or not applicable and (6) comments to capture specific 

notes about the control’s implementation. (Note: if not in place, an explanation will need to be provided 

under this section). Implementation statements of controls identified as common will reference the system 

and/or SSP that the control is inherited from.

2.1 Security Controls 

Organizations employ security controls in federal information systems and the environments in which 

those systems operate in accordance with FIPS Publication 199, FIPS Publication 200, and NIST Special 

Publications 800-37 and 800-39. Security categorization of federal information and information systems, 

as required by FIPS Publication 199, is the first step in the risk management process. Next, organizations 

select an appropriate set of security controls for their information systems by satisfying the minimumsecurity requirements set forth in FIPS Publication 200. Appendix D includes three security control 

baselines that are associated with the designated impact levels of information systems as determined 

during the security categorization process. After baseline selection, organizations tailor the baselines by: 

(i) identifying/designating common controls; (ii) applying scoping considerations; (iii) selecting 

compensating controls, if needed; (iv) assigning control parameter values in selection and assignment 

statements; (v) supplementing the baseline controls with additional controls and control enhancements 

from the security control catalog; and (vi) providing additional information for control implementation. 

2.1.1 Access Control (AC) 

2.1.1.1 AC-1 Access Control Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

b. An access control policy that addresses purpose, scope, roles, responsibilities, management 

commitment, coordination among organizational entities, and compliance; and 

c. Procedures to facilitate the implementation of the access control policy and associated 

access controls; and 

d. Reviews and updates the current: 

e. Access control policy [Assignment: organization-defined frequency]; and 

f. Access control procedures [Assignment: organization-defined frequency]. 
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NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-1] 

Implementation Statement: 

AC-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.2 AC-2 Account Management 

The organization: 

a. Identifies and selects the following types of information system accounts to support 

organizational missions/business functions: [Assignment: organization-defined information 

system account types]; 

b. Assigns account managers for information system accounts; 

c. Establishes conditions for group and role membership; 

d. Specifies authorized users of the information system, group and role membership, and 

access authorizations (i.e., privileges) and other attributes (as required) for each account; 

e. Requires approvals by [Assignment: organization-defined personnel or roles] for requests to 

create information system accounts; 

f. Creates, enables, modifies, disables, and removes information system accounts in 

accordance with [Assignment: organization-defined procedures or conditions]; 

g. Monitors the use of, information system accounts; 

h. Notifies account managers: 

1. When accounts are no longer required; 

2. When users are terminated or transferred; and 

3. When individual information system usage or need-to-know changes; 

i. Authorizes access to the information system based on: 

1. A valid access authorization; 

2. Intended system usage; and 

3. Other attributes as required by the organization or associated missions/business 

functions; 

j. Reviews accounts for compliance with account management requirements [Assignment: 

organization-defined frequency]; and 

k. Establishes a process for reissuing shared/group account credentials (if deployed) when 

individuals are removed from the group. 
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(1) ACCOUNT MANAGEMENT | AUTOMATED SYSTEM ACCOUNT MANAGEMENT 

The organization employs automated mechanisms to support the management of information 

system accounts. 

(2) ACCOUNT MANAGEMENT | REMOVAL OF TEMPORARY / EMERGENCY ACCOUNTS 

The information system automatically [Selection: removes; disables] temporary and 

emergency accounts after [Assignment: organization-defined time period for each type of 

account]. 

(3) ACCOUNT MANAGEMENT | DISABLE INACTIVE ACCOUNTS 

The information system automatically disables inactive accounts after [Assignment: 

organization-defined time period]. 

(4) ACCOUNT MANAGEMENT | AUTOMATED AUDIT ACTIONS 

The information system automatically audits account creation, modification, enabling, 

disabling, and removal actions, and notifies [Assignment: organization-defined personnel or 

roles]. 

NIST SP 800-53 Access Controls Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-2] 

Implementation Statement: 

AC-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AC-2(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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<Document Name> 

Version <X.X> 

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Comments: 

Control Enhancement AC-2(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-2(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-2(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.1.3 AC-3 Access Enforcement 
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<Document Name> 

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The information system enforces approved authorizations for logical access to information and system 

resources in accordance with applicable access control policies. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-3] 

Implementation Statement: 

AC-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.4 AC-4 Information Flow Enforcement 

The information system enforces approved authorizations for controlling the flow of information within the 

system and between interconnected systems based on [Assignment: organization-defined information 

flow control policies]. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-4] 

Implementation Statement: 

AC-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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<Document Name> 

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Comments:

2.1.1.5 AC-5 Separation of Duties 

The organization: 

a. Separates [Assignment: organization-defined duties of individuals]; 

b. Documents separation of duties of individuals; and 

c. Defines information system access authorizations to support separation of duties. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-5] 

Implementation Statement: 

AC-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.6 AC-6 Least Privilege 

The organization employs the principle of least privilege, allowing only authorized accesses for users (or 

processes acting on behalf of users) which are necessary to accomplish assigned tasks in accordance 

with organizational missions and business functions. 

Control Enhancements: 

(1) LEAST PRIVILEGE | AUTHORIZE ACCESS TO SECURITY FUNCTIONS 

The organization explicitly authorizes access to [Assignment: organization-defined security functions 

(deployed in hardware, software, and firmware) and security-relevant information]. 
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(2) LEAST PRIVILEGE | NON-PRIVILEGED ACCESS FOR NONSECURITY FUNCTIONS 

The organization requires that users of information system accounts, or roles, with access to 

[Assignment: organization-defined security functions or security-relevant information], use non-privileged 

accounts or roles, when accessing nonsecurity functions. 

(5) LEAST PRIVILEGE | PRIVILEGED ACCOUNTS 

The organization restricts privileged accounts on the information system to [Assignment: organizationdefined personnel or roles]. 

(9) LEAST PRIVILEGE | AUDITING USE OF PRIVILEGED FUNCTIONS 

The information system audits the execution of privileged functions. 

(10) LEAST PRIVILEGE | PROHIBIT NON-PRIVILEGED USERS FROM EXECUTING PRIVILEGED 

FUNCTIONS 

The information system prevents non-privileged users from executing privileged functions to include 

disabling, circumventing, or altering implemented security safeguards/countermeasures. 

NIST SP 800-53 Access Controls Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-6] 

Implementation Statement: 

AC-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AC-6(1) 

Implementation Statement: 
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<Document Name> 

Version <X.X> 

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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-6(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-6(5) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-6(9) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Control Enhancement AC-6(10) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.1.7 AC-7 Unsuccessful Logon Attempts 

The information system: 

a. Enforces a limit of [Assignment: organization-defined number] consecutive invalid logon 

attempts by a user during a [Assignment: organization-defined time period]; and 

b. Automatically [Selection: locks the account/node for an [Assignment: organization-defined 

time period]; locks the account/node until released by an administrator; delays next logon 

prompt according to [Assignment: organization-defined delay algorithm]] when the maximum 

number of unsuccessful attempts is exceeded. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-7] 

Implementation Statement: 

AC-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.8 AC-8 System Use Notification 
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<Document Name> 

Version <X.X> 

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The information system: 

a. Displays to users [Assignment: organization-defined system use notification message or 

banner] before granting access to the system that provides privacy and security notices 

consistent with applicable federal laws, Executive Orders, directives, policies, regulations, 

standards, and guidance and states that: 

1. Users are accessing a U.S. Government information system; 

2. Information system usage may be monitored, recorded, and subject to audit; 

3. Unauthorized use of the information system is prohibited and subject to criminal and civil 

penalties; and 

4. Use of the information system indicates consent to monitoring and recording; 

b. Retains the notification message or banner on the screen until users acknowledge the usage 

conditions and take explicit actions to log on to or further access the information system; and 

c. For publicly accessible systems: 

1. Displays system use information [Assignment: organization-defined conditions], before 

granting further access; 

2. Displays references, if any, to monitoring, recording, or auditing that are consistent with 

privacy accommodations for such systems that generally prohibit those activities; and 

3. Includes a description of the authorized uses of the system. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-8] 

Implementation Statement: 

AC-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.9 AC-11 Session Lock 

The information system: 

a. Prevents further access to the system by initiating a session lock after [Assignment: 

organization-defined time period] of inactivity or upon receiving a request from a user; and 

b. Retains the session lock until the user reestablishes access using established identification 

and authentication procedures. 

Control Enhancements: 
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(1) SESSION LOCK | PATTERN-HIDING DISPLAYS 

The information system conceals, via the session lock, information previously visible on the display with a 

publicly viewable image. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-11] 

Implementation Statement: 

AC-11 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Implementation Statement: 

AC-11(1) 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.10 AC-12 Session Termination 

The information system automatically terminates a user session after [Assignment: organization-defined 

conditions or trigger events requiring session disconnect].
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<Document Name> 

Version <X.X> 

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NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-12] 

Implementation Statement: 

AC-12 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.11 AC-14 Permitted Actions without Identification or Authentication 

The organization: 

a. Identifies [Assignment: organization-defined user actions] that can be performed on the 

information system without identification or authentication consistent with organizational 

missions/business functions; and 

b. Documents and provides supporting rationale in the security plan for the information system, 

user actions not requiring identification or authentication. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-14] 

Implementation Statement: 

AC-14 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Comments:

2.1.1.12 AC-17 Remote Access 

The organization: 

a. Establishes and documents usage restrictions, configuration/connection requirements, and 

implementation guidance for each type of remote access allowed; and 

b. Authorizes remote access to the information system prior to allowing such connections. 

Control Enhancements: 

(1) REMOTE ACCESS | AUTOMATED MONITORING / CONTROL 

The information system monitors and controls remote access methods. 

(2) REMOTE ACCESS | PROTECTION OF CONFIDENTIALITY / INTEGRITY USING ENCRYPTION 

The information system implements cryptographic mechanisms to protect the confidentiality and integrity 

of remote access sessions. 

 

(3) REMOTE ACCESS | MANAGED ACCESS CONTROL POINTS 

The information system routes all remote accesses through [Assignment: organization-defined number] 

managed network access control points. 

(4) REMOTE ACCESS | PRIVILEGED COMMANDS / ACCESS 

The organization: 

(a) Authorizes the execution of privileged commands and access to security-relevant 

information via remote access only for [Assignment: organization-defined needs]; and 

(b) Documents the rationale for such access in the security plan for the information system. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-17] 
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Implementation Statement: 

AC-17 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AC-17(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-17(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-17(3) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-17(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.1.13 AC-18 Wireless Access 

The organization: 

a. Establishes usage restrictions, configuration/connection requirements, and implementation 

guidance for wireless access; and 

b. Authorizes wireless access to the information system prior to allowing such connections. 

Control Enhancements: 

(1) WIRELESS ACCESS | AUTHENTICATION AND ENCRYPTION 

The information system protects wireless access to the system using authentication of [Selection (one or 

more): users; devices] and encryption. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-18] 

Implementation Statement: 

AC-18 
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<Document Name> 

Version <X.X> 

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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AC-18(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.1.14 AC-19 Access Control for Mobile Devices 

The organization: 

a. Establishes usage restrictions, configuration requirements, connection requirements, and 

implementation guidance for organization-controlled mobile devices; and 

b. Authorizes the connection of mobile devices to organizational information systems. 

(5) ACCESS CONTROL FOR MOBILE DEVICES | FULL DEVICE / CONTAINER-BASED 

ENCRYPTION 

The organization employs [Selection: full-device encryption; container encryption] to protect the 

confidentiality and integrity of information on [Assignment: organization-defined mobile devices]. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-19] 

Implementation Statement: 

AC-19 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AC-19(5) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.1.15 AC-20 Use of External Information Systems 

The organization establishes terms and conditions, consistent with any trust relationships established with 

other organizations owning, operating, and/or maintaining external information systems, allowing 

authorized individuals to: 

a. Access the information system from external information systems; and 

b. Process, store, or transmit organization-controlled information using external information 

systems. 

Control Enhancements: 

(1) USE OF EXTERNAL INFORMATION SYSTEMS | LIMITS ON AUTHORIZED USE 

The organization permits authorized individuals to use an external information system to access the 

information system or to process, store, or transmit organization-controlled information only when the 

organization: 

(a) Verifies the implementation of required security controls on the external system as 

specified in the organization’s information security policy and security plan; or 

(b) Retains approved information system connection or processing agreements with the 

organizational entity hosting the external information system. 

(2) USE OF EXTERNAL INFORMATION SYSTEMS | PORTABLE STORAGE DEVICES 
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<Document Name> 

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The organization [Selection: restricts; prohibits] the use of organization-controlled portable storage 

devices by authorized individuals on external information systems. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-20] 

Implementation Statement: 

AC-20 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AC-20(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement AC-20(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 26 

Comments: 

2.1.1.16 AC-21 Information Sharing 

The organization: 

a. Facilitates information sharing by enabling authorized users to determine whether access 

authorizations assigned to the sharing partner match the access restrictions on the 

information for [Assignment: organization-defined information sharing circumstances where 

user discretion is required]; and 

b. Employs [Assignment: organization-defined automated mechanisms or manual processes] to 

assist users in making information sharing/collaboration decisions. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-21] 

Implementation Statement: 

AC-21 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.1.17 AC-22 Publicly Accessible Content 

The organization: 

a. Designates individuals authorized to post information onto a publicly accessible information 

system; 

b. Trains authorized individuals to ensure that publicly accessible information does not contain 

nonpublic information; 
Social Security Administration 

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Version <X.X> 

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c. Reviews the proposed content of information prior to posting onto the publicly accessible 

information system to ensure that nonpublic information is not included; and 

d. Reviews the content on the publicly accessible information system for nonpublic information 

[Assignment: organization-defined frequency] and removes such information, if discovered. 

NIST SP 800-53 Access Control Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [AC-22] 

Implementation Statement: 

AC-22 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.2 Awareness and Training (AT) 

2.1.2.1 AT-1 Security Awareness and Training Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A security awareness and training policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the security awareness and training policy 

and associated security awareness and training controls; and 

b. Reviews and updates the current: 

1. Security awareness and training policy [Assignment: organization-defined frequency]; 

and 

2. Security awareness and training procedures [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 Awareness and 

Training 

 Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 28 

Revision 4 [AT-1] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

AT-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.2.2 AT-2 Security Awareness Training 

The organization provides basic security awareness training to information system users (including 

managers, senior executives, and contractors): 

a. As part of initial training for new users; 

b. When required by information system changes; and 

c. [Assignment: organization-defined frequency] thereafter. 

Control Enhancements: 

(2) SECURITY AWARENESS | INSIDER THREAT 

The organization includes security awareness training on recognizing and reporting potential indicators of 

insider threat. 

NIST SP 800-53 Awareness and 

Training 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AT-2] 

Implementation Statement: 

AT-2 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 29 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AT-2(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.2.3 AT-3 Role-Based Security Training 

The organization provides role-based security training to personnel with assigned security roles and 

responsibilities: 

a. Before authorizing access to the information system or performing assigned duties; 

b. When required by information system changes; and 

c. [Assignment: organization-defined frequency] thereafter. 

NIST SP 800-53 Awareness and 

Training 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AT-3] 

Implementation Statement: 

AT-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 30 

Comments:

2.1.2.4 AT-4 Security Training Records 

The organization: 

a. Documents and monitors individual information system security training activities including 

basic security awareness training and specific information system security training; and 

b. Retains individual training records for [Assignment: organization-defined time period]. 

NIST SP 800-53 Awareness and 

Training 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AT-4] 

Implementation Statement: 

AT-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.3 Audit and Accountability (AU) 

2.1.3.1 AU-1 Audit and Accountability Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. An audit and accountability policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 31 

2. Procedures to facilitate the implementation of the audit and accountability policy and 

associated audit and accountability controls; and 

b. Reviews and updates the current: 

1. Audit and accountability policy [Assignment: organization-defined frequency]; and 

2. Audit and accountability procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-1] 

Implementation Statement: 

AU-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.3.2 AU-2 Audit Events 

The organization: 

a. Determines that the information system is capable of auditing the following events: 

[Assignment: organization-defined auditable events]; 

b. Coordinates the security audit function with other organizational entities requiring auditrelated information to enhance mutual support and to help guide the selection of auditable 

events; 

c. Provides a rationale for why the auditable events are deemed to be adequate to support 

after-the-fact investigations of security incidents; and 

d. Determines that the following events are to be audited within the information system: 

[Assignment: organization-defined audited events (the subset of the auditable events defined 

in AU-2 a.) along with the frequency of (or situation requiring) auditing for each identified 

event]. 

Control Enhancements: 

(3) AUDIT EVENTS | REVIEWS AND UPDATES 

The organization reviews and updates the audited events [Assignment: organization-defined frequency]. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 32 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-2] 

Implementation Statement: 

AU-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AU-2(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.3.3 AU-3 Content of Audit Records 

The information system generates audit records containing information that establishes what type of 

event occurred, when the event occurred, where the event occurred, the source of the event, the outcome 

of the event, and the identity of any individuals or subjects associated with the event. 

Control Enhancements: 

(1) CONTENT OF AUDIT RECORDS | ADDITIONAL AUDIT INFORMATION 

The information system generates audit records containing the following additional information: 

[Assignment: organization-defined additional, more detailed information]. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 33 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-3] 

Implementation Statement: 

AU-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AU-3(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.3.4 AU-4 Audit Storage 

The organization allocates audit record storage capacity in accordance with [Assignment: organizationdefined audit record storage requirements]. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-4] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 34 

Implementation Statement: 

AU-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.3.5 AU-5 Response to Audit Processing Failures 

The information system: 

a. Alerts [Assignment: organization-defined personnel or roles] in the event of an audit 

processing failure; and 

b. Takes the following additional actions: [Assignment: organization-defined actions to be taken 

(e.g., shut down information system, overwrite oldest audit records, stop generating audit 

records)]. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-5] 

Implementation Statement: 

AU-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.3.6 AU-6 Audit Review, Analysis, and Reporting 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 35 

The organization: 

a. Reviews and analyzes information system audit records [Assignment: organization-defined 

frequency] for indications of [Assignment: organization-defined inappropriate or unusual 

activity]; and 

b. Reports findings to [Assignment: organization-defined personnel or roles]. 

Control Enhancements: 

(1) AUDIT REVIEW, ANALYSIS, AND REPORTING | PROCESS INTEGRATION 

The organization employs automated mechanisms to integrate audit review, analysis, and reporting 

processes to support organizational processes for investigation and response to suspicious activities. 

(3) AUDIT REVIEW, ANALYSIS, AND REPORTING | CORRELATE AUDIT REPOSITORIES 

The organization analyzes and correlates audit records across different repositories to gain organizationwide situational awareness. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-6] 

Implementation Statement: 

AU-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AU-6(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 36 

Scoped 

Comments: 

Control Enhancement AU-6(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.3.7 AU-7 Audit Reduction and Report Generation 

The information system provides an audit reduction and report generation capability that: 

a. Supports on-demand audit review, analysis, and reporting requirements and after-the-fact 

investigations of security incidents; and 

b. Does not alter the original content or time ordering of audit records. 

Control Enhancements: 

(1) AUDIT REDUCTION AND REPORT GENERATION | AUTOMATIC PROCESSING 

The information system provides the capability to process audit records for events of interest based on 

[Assignment: organization-defined audit fields within audit records]. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-7] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

AU-7 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 37 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Implementation Statement: 

AU-7(1) 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.3.8 AU-8 Time Stamps 

The information system: 

a. Uses internal system clocks to generate time stamps for audit records; and 

b. Records time stamps for audit records that can be mapped to Coordinated Universal Time 

(UTC) or Greenwich Mean Time (GMT) and meets [Assignment: organization-defined 

granularity of time measurement]. 

Control Enhancements: 

(1) TIME STAMPS | SYNCHRONIZATION WITH AUTHORITATIVE TIME SOURCE 

The information system: 

(a) Compares the internal information system clocks [Assignment: organization-defined 

frequency] with [Assignment: organization-defined authoritative time source]; and 

(b) Synchronizes the internal system clocks to the authoritative time source when the time difference 

is greater than [Assignment: organization-defined time period]. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 [AU-8] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 38 

 System Specific Control

Implementation Statement: 

AU-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AU-8(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.3.9 AU-9 Protection of Audit Information 

The information system protects audit information and audit tools from unauthorized access, modification, 

and deletion. 

Control Enhancements: 

(4) PROTECTION OF AUDIT INFORMATION | ACCESS BY SUBSET OF PRIVILEGED USERS 

The organization authorizes access to management of audit functionality to only [Assignment: 

organization-defined subset of privileged users]. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 39 

Revision 4 [AU-9] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

AU-9 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement AU-9(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.3.10 AU-11 Audit Record Retention 

The organization retains audit records for [Assignment: organization-defined time period consistent with 

records retention policy] to provide support for after-the-fact investigations of security incidents and to 

meet regulatory and organizational information retention requirements. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-11] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 40 

Implementation Statement: 

AU-11 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.3.11 AU-12 Audit Generation 

The information system: 

a. Provides audit record generation capability for the auditable events defined in AU-2 a. at 

[Assignment: organization-defined information system components]; 

b. Allows [Assignment: organization-defined personnel or roles] to select which auditable events 

are to be audited by specific components of the information system; and 

c. Generates audit records for the events defined in AU-2 d. with the content defined in AU-3. 

NIST SP 800-53 Audit and 

Accountability 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [AU-12] 

Implementation Statement: 

AU-12 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.4 Security Assessment and Authorization (CA) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 41 

2.1.4.1 CA-1 Security Assessment and Authorization Policies and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A security assessment and authorization policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the security assessment and authorization 

policy and associated security assessment and authorization controls; and 

b. Reviews and updates the current: 

1. Security assessment and authorization policy [Assignment: organization-defined 

frequency]; and 

2. Security assessment and authorization procedures [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CA-1] 

Implementation Statement: 

CA-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.4.2 CA-2 Security Assessments 

The organization: 

a. Develops a security assessment plan that describes the scope of the assessment including: 

1. Security controls and control enhancements under assessment; 

2. Assessment procedures to be used to determine security control effectiveness; and 

3. Assessment environment, assessment team, and assessment roles and responsibilities; 

b. Assesses the security controls in the information system and its environment of operation 

[Assignment: organization-defined frequency] to determine the extent to which the controls 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 42 

are implemented correctly, operating as intended, and producing the desired outcome with 

respect to meeting established security requirements; 

c. Produces a security assessment report that documents the results of the assessment; and 

d. Provides the results of the security control assessment to [Assignment: organization-defined 

individuals or roles]. 

Control Enhancements: 

(1) SECURITY ASSESSMENTS | INDEPENDENT ASSESSORS 

The organization employs assessors or assessment teams with [Assignment: organization-defined level 

of independence] to conduct security control assessments. 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CA-2] 

Implementation Statement: 

CA-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CA-2(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 43 

2.1.4.3 CA-3 System Interconnections 

The organization: 

a. Authorizes connections from the information system to other information systems through the 

use of Interconnection Security Agreements; 

b. Documents, for each interconnection, the interface characteristics, security requirements, and 

the nature of the information communicated; and 

c. Reviews and updates Interconnection Security Agreements [Assignment: organizationdefined frequency]. 

Control Enhancements: 

(5) SYSTEM INTERCONNECTIONS | RESTRICTIONS ON EXTERNAL SYSTEM CONNECTIONS 

The organization employs [Selection: allow-all, deny-by-exception; deny-all, permit-by-exception] policy 

for allowing [Assignment: organization-defined information systems] to connect to external information 

systems. 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CA-3] 

Implementation Statement: 

CA-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CA-3(5) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 44 

Scoped 

Comments: 

2.1.4.4 CA-5 Plan of Action and Milestones 

The organization: 

a. Develops a plan of action and milestones for the information system to document the 

organization’s planned remedial actions to correct weaknesses or deficiencies noted during 

the assessment of the security controls and to reduce or eliminate known vulnerabilities in 

the system; and 

b. Updates existing plan of action and milestones [Assignment: organization-defined frequency] 

based on the findings from security controls assessments, security impact analyses, and 

continuous monitoring activities. 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CA-5] 

Implementation Statement: 

CA-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.4.5 CA-6 Security Authorization 

The organization: 

a. Assigns a senior-level executive or manager as the authorizing official for the information 

system; 

b. Ensures that the authorizing official authorizes the information system for processing before 

commencing operations; and 

c. Updates the security authorization [Assignment: organization-defined frequency]. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 45 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CA-6] 

Implementation Statement: 

CA-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.4.6 CA-7 Continuous Monitoring 

The organization develops a continuous monitoring strategy and implements a continuous monitoring 

program that includes: 

a. Establishment of [Assignment: organization-defined metrics] to be monitored; 

b. Establishment of [Assignment: organization-defined frequencies] for monitoring and 

[Assignment: organization-defined frequencies] for assessments supporting such monitoring; 

c. Ongoing security control assessments in accordance with the organizational continuous 

monitoring strategy; 

d. Ongoing security status monitoring of organization-defined metrics in accordance with the 

organizational continuous monitoring strategy; 

e. Correlation and analysis of security-related information generated by assessments and 

monitoring; 

f. Response actions to address results of the analysis of security-related information; and 

g. Reporting the security status of organization and the information system to [Assignment: 

organization-defined personnel or roles] [Assignment: organization-defined frequency]. 

Control Enhancements: 

(1) CONTINUOUS MONITORING | INDEPENDENT ASSESSMENT 

The organization employs assessors or assessment teams with [Assignment: organization-defined level 

of independence] to monitor the security controls in the information system on an ongoing basis. 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 46 

Revision 4 [CA-7] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

CA-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CA-7(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.4.7 CA-9 Internal System Connections 

The organization: 

a. Authorizes internal connections of [Assignment: organization-defined information system 

components or classes of components] to the information system; and 

b. Documents, for each internal connection, the interface characteristics, security requirements, 

and the nature of the information communicated. 

NIST SP 800-53 Security Assessment 

and Authorization 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CA-9] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 47 

Implementation Statement: 

CA-9 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.5 Configuration Management (CM) 

2.1.5.1 CM-1 Configuration Management Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A configuration management policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the configuration management policy and 

associated configuration management controls; and 

b. Reviews and updates the current: 

1. Configuration management policy [Assignment: organization-defined frequency]; and 

2. Configuration management procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-1] 

Implementation Statement: 

CM-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments:

2.1.5.2 CM-2 Baseline Configuration 

The organization develops, documents, and maintains under configuration control, a current baseline 

configuration of the information system. 

Control Enhancements: 

(1) BASELINE CONFIGURATION | REVIEWS AND UPDATES 

The organization reviews and updates the baseline configuration of the information system: 

(a) [Assignment: organization-defined frequency]; 

(b) When required due to [Assignment organization-defined circumstances]; and 

(c) As an integral part of information system component installations and upgrades. 

(3) BASELINE CONFIGURATION | RETENTION OF PREVIOUS CONFIGURATIONS 

The organization retains [Assignment: organization-defined previous versions of baseline configurations 

of the information system] to support rollback. 

(7) BASELINE CONFIGURATION | CONFIGURE SYSTEMS, COMPONENTS, OR DEVICES FOR 

HIGH-RISK AREAS 

The organization: 

(a) Issues [Assignment: organization-defined information systems, system components, or 

devices] with [Assignment: organization-defined configurations] to individuals traveling to 

locations that the organization deems to be of significant risk; and 

(b) Applies [Assignment: organization-defined security safeguards] to the devices when the 

individuals return. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-2] 
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Implementation Statement: 

CM-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CM-2(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CM-2(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CM-2(7) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.5.3 CM-3 Configuration Change Control 

The organization: 

a. Determines the types of changes to the information system that are configuration-controlled; 

b. Reviews proposed configuration-controlled changes to the information system and approves 

or disapproves such changes with explicit consideration for security impact analyses; 

c. Documents configuration change decisions associated with the information system; 

d. Implements approved configuration-controlled changes to the information system; 

e. Retains records of configuration-controlled changes to the information system for 

[Assignment: organization-defined time period]; 

f. Audits and reviews activities associated with configuration-controlled changes to the 

information system; and 

g. Coordinates and provides oversight for configuration change control activities through 

[Assignment: organization-defined configuration change control element (e.g., committee, 

board] that convenes [Selection (one or more): [Assignment: organization-defined frequency]; 

[Assignment: organization-defined configuration change conditions]]. 

Control Enhancements: 

(2) CONFIGURATION CHANGE CONTROL | TEST / VALIDATE / DOCUMENT CHANGES 

The organization tests, validates, and documents changes to the information system before implementing 

the changes on the operational system. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-3] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

CM-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
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Scoped 

Comments:

Control Enhancement CM-3(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.5.4 CM-4 Security Impact Analysis 

The organization analyzes changes to the information system to determine potential security impacts 

prior to change implementation. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-4] 

Implementation Statement: 

CM-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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2.1.5.5 CM-5 Access Restrictions for Change 

The organization defines documents, approves, and enforces physical and logical access restrictions 

associated with changes to the information system. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-5] 

Implementation Statement: 

CM-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.5.6 CM-6 Configuration Settings 

The organization: 

a. Establishes and documents configuration settings for information technology products 

employed within the information system using [Assignment: organization-defined security 

configuration checklists] that reflect the most restrictive mode consistent with operational 

requirements; 

b. Implements the configuration settings; 

c. Identifies, documents, and approves any deviations from established configuration settings 

for [Assignment: organization-defined information system components] based on 

[Assignment: organization-defined operational requirements]; and 

d. Monitors and controls changes to the configuration settings in accordance with organizational 

policies and procedures. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-6] 
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Implementation Statement: 

CM-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.5.7 CM-7 Least Functionality 

The organization: 

a. Configures the information system to provide only essential capabilities; and 

b. Prohibits or restricts the use of the following functions, ports, protocols, and/or services: 

[Assignment: organization-defined prohibited or restricted functions, ports, protocols, 

and/or services]. 

Control Enhancements: 

(1) LEAST FUNCTIONALITY | PERIODIC REVIEW 

The organization: 

(a) Reviews the information system [Assignment: organization-defined frequency] to identify 

unnecessary and/or nonsecure functions, ports, protocols, and services; and 

(b) Disables [Assignment: organization-defined functions, ports, protocols, and services 

within the information system deemed to be unnecessary and/or nonsecure]. 

(2) LEAST FUNCTIONALITY | PREVENT PROGRAM EXECUTION 

The information system prevents program execution in accordance with [Selection (one or more): 

[Assignment: organization-defined policies regarding software program usage and restrictions]; rules 

authorizing the terms and conditions of software program usage]. 

(4) LEAST FUNCTIONALITY | UNAUTHORIZED SOFTWARE / BLACKLISTING 

The organization: 

(a) Identifies [Assignment: organization-defined software programs not authorized to execute 

on the information system]; 
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(b) Employs an allow-all, deny-by-exception policy to prohibit the execution of unauthorized 

software programs on the information system; and 

(c) Reviews and updates the list of unauthorized software programs [Assignment: organizationdefined frequency]. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-7] 

Implementation Statement: 

CM-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CM-7(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CM-7(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments: 

Control Enhancement CM-7(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.5.8 CM-8 Information System Component Inventory 

The organization: 

a. Develops and documents an inventory of information system components that: 

1. Accurately reflects the current information system; 

2. Includes all components within the authorization boundary of the information system; 

3. Is at the level of granularity deemed necessary for tracking and reporting; and 

4. Includes [Assignment: organization-defined information deemed necessary to achieve 

effective information system component accountability]; and 

b. Reviews and updates the information system component inventory [Assignment: 

organization-defined frequency]. 

Control Enhancements: 

(1) INFORMATION SYSTEM COMPONENT INVENTORY | UPDATES DURING INSTALLATIONS / 

REMOVALS 

The organization updates the inventory of information system components as an integral part of 

component installations, removals, and information system updates. 

(3) INFORMATION SYSTEM COMPONENT INVENTORY | AUTOMATED UNAUTHORIZED 

COMPONENT DETECTION 

The organization: 

(a) Employs automated mechanisms [Assignment: organization-defined frequency] to detect 

the presence of unauthorized hardware, software, and firmware components within the 

information system; and 
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(b) Takes the following actions when unauthorized components are detected: [Selection (one 

or more): disables network access by such components; isolates the components; notifies 

[Assignment: organization-defined personnel or roles]]. 

(5) INFORMATION SYSTEM COMPONENT INVENTORY | NO DUPLICATE ACCOUNTING OF 

COMPONENTS 

The organization verifies that all components within the authorization boundary of the information system 

are not duplicated in other information system inventories. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-8] 

Implementation Statement: 

CM-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CM-8(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CM-8(3) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CM-8(5) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.5.9 CM-9 Configuration Management Plan 

The organization develops, documents, and implements a configuration management plan for the 

information system that: 

a. Addresses roles, responsibilities, and configuration management processes and procedures; 

b. Establishes a process for identifying configuration items throughout the system development 

life cycle and for managing the configuration of the configuration items; 

c. Defines the configuration items for the information system and places the configuration items 

under configuration management; and 

d. Protects the configuration management plan from unauthorized disclosure and modification. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-9] 

Implementation Statement: 

CM-9 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
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Scoped 

Comments:

2.1.5.10 CM-10 Software Usage Restrictions 

The organization: 

a. Uses software and associated documentation in accordance with contract agreements and 

copyright laws; 

b. Tracks the use of software and associated documentation protected by quantity licenses to 

control copying and distribution; and 

c. Controls and documents the use of peer-to-peer file sharing technology to ensure that this 

capability is not used for the unauthorized distribution, display, performance, or reproduction 

of copyrighted work. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-10] 

Implementation Statement: 

CM-10 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.5.11 CM-11 User-Installed Software 

The organization: 

a. Establishes [Assignment: organization-defined policies] governing the installation of 

software by users; 

b. Enforces software installation policies through [Assignment: organization-defined 

methods]; and 
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c. Monitors policy compliance at [Assignment: organization-defined frequency]. 

NIST SP 800-53 Configuration 

Management 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [CM-11] 

Implementation Statement: 

CM-11 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.6 Contingency Planning (CP) 

2.1.6.1 CP-1 Contingency Planning Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A contingency planning policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the contingency planning policy and 

associated contingency planning controls; and 

b. Reviews and updates the current: 

1. Contingency planning policy [Assignment: organization-defined frequency]; and 

2. Contingency planning procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-1] 
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Implementation Statement: 

CP-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.6.2 CP-2 Contingency Plan 

The organization: 

a. Develops a contingency plan for the information system that: 

1. Identifies essential missions and business functions and associated contingency 

requirements; 

2. Provides recovery objectives, restoration priorities, and metrics; 

3. Addresses contingency roles, responsibilities, assigned individuals with contact 

information; 

4. Addresses maintaining essential missions and business functions despite an information 

system disruption, compromise, or failure; 

5. Addresses eventual, full information system restoration without deterioration of the 

security safeguards originally planned and implemented; and 

6. Is reviewed and approved by [Assignment: organization-defined personnel or roles]; 

b. Distributes copies of the contingency plan to [Assignment: organization-defined key 

contingency personnel (identified by name and/or by role) and organizational elements]; 

c. Coordinates contingency planning activities with incident handling activities; 

d. Reviews the contingency plan for the information system [Assignment: organization-defined 

frequency]; 

e. Updates the contingency plan to address changes to the organization, information system, or 

environment of operation and problems encountered during contingency plan 

implementation, execution, or testing; 

f. Communicates contingency plan changes to [Assignment: organization-defined key 

contingency personnel (identified by name and/or by role) and organizational elements]; and 

g. Protects the contingency plan from unauthorized disclosure and modification. 

Control Enhancements: 

(1) CONTINGENCY PLAN | COORDINATE WITH RELATED PLANS 

The organization coordinates contingency plan development with organizational elements responsible for 

related plans. 
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(3) CONTINGENCY PLAN | RESUME ESSENTIAL MISSIONS / BUSINESS FUNCTIONS 

The organization plans for the resumption of essential missions and business functions within 

[Assignment: organization-defined time period] of contingency plan activation. 

(8) CONTINGENCY PLAN | IDENTIFY CRITICAL ASSETS 

The organization identifies critical information system assets supporting essential missions and business 

functions. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-2] 

Implementation Statement: 

CP-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CP-2(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CP-2(3) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CP-2(8) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.6.3 CP-3 Contingency Training 

The organization provides contingency training to information system users consistent with assigned roles 

and responsibilities: 

a. Within [Assignment: organization-defined time period] of assuming a contingency role or 

responsibility; 

b. When required by information system changes; and 

c. [Assignment: organization-defined frequency] thereafter. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-3] 

Implementation Statement: 

CP-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments:

2.1.6.4 CP-4 Contingency Plan Testing 

The organization: 

a. Tests the contingency plan for the information system [Assignment: organization-defined 

frequency] using [Assignment: organization-defined tests] to determine the effectiveness of 

the plan and the organizational readiness to execute the plan; 

b. Reviews the contingency plan test results; and 

c. Initiates corrective actions, if needed. 

Control Enhancements: 

(1) CONTINGENCY PLAN TESTING | COORDINATE WITH RELATED PLANS 

The organization coordinates contingency plan testing with organizational elements responsible for 

related plans. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-4] 

Implementation Statement: 

CP-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CP-4(1) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.6.5 CP-6 Alternate Storage Site 

The organization: 

a. Establishes an alternate storage site including necessary agreements to permit the storage 

and retrieval of information system backup information; and 

b. Ensures that the alternate storage site provides information security safeguards equivalent to 

that of the primary site. 

Control Enhancements: 

(1) ALTERNATE STORAGE SITE | SEPARATION FROM PRIMARY SITE 

The organization identifies an alternate storage site that is separated from the primary storage site to 

reduce susceptibility to the same threats. 

. 

(3) ALTERNATE STORAGE SITE | ACCESSIBILITY 

The organization identifies potential accessibility problems to the alternate storage site in the event of an 

area-wide disruption or disaster and outlines explicit mitigation actions. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-6] 

Implementation Statement: 

CP-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments:

Control Enhancement CP-6(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CP-6(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.6.6 CP-7 Alternate Processing Site 

The organization: 

a. Establishes an alternate processing site including necessary agreements to permit the 

transfer and resumption of [Assignment: organization-defined information system operations] 

for essential missions/business functions within [Assignment: organization-defined time 

period consistent with recovery time and recovery point objectives] when the primary 

processing capabilities are unavailable; 

b. Ensures that equipment and supplies required to transfer and resume operations are 

available at the alternate processing site or contracts are in place to support delivery to the 

site within the organization-defined time period for transfer/resumption; and 

c. Ensures that the alternate processing site provides information security safeguards 

equivalent to that of the primary site. 
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Control Enhancements: 

(1) ALTERNATE PROCESSING SITE | SEPARATION FROM PRIMARY SITE 

The organization identifies an alternate processing site that is separated from the primary processing site 

to reduce susceptibility to the same threats. 

(2) ALTERNATE PROCESSING SITE | ACCESSIBILITY 

The organization identifies potential accessibility problems to the alternate processing site in the event of 

an area-wide disruption or disaster and outlines explicit mitigation actions. 

(3) ALTERNATE PROCESSING SITE | PRIORITY OF SERVICE 

The organization develops alternate processing site agreements that contain priority-of-service provisions 

in accordance with organizational availability requirements (including recovery time objectives). 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-7] 

Implementation Statement: 

CP-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CP-7(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments: 

Control Enhancement CP-7(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement CP-7(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.6.7 CP-8 Telecommunications Services 

The organization establishes alternate telecommunications services including necessary agreements to 

permit the resumption of [Assignment: organization-defined information system operations] for essential 

missions and business functions within [Assignment: organization-defined time period] when the primary 

telecommunications capabilities are unavailable at either the primary or alternate processing or storage 

sites. 

Control Enhancements: 

(1) TELECOMMUNICATIONS SERVICES | PRIORITY OF SERVICE PROVISIONS 

The organization: 
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(a) Develops primary and alternate telecommunications service agreements that contain priorityof-service provisions in accordance with organizational availability requirements (including 

recovery time objectives); and 

(b) Requests Telecommunications Service Priority for all telecommunications services used for 

national security emergency preparedness in the event that the primary and/or alternate 

telecommunications services are provided by a common carrier. 

(2) TELECOMMUNICATIONS SERVICES | SINGLE POINTS OF FAILURE 

The organization obtains alternate telecommunications services to reduce the likelihood of sharing a 

single point of failure with primary telecommunications services. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-8] 

Implementation Statement: 

CP-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Implementation Statement: 

CP-8(1) 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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Implementation Statement: 

CP-8(2) 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.6.8 CP-9 Information System Backup 

The organization: 

a. Conducts backups of user-level information contained in the information system [Assignment: 

organization-defined frequency consistent with recovery time and recovery point objectives]; 

b. Conducts backups of system-level information contained in the information system 

[Assignment: organization-defined frequency consistent with recovery time and recovery 

point objectives]; 

c. Conducts backups of information system documentation including security-related 

documentation [Assignment: organization-defined frequency consistent with recovery time 

and recovery point objectives]; and 

d. Protects the confidentiality, integrity, and availability of backup information at storage 

locations. 

Control Enhancements: 

(1) INFORMATION SYSTEM BACKUP | TESTING FOR RELIABILITY / INTEGRITY 

The organization tests backup information [Assignment: organization-defined frequency] to verify media 

reliability and information integrity. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-9] 
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Implementation Statement: 

CP-9 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement CP-9(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.6.9 CP-10 Information System Recovery and Reconstitution 

The organization provides for the recovery and reconstitution of the information system to a known state 

after a disruption, compromise, or failure. 

Control Enhancements: 

(2) INFORMATION SYSTEM RECOVERY AND RECONSTITUTION | TRANSACTION RECOVERY 

The information system implements transaction recovery for systems that are transaction-based. 

NIST SP 800-53 Contingency Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [CP-10] 
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Implementation Statement: 

CP-10 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Implementation Statement: 

CP-10(2) 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.7 Identification and Authentication (IA) 

2.1.7.1 IA-1 Identification and Authentication Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. An identification and authentication policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the identification and authentication policy 

and associated identification and authentication controls; and 

b. Reviews and updates the current: 

1. Identification and authentication policy [Assignment: organization-defined frequency]; and 

2. Identification and authentication procedures [Assignment: organization-defined 

frequency]. 
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NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-1] 

Implementation Statement: 

IA-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.7.2 IA-2 Identification and Authentication 

The information system uniquely identifies and authenticates organizational users (or processes acting on 

behalf of organizational users). 

Control Enhancements: 

(1) IDENTIFICATION AND AUTHENTICATION | NETWORK ACCESS TO PRIVILEGED ACCOUNTS 

The information system implements multifactor authentication for network access to privileged accounts. 

(2) IDENTIFICATION AND AUTHENTICATION | NETWORK ACCESS TO NON-PRIVILEGED 

ACCOUNTS 

The information system implements multifactor authentication for network access to non-privileged 

accounts. 

(3) IDENTIFICATION AND AUTHENTICATION | LOCAL ACCESS TO PRIVILEGED ACCOUNTS 

The information system implements multifactor authentication for local access to privileged accounts. 

(8) IDENTIFICATION AND AUTHENTICATION | NETWORK ACCESS TO PRIVILEGED ACCOUNTS - 

REPLAY RESISTANT 

The information system implements replay-resistant authentication mechanisms for network access to 

privileged accounts. 
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(11) IDENTIFICATION AND AUTHENTICATION | REMOTE ACCESS - SEPARATE DEVICE 

The information system implements multifactor authentication for remote access to privileged and nonprivileged accounts such that one of the factors is provided by a device separate from the system gaining 

access and the device meets [Assignment: organization-defined strength of mechanism requirements]. 

(12) IDENTIFICATION AND AUTHENTICATION | ACCEPTANCE OF PIV CREDENTIALS 

The information system accepts and electronically verifies Personal Identity Verification (PIV) credentials. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-2] 

Implementation Statement: 

IA-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement IA-2(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-2(2) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-2(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-2(8) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-2(11) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments: 

Control Enhancement IA-2(12) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.7.3 IA-3 Device Identification and Authentication 

The information system uniquely identifies and authenticates [Assignment: organization-defined specific 

and/or types of devices] before establishing a [Selection (one or more): local; remote; network] 

connection. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-3] 

Implementation Statement: 

IA-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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2.1.7.4 IA-4 Identifier Management 

The organization manages information system identifiers by: 

a. Receiving authorization from [Assignment: organization-defined personnel or roles] to assign 

an individual, group, role, or device identifier; 

b. Selecting an identifier that identifies an individual, group, role, or device; 

c. Assigning the identifier to the intended individual, group, role, or device; 

d. Preventing reuse of identifiers for [Assignment: organization-defined time period]; and 

e. Disabling the identifier after [Assignment: organization-defined time period of inactivity]. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-4] 

Implementation Statement: 

IA-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.7.5 IA-5 Authenticator Management 

The organization manages information system authenticators by: 

a. Verifying, as part of the initial authenticator distribution, the identity of the individual, group, 

role, or device receiving the authenticator; 

b. Establishing initial authenticator content for authenticators defined by the organization; 

c. Ensuring that authenticators have sufficient strength of mechanism for their intended use; 

d. Establishing and implementing administrative procedures for initial authenticator distribution, 

for lost/compromised or damaged authenticators, and for revoking authenticators; 

e. Changing default content of authenticators prior to information system installation; 

f. Establishing minimum and maximum lifetime restrictions and reuse conditions for 

authenticators; 

g. Changing/refreshing authenticators [Assignment: organization-defined time period by 

authenticator type]; 

h. Protecting authenticator content from unauthorized disclosure and modification; 

i. Requiring individuals to take, and having devices implement, specific security safeguards to 

protect authenticators; and 
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j. Changing authenticators for group/role accounts when membership to those accounts 

changes. 

Control Enhancements: 

 

(1) AUTHENTICATOR MANAGEMENT | PASSWORD-BASED AUTHENTICATION 

The information system, for password-based authentication: 

a. Enforces minimum password complexity of [Assignment: organization-defined requirements 

for case sensitivity, number of characters, mix of upper-case letters, lower-case letters, 

numbers, and special characters, including minimum requirements for each type]; 

b. Enforces at least the following number of changed characters when new passwords are 

created: [Assignment: organization-defined number]; 

c. Stores and transmits only encrypted representations of passwords; 

d. Enforces password minimum and maximum lifetime restrictions of [Assignment: organizationdefined numbers for lifetime minimum, lifetime maximum]; 

e. Prohibits password reuse for [Assignment: organization-defined number] generations; and 

f. Allows the use of a temporary password for system logons with an immediate change to a 

permanent password. 

(2) AUTHENTICATOR MANAGEMENT | PKI-BASED AUTHENTICATION 

The information system, for PKI-based authentication: 

a. Validates certifications by constructing and verifying a certification path to an accepted trust 

anchor including checking certificate status information; 

b. Enforces authorized access to the corresponding private key; 

c. Maps the authenticated identity to the account of the individual or group; and 

d. Implements a local cache of revocation data to support path discovery and validation in case 

of inability to access revocation information via the network. 

(3) AUTHENTICATOR MANAGEMENT | IN-PERSON OR TRUSTED THIRD-PARTY REGISTRATION 

The organization requires that the registration process to receive [Assignment: organization-defined types 

of and/or specific authenticators] be conducted [Selection: in person; by a trusted third party] before 

[Assignment: organization-defined registration authority] with authorization by [Assignment: organizationdefined personnel or roles]. 

(11) AUTHENTICATOR MANAGEMENT | HARDWARE TOKEN-BASED AUTHENTICATION 

The information system, for hardware token-based authentication, employs mechanisms that satisfy 

[Assignment: organization-defined token quality requirements]. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 
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Revision 4 [IA-5] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

IA-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement IA-5(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-5(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
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Control Enhancement IA-5(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-5(11) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.7.6 IA-6 Authenticator Feedback 

The information system obscures feedback of authentication information during the authentication 

process to protect the information from possible exploitation/use by unauthorized individuals. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-6] 

Implementation Statement: 

IA-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
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Scoped 

Comments:

2.1.7.7 IA-7 Cryptographic Module Authentication 

The information system implements mechanisms for authentication to a cryptographic module that meet 

the requirements of applicable federal laws, Executive Orders, directives, policies, regulations, standards, 

and guidance for such authentication. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-7] 

Implementation Statement: 

IA-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.7.8 IA-8 Identification and Authentication (Non-Organizational Users) 

The information system uniquely identifies and authenticates non-organizational users (or processes 

acting on behalf of non-organizational users). 

Control Enhancements: 

(1) IDENTIFICATION AND AUTHENTICATION | ACCEPTANCE OF PIV CREDENTIALS FROM 

OTHER AGENCIES 
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The information system accepts and electronically verifies Personal Identity Verification (PIV) credentials 

from other federal agencies. 

(2) IDENTIFICATION AND AUTHENTICATION | ACCEPTANCE OF THIRD-PARTY 

CREDENTIALS 

The information system accepts only FICAM-approved third-party credentials. 

(3) IDENTIFICATION AND AUTHENTICATION | USE OF FICAM-APPROVED PRODUCTS 

The organization employs only FICAM-approved information system components in [Assignment: 

organization-defined information systems] to accept third-party credentials. 

(4) IDENTIFICATION AND AUTHENTICATION | USE OF FICAM-ISSUED PROFILES 

The information system conforms to FICAM-issued profiles. 

NIST SP 800-53 Identification and 

Authentication 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [IA-8] 

Implementation Statement: 

IA-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement IA-8(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments: 

Control Enhancement IA-8(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-8(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement IA-8(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.8 Incident Response (IR) 
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2.1.8.1 IR-1 Incident Response Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. An incident response policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the incident response policy and 

associated incident response controls; and 

b. Reviews and updates the current: 

1. Incident response policy [Assignment: organization-defined frequency]; and 

2. Incident response procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-1] 

Implementation Statement: 

IR-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.8.2 IR-2 Incident Response Training 

The organization provides incident response training to information system users consistent with 

assigned roles and responsibilities: 

a. Within [Assignment: organization-defined time period] of assuming an incident response role 

or responsibility; 

b. When required by information system changes; and 

c. [Assignment: organization-defined frequency] thereafter. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-2] 
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Implementation Statement: 

IR-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.8.3 IR-3 Incident Response Testing 

The organization tests the incident response capability for the information system [Assignment: 

organization-defined frequency] using [Assignment: organization-defined tests] to determine the incident 

response effectiveness and documents the results. 

Control Enhancements: 

(2) INCIDENT RESPONSE TESTING | COORDINATION WITH RELATED PLANS 

The organization coordinates incident response testing with organizational elements responsible for 

related plans. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-3] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

IR-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments:

Control Enhancement IR-3(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.8.4 IR-4 Incident Handling 

The organization: 

a. Implements an incident handling capability for security incidents that includes preparation, 

detection and analysis, containment, eradication, and recovery; 

b. Coordinates incident handling activities with contingency planning activities; and 

c. Incorporates lessons learned from ongoing incident handling activities into incident response 

procedures, training, and testing/exercises, and implements the resulting changes 

accordingly. 

Control Enhancements: 

(1) INCIDENT HANDLING | AUTOMATED INCIDENT HANDLING PROCESSES 

The organization employs automated mechanisms to support the incident handling process. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-4] 

Implementation Statement: 

IR-4 

Implementation Status: Status (check all that apply): 
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 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement IR-4(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.8.5 IR-5 Incident Monitoring 

The organization tracks and documents information system security incidents. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-5] 

Implementation Statement: 

IR-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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2.1.8.6 IR-6 Incident Reporting 

The organization: 

a. Requires personnel to report suspected security incidents to the organizational incident 

response capability within [Assignment: organization-defined time period]; and 

b. Reports security incident information to [Assignment: organization-defined authorities]. 

Control Enhancements: 

(1) INCIDENT REPORTING | AUTOMATED REPORTING 

The organization employs automated mechanisms to assist in the reporting of security incidents. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-6] 

Implementation Statement: 

IR-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement IR-6(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
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2.1.8.7 IR-7 Incident Response Assistance 

The organization provides an incident response support resource, integral to the organizational incident 

response capability that offers advice and assistance to users of the information system for the handling 

and reporting of security incidents. 

Control Enhancements: 

(1) INCIDENT RESPONSE ASSISTANCE | AUTOMATION SUPPORT FOR AVAILABILITY OF 

INFORMATION / SUPPORT 

The organization employs automated mechanisms to increase the availability of incident response-related 

information and support. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-7] 

Implementation Statement: 

IR-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement IR-7(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
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2.1.8.8 IR-8 Incident Response Plan 

The organization: 

a. Develops an incident response plan that: 

1. Provides the organization with a roadmap for implementing its incident response 

capability; 

2. Describes the structure and organization of the incident response capability; 

3. Provides a high-level approach for how the incident response capability fits into the 

overall organization; 

4. Meets the unique requirements of the organization, which relate to mission, size, 

structure, and functions; 

5. Defines reportable incidents; 

6. Provides metrics for measuring the incident response capability within the 

organization; 

7. Defines the resources and management support needed to effectively maintain and 

mature an incident response capability; and 

8. Is reviewed and approved by [Assignment: organization-defined personnel or roles]; 

b. Distributes copies of the incident response plan to [Assignment: organization-defined incident 

response personnel (identified by name and/or by role) and organizational elements]; 

c. Reviews the incident response plan [Assignment: organization-defined frequency]; 

d. Updates the incident response plan to address system/organizational changes or problems 

encountered during plan implementation, execution, or testing; 

e. Communicates incident response plan changes to [Assignment: organization-defined incident 

response personnel (identified by name and/or by role) and organizational elements]; and 

f. Protects the incident response plan from unauthorized disclosure and modification. 

NIST SP 800-53 Incident Response Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [IR-8] 

Implementation Statement: 

IR-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.9 Maintenance (MA) 
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2.1.9.1 MA-1 System Maintenance Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A system maintenance policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the system maintenance policy and 

associated system maintenance controls; and 

b. Reviews and updates the current: 

1. System maintenance policy [Assignment: organization-defined frequency]; and 

2. System maintenance procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Maintenance Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MA-1] 

Implementation Statement: 

MA-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.9.2 MA-2 Controlled Maintenance 

The organization: 

a. Schedules, performs, documents, and reviews records of maintenance and repairs on 

information system components in accordance with manufacturer or vendor specifications 

and/or organizational requirements; 

b. Approves and monitors all maintenance activities, whether performed on site or remotely and 

whether the equipment is serviced on site or removed to another location; 

c. Requires that [Assignment: organization-defined personnel or roles] explicitly approve the 

removal of the information system or system components from organizational facilities for offsite maintenance or repairs; 
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d. Sanitizes equipment to remove all information from associated media prior to removal from 

organizational facilities for off-site maintenance or repairs; 

e. Checks all potentially impacted security controls to verify that the controls are still functioning 

properly following maintenance or repair actions; and 

f. Includes [Assignment: organization-defined maintenance-related information] in 

organizational maintenance records. 

NIST SP 800-53 Maintenance Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MA-2] 

Implementation Statement: 

MA-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.9.3 MA-3 Maintenance Tools 

The organization approves, controls, and monitors information system maintenance tools. 

Control Enhancements: 

(1) MAINTENANCE TOOLS | INSPECT TOOLS 

The organization inspects the maintenance tools carried into a facility by maintenance personnel for 

improper or unauthorized modifications. 

(2) MAINTENANCE TOOLS | INSPECT MEDIA 

The organization checks media containing diagnostic and test programs for malicious code before the 

media are used in the information system. 

NIST SP 800-53 Maintenance Common (Fully Inherited Control) 

Revision 4 Hybrid (Partially Inherited Control) [MA-3] 
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 System Specific Control

Implementation Statement: 

MA-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement MA-3(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.9.4 MA-4 Nonlocal Maintenance 

The organization: 

a. Approves and monitors nonlocal maintenance and diagnostic activities; 

b. Allows the use of nonlocal maintenance and diagnostic tools only as consistent with 

organizational policy and documented in the security plan for the information system; 

Employs strong authenticators in the establishment of nonlocal maintenance and diagnostic sessions; 

Maintains records for nonlocal maintenance and diagnostic activities; and terminates session and network 

connections when nonlocal maintenance is completed. 

Control Enhancements: 

(2) NONLOCAL MAINTENANCE | DOCUMENT NONLOCAL MAINTENANCE 
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The organization documents in the security plan for the information system, the policies and procedures 

for the establishment and use of nonlocal maintenance and diagnostic connections. 

NIST SP 800-53 Maintenance Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MA-4] 

Implementation Statement: 

MA-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement MA-4(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.9.5 MA-5 Maintenance Personnel 

The organization: 

a. Establishes a process for maintenance personnel authorization and maintains a list of 

authorized maintenance organizations or personnel; 

b. Ensures that non-escorted personnel performing maintenance on the information system 

have required access authorizations; and 

c. Designates organizational personnel with required access authorizations and technical 

competence to supervise the maintenance activities of personnel who do not possess the 

required access authorizations. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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NIST SP 800-53 Maintenance Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MA-5] 

Implementation Statement: 

MA-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.9.6 MA-6 Timely Maintenance 

The organization obtains maintenance support and/or spare parts for [Assignment: organization-defined 

information system components] within [Assignment: organization-defined time period] of failure. 

NIST SP 800-53 Maintenance Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MA-6] 

Implementation Statement: 

MA-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.10 Media Protection (MP) 

2.1.10.1 MP-1 Media Protection Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A media protection policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the media protection policy and associated 

media protection controls; and 

b. Reviews and updates the current: 

1. Media protection policy [Assignment: organization-defined frequency]; and 

2. Media protection procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Media Protection Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MP-1] 

Implementation Statement: 

MP-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.10.2 MP-2 Media Access 

The organization restricts access to [Assignment: organization-defined types of digital and/or non-digital 

media] to [Assignment: organization-defined personnel or roles 

NIST SP 800-53 Media Protection Common (Fully Inherited Control) 

Revision 4 Hybrid (Partially Inherited Control) [MP-2] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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 System Specific Control

Implementation Statement: 

MP-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.10.3 MP-3 Media Marking 

The organization: 

a. Marks information system media indicating the distribution limitations, handling caveats, and 

applicable security markings (if any) of the information; and 

b. Exempts [Assignment: organization-defined types of information system media] from marking 

as long as the media remain within [Assignment: organization-defined controlled areas]. 

NIST SP 800-53 Media Protection Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MP-3] 

Implementation Statement: 

MP-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.10.4 MP-4 Media Storage 

The organization: 

a. Physically controls and securely stores [Assignment: organization-defined types of digital 

and/or non-digital media] within [Assignment: organization-defined controlled areas]; and 

b. Protects information system media until the media are destroyed or sanitized using approved 

equipment, techniques, and procedures. 

NIST SP 800-53 Media Protection Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MP-4] 

Implementation Statement: 

MP-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.10.5 MP-5 Media Transport 

The organization: 

a. Protects and controls [Assignment: organization-defined types of information system media] 

during transport outside of controlled areas using [Assignment: organization-defined security 

safeguards]; 

b. Maintains accountability for information system media during transport outside of controlled 

areas; 

c. Documents activities associated with the transport of information system media; and 

d. Restricts the activities associated with the transport of information system media to 

authorized personnel. 

Control Enhancements: 

(4) MEDIA TRANSPORT | CRYPTOGRAPHIC PROTECTION 

The information system implements cryptographic mechanisms to protect the confidentiality and integrity 

of information stored on digital media during transport outside of controlled areas. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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NIST SP 800-53 Media Protection Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MP-5] 

Implementation Statement: 

MP-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement MA-5(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.10.6 MP-6 Media Sanitization 

The organization: 

a. Sanitizes [Assignment: organization-defined information system media] prior to disposal, 

release out of organizational control, or release for reuse using [Assignment: organizationdefined sanitization techniques and procedures] in accordance with applicable federal and 

organizational standards and policies; and 

b. Employs sanitization mechanisms with the strength and integrity commensurate with the 

security category or classification of the information. 

NIST SP 800-53 Media Protection Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Revision 4 [MP-6] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

MP-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.10.7 MP-7 Media Use 

The organization [Selection: restricts; prohibits] the use of [Assignment: organization-defined types of 

information system media] on [Assignment: organization-defined information systems or system 

components] using [Assignment: organization-defined security safeguards]. 

Control Enhancements: 

(1) MEDIA USE | PROHIBIT USE WITHOUT OWNER 

The organization prohibits the use of portable storage devices in organizational information systems when 

such devices have no identifiable owner. 

NIST SP 800-53 Media Protection Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [MP-7] 

Implementation Statement: 

MP-7 

Implementation Status: Status (check all that apply): 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

MP-7(1) Control Enhancement 

Implementation Statement: 

Implementation Status: Status (check all that apply 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.11 Physical and Environmental Protection (PE) 

2.1.11.1 PE-1 Physical and Environmental Protection Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A physical and environmental protection policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the physical and environmental protection 

policy and associated physical and environmental protection controls; and 

b. Reviews and updates the current: 

1. Physical and environmental protection policy [Assignment: organization-defined 

frequency]; and 

2. Physical and environmental protection procedures [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-1] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Implementation Statement: 

PE-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.2 PE-2 Physical Access Authorizations 

The organization: 

a. Develops, approves, and maintains a list of individuals with authorized access to the facility 

where the information system resides; 

b. Issues authorization credentials for facility access; 

c. Reviews the access list detailing authorized facility access by individuals [Assignment: 

organization-defined frequency]; and 

d. Removes individuals from the facility access list when access is no longer required. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-2] 

Implementation Statement: 

PE-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.11.3 PE-3 Physical Access Control 

The organization: 

a. Enforces physical access authorizations at [Assignment: organization-defined entry/exit 

points to the facility where the information system resides] by; 

1. Verifying individual access authorizations before granting access to the facility; and 

2. Controlling ingress/egress to the facility using [Selection (one or more): [Assignment: 

organization-defined physical access control systems/devices]; guards]; 

b. Maintains physical access audit logs for [Assignment: organization-defined entry/exit points]; 

c. Provides [Assignment: organization-defined security safeguards] to control access to areas 

within the facility officially designated as publicly accessible; 

d. Escorts visitors and monitors visitor activity [Assignment: organization-defined circumstances 

requiring visitor escorts and monitoring]; 

e. Secures keys, combinations, and other physical access devices; 

f. Inventories [Assignment: organization-defined physical access devices] every [Assignment: 

organization-defined frequency]; and 

g. Changes combinations and keys [Assignment: organization-defined frequency] and/or when 

keys are lost, combinations are compromised, or individuals are transferred or terminated. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-3] 

Implementation Statement: 

PE-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.4 PE-4 Access Control for Transmission Medium 

The organization controls physical access to [Assignment: organization-defined information system 

distribution and transmission lines] within organizational facilities using [Assignment: organization-defined 

security safeguards]. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-4] 

Implementation Statement: 

PE-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.5 PE-5 Access Control for Output Devices 

The organization controls physical access to information system output devices to prevent unauthorized 

individuals from obtaining the output. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-5] 

Implementation Statement: 

PE-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.11.6 PE-6 Monitoring Physical Access 

The organization: 

a. Monitors physical access to the facility where the information system resides to detect and 

respond to physical security incidents; 

b. Reviews physical access logs [Assignment: organization-defined frequency] and upon 

occurrence of [Assignment: organization-defined events or potential indications of events]; 

and 

c. Coordinates results of reviews and investigations with the organizational incident response 

capability. 

Control Enhancements: 

(1) MONITORING PHYSICAL ACCESS | INTRUSION ALARMS / SURVEILLANCE EQUIPMENT 

The organization monitors physical intrusion alarms and surveillance equipment. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-6] 

Implementation Statement: 

PE-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement PE-6(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.11.7 PE-8 Visitor Access Records 

The organization: 

a. Maintains visitor access records to the facility where the information system resides for 

[Assignment: organization-defined time period]; and 

b. Reviews visitor access records [Assignment: organization-defined frequency]. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-8] 

Implementation Statement: 

PE-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.8 PE-9 Power Equipment and Cabling 

The organization protects power equipment and power cabling for the information system from damage 

and destruction. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-9] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Implementation Statement: 

PE-9 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.9 PE-10 Emergency Shutoff 

The organization: 

a. Provides the capability of shutting off power to the information system or individual system 

components in emergency situations; 

b. Places emergency shutoff switches or devices in [Assignment: organization-defined location 

by information system or system component] to facilitate safe and easy access for personnel; 

and 

c. Protects emergency power shutoff capability from unauthorized activation. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-10] 

Implementation Statement: 

PE-10 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.11.10 PE-11 Emergency Power 

The organization provides a short-term uninterruptible power supply to facilitate [Selection (one or more): 

an orderly shutdown of the information system; transition of the information system to long-term alternate 

power] in the event of a primary power source loss. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-11] 

Implementation Statement: 

PE-11 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.11 PE-12 Emergency Lighting 

The organization employs and maintains automatic emergency lighting for the information system that 

activates in the event of a power outage or disruption and that covers emergency exits and evacuation 

routes within the facility. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-12] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Implementation Statement: 

PE-12 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.12 PE-13 Fire Protection 

The organization employs and maintains fire suppression and detection devices/systems for the 

information system that are supported by an independent energy source. 

Control Enhancements: 

(3) FIRE PROTECTION | AUTOMATIC FIRE SUPPRESSION 

The organization employs an automatic fire suppression capability for the information system when the 

facility is not staffed on a continuous basis. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-13] 

Implementation Statement: 

PE-13 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Comments:

Control Enhancement PE-13(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.11.13 PE-14 Temperature and Humidity Controls 

The organization: 

a. Maintains temperature and humidity levels within the facility where the information system 

resides at [Assignment: organization-defined acceptable levels]; and 

b. Monitors temperature and humidity levels [Assignment: organization-defined frequency]. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-14] 

Implementation Statement: 

PE-14 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Comments:

2.1.11.14 PE-15 Water Damage Protection 

The organization protects the information system from damage resulting from water leakage by providing 

master shutoff or isolation valves that are accessible, working properly, and known to key personnel. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-15] 

Implementation Statement: 

PE-15 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.15 PE-16 Delivery and Removal 

The organization authorizes, monitors, and controls [Assignment: organization-defined types of 

information system components] entering and exiting the facility and maintains records of those items. 

NIST SP 800-53 Physical and 

Environmental 

 Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Protection Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-16] 

Implementation Statement: 

PE-16 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.11.16 PE-17 Alternate Work Site 

The organization: 

a. Employs [Assignment: organization-defined security controls] at alternate work sites; 

b. Assesses as feasible, the effectiveness of security controls at alternate work sites; and 

c. Provides a means for employees to communicate with information security personnel in case 

of security incidents or problems. 

NIST SP 800-53 

Physical and 

Environmental 

Protection 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 System Specific Control [PE-17] 

Implementation Statement: 

PE-17 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.12 Planning (PL) 

2.1.12.1 PL-1 Security Planning Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A security planning policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the security planning policy and associated 

security planning controls; and 

b. Reviews and updates the current: 

1. Security planning policy [Assignment: organization-defined frequency]; and 

2. Security planning procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PL-1] 

Implementation Statement: 

PL-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.12.2 PL-2 System Security Plan 

The organization: 

a. Develops a security plan for the information system that: 

1. Is consistent with the organization’s enterprise architecture; 

2. Explicitly defines the authorization boundary for the system; 

3. Describes the operational context of the information system in terms of missions and 

business processes; 

4. Provides the security categorization of the information system including supporting 

rationale; 

5. Describes the operational environment for the information system and relationships with 

or connections to other information systems; 

6. Provides an overview of the security requirements for the system; 

7. Identifies any relevant overlays, if applicable; 

8. Describes the security controls in place or planned for meeting those requirements 

including a rationale for the tailoring and supplementation decisions; and 

9. Is reviewed and approved by the authorizing official or designated representative prior to 

plan implementation; 

b. Distributes copies of the security plan and communicates subsequent changes to the plan to 

[Assignment: organization-defined personnel or roles]; 

c. Reviews the security plan for the information system [Assignment: organization-defined 

frequency]; 

d. Updates the plan to address changes to the information system/environment of operation or 

problems identified during plan implementation or security control assessments; and 

e. Protects the security plan from unauthorized disclosure and modification. 

Control Enhancements: 

(1) SYSTEM SECURITY PLAN | PLAN / COORDINATE WITH OTHER ORGANIZATIONAL ENTITIES 

The organization plans and coordinates security-related activities affecting the information system with 

[Assignment: organization-defined individuals or groups] before conducting such activities in order to 

reduce the impact on other organizational entities. 

NIST SP 800-53 Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PL-2] 

Implementation Statement: 

PL-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

TMP V7.4 FY17 UNCLASSIFIED // FOR OFFICIAL USE ONLY 114 

Scoped 

Comments:

Control Enhancement PL-2(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.12.3 PL-4 Rules of Behavior 

The organization: 

a. Establishes and makes readily available to individuals requiring access to the information 

system, the rules that describe their responsibilities and expected behavior with regard to 

information and information system usage; 

b. Receives a signed acknowledgment from such individuals, indicating that they have read, 

understand, and agree to abide by the rules of behavior, before authorizing access to 

information and the information system; 

c. Reviews and updates the rules of behavior [Assignment: organization-defined frequency]; 

and 

d. Requires individuals who have signed a previous version of the rules of behavior to read and 

resign when the rules of behavior are revised/updated. 

Control Enhancements: 

(1) RULES OF BEHAVIOR | SOCIAL MEDIA AND NETWORKING RESTRICTIONS 

The organization includes in the rules of behavior, explicit restrictions on the use of social 

media/networking sites and posting organizational information on public websites. 

NIST SP 800-53 Planning Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PL-4] 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Implementation Statement: 

PL-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement PL-4(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.12.4 PL-8 Information Security Architecture 

The organization: 

a. Develops an information security architecture for the information system that: 

1. Describes the overall philosophy, requirements, and approach to be taken with regard to 

protecting the confidentiality, integrity, and availability of organizational information; 

2. Describes how the information security architecture is integrated into and supports the 

enterprise architecture; and 

3. Describes any information security assumptions about, and dependencies on, external 

services; 

b. Reviews and updates the information security architecture [Assignment: organization-defined 

frequency] to reflect updates in the enterprise architecture; and 

c. Ensures that planned information security architecture changes are reflected in the security 

plan, the security Concept of Operations (CONOPS), and organizational 

procurements/acquisitions. 

NIST SP 800-53 Planning Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Revision 4 [PL-8] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

PL-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13 Personnel Security (PS) 

2.1.13.1 PS-1 Personnel Security Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A personnel security policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the personnel security policy and 

associated personnel security controls; and 

b. Reviews and updates the current: 

1. Personnel security policy [Assignment: organization-defined frequency]; and 

2. Personnel security procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-1] 

Implementation Statement: 

PS-1 
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<System Name><(System Acronym)> 

<Document Name> 

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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13.2 PS-2 Position Risk Designation 

The organization: 

a. Assigns a risk designation to all organizational positions; 

b. Establishes screening criteria for individuals filling those positions; and 

c. Reviews and updates position risk designations [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-2] 

Implementation Statement: 

PS-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13.3 PS-3 Personnel Screening 

The organization: 

a. Screens individuals prior to authorizing access to the information system; and 

b. Rescreens individuals according to [Assignment: organization-defined conditions requiring 

rescreening and, where rescreening is so indicated, the frequency of such rescreening]. 
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Version <X.X> 

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NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-3] 

Implementation Statement: 

PS-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13.4 PS-4 Personnel Termination 

The organization, upon termination of individual employment: 

a. Disables information system access within [Assignment: organization-defined time period]; 

b. Terminates/revokes any authenticators/credentials associated with the individual; 

c. Conducts exit interviews that include a discussion of [Assignment: organization-defined 

information security topics]; 

d. Retrieves all security-related organizational information system-related property; 

e. Retains access to organizational information and information systems formerly controlled by 

terminated individual; and 

f. Notifies [Assignment: organization-defined personnel or roles] within [Assignment: 

organization-defined time period]. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-4] 

Implementation Statement: 

PS-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Scoped 

Comments:

2.1.13.5 PS-5 Personnel Transfer 

The organization: 

a. Reviews and confirms ongoing operational need for current logical and physical access 

authorizations to information systems/facilities when individuals are reassigned or transferred 

to other positions within the organization; 

b. Initiates [Assignment: organization-defined transfer or reassignment actions] within 

[Assignment: organization-defined time period following the formal transfer action]; 

c. Modifies access authorization as needed to correspond with any changes in operational need 

due to reassignment or transfer; and 

d. Notifies [Assignment: organization-defined personnel or roles] within [Assignment: 

organization-defined time period]. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-5] 

Implementation Statement: 

PS-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13.6 PS-6 Access Agreements 

The organization: 

a. Develops and documents access agreements for organizational information systems; 
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b. Reviews and updates the access agreements [Assignment: organization-defined frequency]; 

and 

c. Ensures that individuals requiring access to organizational information and information 

systems: 

1. Sign appropriate access agreements prior to being granted access; and 

2. Re-sign access agreements to maintain access to organizational information systems 

when access agreements have been updated or [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-6] 

Implementation Statement: 

PS-6 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13.7 PS-7 Third-Party Personnel Security 

The organization: 

a. Establishes personnel security requirements including security roles and responsibilities for 

third-party providers; 

b. Requires third-party providers to comply with personnel security policies and procedures 

established by the organization; 

c. Documents personnel security requirements; 

d. Requires third-party providers to notify [Assignment: organization-defined personnel or roles] 

of any personnel transfers or terminations of third-party personnel who possess 

organizational credentials and/or badges, or who have information system privileges within 

[Assignment: organization-defined time period]; and 

e. Monitors provider compliance. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-7] 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Implementation Statement: 

PS-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.13.8 PS-8 Personnel Sanctions 

The organization: 

a. Employs a formal sanctions process for individuals failing to comply with established information 

security policies and procedures; and 

b. Notifies [Assignment: organization-defined personnel or roles] within [Assignment: organizationdefined time period] when a formal employee sanctions process is initiated, identifying the 

individual sanctioned and the reason for the sanction. 

NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [PS-8] 

Implementation Statement: 

PS-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.14 Risk Assessment (RA) 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.14.1 RA-1 Risk Assessment Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A risk assessment policy that addresses purpose, scope, roles, responsibilities, 

management commitment, coordination among organizational entities, and compliance; 

and 

2. Procedures to facilitate the implementation of the risk assessment policy and associated 

risk assessment controls; and 

b. Reviews and updates the current: 

1. Risk assessment policy [Assignment: organization-defined frequency]; and 

2. Risk assessment procedures [Assignment: organization-defined frequency]. 

NIST SP 800-53 Risk Assessment Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [RA-1] 

Implementation Statement: 

RA-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.14.2 RA-2 Security Categorization 

The organization: 

a. Categorizes information and the information system in accordance with applicable federal 

laws, Executive Orders, directives, policies, regulations, standards, and guidance; 

b. Documents the security categorization results (including supporting rationale) in the security 

plan for the information system; and 

c. Ensures that the security categorization decision is reviewed and approved by the authorizing 

official or authorizing official designated representative. 

NIST SP 800-53 Risk Assessment Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Revision 4 [RA-2] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

RA-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.14.3 RA-3 Risk Assessment 

The organization: 

a. Conducts an assessment of risk, including the likelihood and magnitude of harm, from the 

unauthorized access, use, disclosure, disruption, modification, or destruction of the 

information system and the information it processes, stores, or transmits; 

b. Documents risk assessment results in [Selection: security plan; risk assessment report;

[Assignment: organization-defined document]]; 

c. Reviews risk assessment results [Assignment: organization-defined frequency]; 

d. Disseminates risk assessment results to [Assignment: organization-defined personnel or 

roles]; and 

e. Updates the risk assessment [Assignment: organization-defined frequency] or whenever 

there are significant changes to the information system or environment of operation (including 

the identification of new threats and vulnerabilities), or other conditions that may impact the 

security state of the system. 

NIST SP 800-53 Risk Assessment Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [RA-3] 

Implementation Statement: 

RA-3 

Implementation Status: Status (check all that apply): 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.14.4 RA-5 Vulnerability Scanning 

The organization: 

a. Scans for vulnerabilities in the information system and hosted applications [Assignment: 

organization-defined frequency and/or randomly in accordance with organization-defined 

process] and when new vulnerabilities potentially affecting the system/applications are 

identified and reported; 

b. Employs vulnerability scanning tools and techniques that facilitate interoperability among 

tools and automate parts of the vulnerability management process by using standards for: 

1. Enumerating platforms, software flaws, and improper configurations; 

2. Formatting checklists and test procedures; and 

3. Measuring vulnerability impact; 

c. Analyzes vulnerability scan reports and results from security control assessments; 

d. Remediates legitimate vulnerabilities [Assignment: organization-defined response times] in 

accordance with an organizational assessment of risk; and 

e. Shares information obtained from the vulnerability scanning process and security control 

assessments with [Assignment: organization-defined personnel or roles] to help eliminate 

similar vulnerabilities in other information systems (i.e., systemic weaknesses or 

deficiencies). 

Control Enhancements: 

(1) VULNERABILITY SCANNING | UPDATE TOOL CAPABILITY 

The organization employs vulnerability scanning tools that include the capability to readily update the 

information system vulnerabilities to be scanned. 

(2) VULNERABILITY SCANNING | UPDATE BY FREQUENCY / PRIOR TO NEW SCAN / WHEN 

IDENTIFIED 

The organization updates the information system vulnerabilities scanned [Selection (one or more): 

[Assignment: organization-defined frequency]; prior to a new scan; when new vulnerabilities are identified 

and reported]. 

(5) VULNERABILITY SCANNING | PRIVILEGED ACCESS 

The information system implements privileged access authorization to [Assignment: organizationidentified information system components] for selected [Assignment: organization-defined vulnerability 

scanning activities]. 
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<System Name><(System Acronym)> 

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NIST SP 800-53 Personnel Security Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control

Revision 4 [RA-5] 

Implementation Statement: 

RA-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement RA-5(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement RA-5(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Control Enhancement RA-5(5) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.15 System and Services Acquisition 

2.1.15.1 SA-1 System and Services Acquisition Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A system and services acquisition policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the system and services acquisition policy 

and associated system and services acquisition controls; and 

b. Reviews and updates the current: 

1. System and services acquisition policy [Assignment: organization-defined frequency]; 

and 

2. System and services acquisition procedures [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-1] 

Implementation Statement: 

SA-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Scoped 

Comments:

2.1.15.2 SA-2 Allocation of Resources 

The organization: 

a. Determines information security requirements for the information system or information 

system service in mission/business process planning; 

b. Determines, documents, and allocates the resources required to protect the information 

system or information system service as part of its capital planning and investment control 

process; and 

c. Establishes a discrete line item for information security in organizational programming and 

budgeting documentation. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-2] 

Implementation Statement: 

SA-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.15.3 SA-3 System Development Life Cycle 

The organization: 

a. Manages the information system using [Assignment: organization-defined system 

development life cycle] that incorporates information security considerations; 

b. Defines and documents information security roles and responsibilities throughout the system 

development life cycle; 
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c. Identifies individuals having information security roles and responsibilities; and 

d. Integrates the organizational information security risk management process into system 

development life cycle activities. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-3] 

Implementation Statement: 

SA-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.15.4 SA-4 Acquisition Process 

The organization includes the following requirements, descriptions, and criteria, explicitly or by reference, 

in the acquisition contract for the information system, system component, or information system service in 

accordance with applicable federal laws, Executive Orders, directives, policies, regulations, standards, 

guidelines, and organizational mission/business needs: 

a. Security functional requirements; 

b. Security strength requirements; 

c. Security assurance requirements; 

d. Security-related documentation requirements; 

e. Requirements for protecting security-related documentation; 

f. Description of the information system development environment and environment in which 

the system is intended to operate; and 

g. Acceptance criteria. 

Control Enhancements: 

(1) ACQUISITION PROCESS | FUNCTIONAL PROPERTIES OF SECURITY CONTROLS 

The organization requires the developer of the information system, system component, or information 

system service to provide a description of the functional properties of the security controls to be 

employed. 
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Version <X.X> 

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(2) ACQUISITION PROCESS | DESIGN / IMPLEMENTATION INFORMATION FOR SECURITY 

CONTROLS 

The organization requires the developer of the information system, system component, or information 

system service to provide design and implementation information for the security controls to be employed 

that includes: [Selection (one or more): security-relevant external system interfaces; high-level design; 

low-level design; source code or hardware schematics; [Assignment: organization-defined 

design/implementation information]] at [Assignment: organization-defined level of detail]. 

(9) ACQUISITION PROCESS | FUNCTIONS / PORTS / PROTOCOLS / SERVICES IN USE 

The organization requires the developer of the information system, system component, or information 

system service to identify early in the system development life cycle, the functions, ports, protocols, and 

services intended for organizational use. 

(10) ACQUISITION PROCESS | USE OF APPROVED PIV PRODUCTS 

The organization employs only information technology products on the FIPS 201-approved products list 

for Personal Identity Verification (PIV) capability implemented within organizational information systems. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-4] 

Implementation Statement: 

SA-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SA-4(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Scoped 

Comments: 

Control Enhancement SA-4(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SA-4(9) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SA-4(10) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.15.5 SA-5 Information System Documentation 
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<Document Name> 

Version <X.X> 

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The organization: 

a. Obtains administrator documentation for the information system, system component, or 

information system service that describes: 

1. Secure configuration, installation, and operation of the system, component, or service; 

2. Effective use and maintenance of security functions/mechanisms; and 

3. Known vulnerabilities regarding configuration and use of administrative (i.e., privileged) 

functions; 

b. Obtains user documentation for the information system, system component, or information 

system service that describes: 

1. User-accessible security functions/mechanisms and how to effectively use those security 

functions/mechanisms; 

2. Methods for user interaction, which enables individuals to use the system, component, or 

service in a more secure manner; and 

3. User responsibilities in maintaining the security of the system, component, or service; 

c. Documents attempts to obtain information system, system component, or information system 

service documentation when such documentation is either unavailable or nonexistent and 

[Assignment: organization-defined actions] in response; 

d. Protects documentation as required, in accordance with the risk management strategy; and 

e. Distributes documentation to [Assignment: organization-defined personnel or roles]. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-5] 

Implementation Statement: 

SA-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.15.6 SA-8 Security Engineering Principles 

The organization applies information system security engineering principles in the specification, design, 

development, implementation, and modification of the information system. 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-8] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SA-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.15.7 SA-9 External Information System Services 

The organization: 

a. Requires that providers of external information system services comply with organizational 

information security requirements and employ [Assignment: organization-defined security 

controls] in accordance with applicable federal laws, Executive Orders, directives, policies, 

regulations, standards, and guidance; 

b. Defines and documents government oversight and user roles and responsibilities with regard 

to external information system services; and 

c. Employs [Assignment: organization-defined processes, methods, and techniques] to monitor 

security control compliance by external service providers on an ongoing basis. 

Control Enhancements: 

(2) EXTERNAL INFORMATION SYSTEMS | IDENTIFICATION OF FUNCTIONS / PORTS / 

PROTOCOLS / SERVICES 

The organization requires providers of [Assignment: organization-defined external information system 

services] to identify the functions, ports, protocols, and other services required for the use of such 

services. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

Revision 4 [SA-9] 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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 System Specific Control

Implementation Statement: 

SA-9 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SA-9(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.15.8 SA-10 Developer Configuration Management 

The organization requires the developer of the information system, system component, or information 

system service to: 

a. Perform configuration management during system, component, or service [Selection (one or 

more): design; development; implementation; operation]; 

b. Document, manage, and control the integrity of changes to [Assignment: organization-defined 

configuration items under configuration management]; 

c. Implement only organization-approved changes to the system, component, or service; 

d. Document approved changes to the system, component, or service and the potential security 

impacts of such changes; and 

e. Track security flaws and flaw resolution within the system, component, or service and report 

findings to [Assignment: organization-defined personnel]. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Revision 4 [SA-10] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SA-10 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.15.9 SA-11 Developer Security Testing and Evaluation 

The organization requires the developer of the information system, system component, or information 

system service to: 

a. Create and implement a security assessment plan; 

b. Perform [Selection (one or more): unit; integration; system; regression] testing/evaluation at 

[Assignment: organization-defined depth and coverage]; 

c. Produce evidence of the execution of the security assessment plan and the results of the 

security testing/evaluation; 

d. Implement a verifiable flaw remediation process; and 

e. Correct flaws identified during security testing/evaluation. 

NIST SP 800-53 System and Services 

Acquisition 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SA-11] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SA-11 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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Comments:

2.1.16 System and Communications Protection 

2.1.16.1 SC-1 System and Communications Protection Policy and Procedures 

The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A system and communications protection policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the system and communications protection 

policy and associated system and communications protection controls; and 

b. Reviews and updates the current: 

1. System and communications protection policy [Assignment: organization-defined 

frequency]; and 

2. System and communications protection procedures [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-1] 

Implementation Statement: 

SC-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
Social Security Administration 

<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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2.1.16.2 SC-2 Application Partitioning 

The information system separates user functionality (including user interface services) from information 

system management functionality. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-2] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SC-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.3 SC-4 Information in Shared Resources 

The information system prevents unauthorized and unintended information transfer via shared system 

resources. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-3] 

Implementation Statement: 

SC-4 

Implementation Status: Status (check all that apply): 
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<System Name><(System Acronym)> 

<Document Name> 

Version <X.X> 

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 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.4 SC-5 Denial of Service Protection 

The information system protects against or limits the effects of the following types of denial of service 

attacks: [Assignment: organization-defined types of denial of service attacks or reference to source for 

such information] by employing [Assignment: organization-defined security safeguards]. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-5] 

Implementation Statement: 

SC-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.5 SC-7 Boundary Protection 

The information system: 

a. Monitors and controls communications at the external boundary of the system and at key 

internal boundaries within the system; 

b. Implements subnetworks for publicly accessible system components that are [Selection: 

physically; logically] separated from internal organizational networks; and 
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c. Connects to external networks or information systems only through managed interfaces 

consisting of boundary protection devices arranged in accordance with organizational 

security architecture. 

Control Enhancements: 

(3) BOUNDARY PROTECTION | ACCESS POINTS 

The organization limits the number of external network connections to the information system. 

Supplemental Guidance: Limiting the number of external network connections facilitates more 

comprehensive monitoring of inbound and outbound communications traffic. The Trusted Internet 

Connection (TIC) initiative is an example of limiting the number of external network connections. 

(4) BOUNDARY PROTECTION | EXTERNAL TELECOMMUNICATIONS SERVICES 

The organization: 

(a) Implements a managed interface for each external telecommunication service; 

(b) Establishes a traffic flow policy for each managed interface; 

(c) Protects the confidentiality and integrity of the information being transmitted across each 

interface; 

(d) Documents each exception to the traffic flow policy with a supporting mission/business 

need and duration of that need; and 

(e) Reviews exceptions to the traffic flow policy [Assignment: organization-defined frequency] 

and removes exceptions that are no longer supported by an explicit mission/business 

need. 

(5) BOUNDARY PROTECTION | DENY BY DEFAULT / ALLOW BY EXCEPTION 

The information system at managed interfaces denies network communications traffic by default and 

allows network communications traffic by exception (i.e., deny all, permit by exception). 

(7) BOUNDARY PROTECTION | PREVENT SPLIT TUNNELING FOR REMOTE DEVICES 

The information system, in conjunction with a remote device, prevents the device from simultaneously 

establishing non-remote connections with the system and communicating via some other connection to 

resources in external networks. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-7] 
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Implementation Statement: 

SC-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SC-7(3) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SC-7(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SC-7(5) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SC-7(7) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.16.6 SC-8 Transmission Confidentiality and Integrity 

The information system protects the [Selection (one or more): confidentiality; integrity] of transmitted 

information. 

Control Enhancements: 

(1) TRANSMISSION CONFIDENTIALITY AND INTEGRITY | CRYPTOGRAPHIC OR ALTERNATE 

PHYSICAL PROTECTION 

The information system implements cryptographic mechanisms to [Selection (one or more): prevent 

unauthorized disclosure of information; detect changes to information] during transmission unless 

otherwise protected by [Assignment: organization-defined alternative physical safeguards]. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-8] 
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Implementation Statement: 

SC-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SC-8(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.16.7 SC-10 Network Disconnect 

The information system terminates the network connection associated with a communications session at 

the end of the session or after [Assignment: organization-defined time period] of inactivity.

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-10] 

Implementation Statement: 

SC-10 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.8 SC-12 Cryptographic Key Establishment and Management 

The organization establishes and manages cryptographic keys for required cryptography employed within 

the information system in accordance with [Assignment: organization-defined requirements for key 

generation, distribution, storage, access, and destruction]. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-12] 

Implementation Statement: 

SC-12 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.9 SC-13 Cryptographic Protection 

The information system implements [Assignment: organization-defined cryptographic uses and type of 

cryptography required for each use] in accordance with applicable federal laws, Executive Orders, 

directives, policies, regulations, and standards. 
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NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-13] 

Implementation Statement: 

SC-13 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.10 SC-15 Collaborative Computing Devices 

The information system: 

a. Prohibits remote activation of collaborative computing devices with the following exceptions: 

[Assignment: organization-defined exceptions where remote activation is to be allowed]; and 

b. Provides an explicit indication of use to users physically present at the devices. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-15] 

Implementation Statement: 

SC-15 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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2.1.16.11 SC-17 Public Key Infrastructure Certificates 

The organization issues public key certificates under an [Assignment: organization-defined certificate 

policy] or obtains public key certificates from an approved service provider 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-17] 

Implementation Statement: 

SC-17 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.12 SC-18 Mobile Code 

The organization: 

a. Defines acceptable and inacceptable mobile code and mobile code technologies; 

b. Establishes usage restrictions and implementation guidance for acceptable mobile code and 

mobile code technologies; and 

c. Authorizes, monitors, and controls the use of mobile code within the information system. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 
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Revision 4 [SC-18] Hybrid (Partially Inherited Control) 

 System Specific Control

Implementation Statement: 

SC-18 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.13 SC-19 Voice Over Internet Protocol 

The organization: 

a. Establishes usage restrictions and implementation guidance for Voice over Internet Protocol 

(VoIP) technologies based on the potential to cause damage to the information system if 

used maliciously; and 

b. Authorizes, monitors, and controls the use of VoIP within the information system. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-19] 

Implementation Statement: 

SC-19 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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2.1.16.14 SC-20 Secure Name / Address Resolution Service (Authoritative Source) 

The information system: 

a. Provides additional data origin and integrity artifacts along with the authoritative name 

resolution data the system returns in response to external name/address resolution queries; 

and 

Provides the means to indicate the security status of child zones and (if the child supports secure 

resolution services) to enable verification of a chain of trust among parent and child domains, when 

operating as part of a distributed, hierarchical namespace. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-20] 

Implementation Statement: 

SC-20 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.15 SC-21 Secure Name / Address Resolution Service (Recursive or Caching 

Resolver) 

The information system requests and performs data origin authentication and data integrity verification on 

the name/address resolution responses the system receives from authoritative sources. 
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NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-21] 

Implementation Statement: 

SC-21 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.16 SC-22 Architecture and Provisioning for Name / Address Resolution 

Service 

The information systems that collectively provide name/address resolution service for an organization are 

fault-tolerant and implement internal/external role separation 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-22] 

Implementation Statement: 

SC-22 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 
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Comments:

2.1.16.17 SC-23 Session Authenticity 

The information system protects the authenticity of communications sessions. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-23] 

Implementation Statement: 

SC-23 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.18 SC-28 Protection of Information at Rest 

The information system protects the [Selection (one or more): confidentiality; integrity] of [Assignment: 

organization-defined information at rest]. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-28] 
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Implementation Statement: 

SC-28 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.16.19 SC-39 Process Isolation 

The information system maintains a separate execution domain for each executing process. 

NIST SP 800-53 System and 

Communications 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SC-39] 

Implementation Statement: 

SC-39 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.17 System and Information Integrity 

2.1.17.1 SI-1 System and Information Integrity Policy and Procedures 
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The organization: 

a. Develops, documents, and disseminates to [Assignment: organization-defined personnel or 

roles]: 

1. A system and information integrity policy that addresses purpose, scope, roles, 

responsibilities, management commitment, coordination among organizational entities, 

and compliance; and 

2. Procedures to facilitate the implementation of the system and information integrity policy 

and associated system and information integrity controls; and 

b. Reviews and updates the current: 

1. System and information integrity policy [Assignment: organization-defined frequency]; 

and 

2. System and information integrity procedures [Assignment: organization-defined 

frequency]. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-1] 

Implementation Statement: 

SI-1 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.17.2 SI-2 Flaw Remediation 

The organization: 

a. Identifies, reports, and corrects information system flaws; 

b. Tests software and firmware updates related to flaw remediation for effectiveness and 

potential side effects before installation; 

c. Installs security-relevant software and firmware updates within [Assignment: organizationdefined time period] of the release of the updates; and 

d. Incorporates flaw remediation into the organizational configuration management process. 

Control Enhancements: 
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(2) FLAW REMEDIATION | AUTOMATED FLAW REMEDIATION STATUS 

The organization employs automated mechanisms [Assignment: organization-defined frequency] to 

determine the state of information system components with regard to flaw remediation. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-2] 

Implementation Statement: 

SI-2 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SI-2(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.17.3 SI-3 Malicious Code Protection 

The organization: 

a. Employs malicious code protection mechanisms at information system entry and exit points 

to detect and eradicate malicious code; 

b. Updates malicious code protection mechanisms whenever new releases are available in 

accordance with organizational configuration management policy and procedures; 
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c. Configures malicious code protection mechanisms to: 

1. Perform periodic scans of the information system [Assignment: organization-defined 

frequency] and real-time scans of files from external sources at [Selection (one or more); 

endpoint; network entry/exit points] as the files are downloaded, opened, or executed in 

accordance with organizational security policy; and 

2. [Selection (one or more): block malicious code; quarantine malicious code; send alert to 

administrator; [Assignment: organization-defined action]] in response to malicious code 

detection; and 

d. Addresses the receipt of false positives during malicious code detection and eradication and 

the resulting potential impact on the availability of the information system. 

Control Enhancements: 

(1) MALICIOUS CODE PROTECTION | CENTRAL MANAGEMENT 

The organization centrally manages malicious code protection mechanisms. 

(2) MALICIOUS CODE PROTECTION | AUTOMATIC UPDATES 

The information system automatically updates malicious code protection mechanisms. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-3] 

Implementation Statement: 

SI-3 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SI-3(1) 

Implementation Statement: 
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Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SI-3(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.17.4 SI-4 Information System Monitoring 

The organization: 

a. Monitors the information system to detect: 

1. Attacks and indicators of potential attacks in accordance with [Assignment: 

organization-defined monitoring objectives]; and 

2. Unauthorized local, network, and remote connections; 

b. Identifies unauthorized use of the information system through [Assignment: organizationdefined techniques and methods]; 

c. Deploys monitoring devices: (i) strategically within the information system to collect 

organization-determined essential information; and (ii) at ad hoc locations within the system 

to track specific types of transactions of interest to the organization; 

d. Protects information obtained from intrusion-monitoring tools from unauthorized access, 

modification, and deletion; 

e. Heightens the level of information system monitoring activity whenever there is an indication 

of increased risk to organizational operations and assets, individuals, other organizations, or 

the Nation based on law enforcement information, intelligence information, or other credible 

sources of information; 

f. Obtains legal opinion with regard to information system monitoring activities in accordance 

with applicable federal laws, Executive Orders, directives, policies, or regulations; and 

g. Provides [Assignment: organization-defined information system monitoring information] to 

[Assignment: organization-defined personnel or roles] [Selection (one or more): as needed;

[Assignment: organization-defined frequency]]. 

Control Enhancements: 
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(2) INFORMATION SYSTEM MONITORING | AUTOMATED TOOLS FOR REAL-TIME ANALYSIS 

The organization employs automated tools to support near real-time analysis of events. 

(4) INFORMATION SYSTEM MONITORING | INBOUND AND OUTBOUND COMMUNICATIONS 

TRAFFIC 

The information system monitors inbound and outbound communications traffic [Assignment: 

organization-defined frequency] for unusual or unauthorized activities or conditions. 

(5) INFORMATION SYSTEM MONITORING | SYSTEM-GENERATED ALERTS 

The information system alerts [Assignment: organization-defined personnel or roles] when the following 

indications of compromise or potential compromise occur: [Assignment: organization-defined compromise 

indicators]. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-4] 

Implementation Statement: 

SI-4 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SI-4(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
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<Document Name> 

Version <X.X> 

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Control Enhancement SI-4(4) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SI-4(5) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.17.5 SI-5 Security Alerts, Advisories, and Directives 

The organization: 

a. Receives information system security alerts, advisories, and directives from [Assignment: 

organization-defined external organizations] on an ongoing basis; 

b. Generates internal security alerts, advisories, and directives as deemed necessary; 

c. Disseminates security alerts, advisories, and directives to: [Selection (one or more):

[Assignment: organization-defined personnel or roles]; [Assignment: organization-defined 

elements within the organization]; [Assignment: organization-defined external organizations]]; 

and 

d. Implements security directives in accordance with established time frames, or notifies the 

issuing organization of the degree of noncompliance. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-5] 
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Implementation Statement: 

SI-5 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.17.6 SI-7 Software, Firmware, and Information Integrity 

The organization employs integrity verification tools to detect unauthorized changes to [Assignment: 

organization-defined software, firmware, and information]. 

Control Enhancements: 

(1) SOFTWARE, FIRMWARE, AND INFORMATION INTEGRITY | INTEGRITY CHECKS 

The information system performs an integrity check of [Assignment: organization-defined software, 

firmware, and information] [Selection (one or more): at startup; at [Assignment: organization-defined 

transitional states or security-relevant events]; [Assignment: organization-defined frequency]]. 

(7) SOFTWARE, FIRMWARE, AND INFORMATION INTEGRITY | INTEGRATION OF DETECTION 

AND RESPONSE 

The organization incorporates the detection of unauthorized [Assignment: organization-defined securityrelevant changes to the information system] into the organizational incident response capability. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-7] 
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Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SI-7 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SI-7(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

Control Enhancement SI-7(7) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.17.7 SI-8 Spam Protection 

The organization: 
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a. Employs spam protection mechanisms at information system entry and exit points to detect 

and take action on unsolicited messages; and 

b. Updates spam protection mechanisms when new releases are available in accordance with 

organizational configuration management policy and procedures. 

Control Enhancements: 

(1) SPAM PROTECTION | CENTRAL MANAGEMENT 

The organization centrally manages spam protection mechanisms. 

(2) SPAM PROTECTION | AUTOMATIC UPDATES 

The information system automatically updates spam protection mechanisms. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-8] 

Implementation Statement: 

SI-8 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

Control Enhancement SI-8(1) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 
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<Document Name> 

Version <X.X> 

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Control Enhancement SI-8(2) 

Implementation Statement: 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments: 

2.1.17.8 SI-10 Information Input Validation 

The information system checks the validity of [Assignment: organization-defined information inputs]. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-10] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SI-10 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.17.9 SI-11 Error Handling 

The information system: 
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a. Generates error messages that provide information necessary for corrective actions without 

revealing information that could be exploited by adversaries; and 

b. Reveals error messages only to [Assignment: organization-defined personnel or roles]. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-11] 

Implementation Statement: 

SI-11 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:

2.1.17.10 SI-12 Information Handling and Retention 

The organization handles and retains information within the information system and information output 

from the system in accordance with applicable federal laws, Executive Orders, directives, policies, 

regulations, standards, and operational requirements. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-12] 

Implementation Statement: 

SI-12 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 
Social Security Administration 

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<Document Name> 

Version <X.X> 

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Scoped 

Comments:

2.1.17.11 SI-16 Memory Protection 

The information system implements [Assignment: organization-defined security safeguards] to protect its 

memory from unauthorized code execution. 

NIST SP 800-53 System and 

Information Integrity 

 Common (Fully Inherited Control) 

 Hybrid (Partially Inherited Control) 

 System Specific Control Revision 4 [SI-16] 

Implementation Statement: Does not apply to Low systems according to NIST SP 800-53 Rev 4. 

SI-16 

Implementation Status: Status (check all that apply): 

 Implemented (In Place) Planned (Not in Place) Compensated Not Applicable 

Scoped 

Comments:
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3 APPENDIX LISTING 

3.1 Required Appendices 

APPENDIX DESCRIPTION STATUS 

A Acronym List Refer to Appendix 3.2 below 

B Definitions Refer to Appendix 3.3 below 

C Applicable Laws and References Refer to Appendix 3.4 below 

D Agency IT Master Inventory System Security Plan Appendices.doc 

E Security Assessment Report Matrix SecurityAssessmentReport.pdf 

G System Documentation [ENTER NAME OF SSP]

H System Rules of Behavior System Security Plan Appendices.doc 

I Security Awareness and Training 

Plan 

System Security Plan Appendices.doc 

J Incident Response Plan System Security Plan Appendices.doc 

K Configuration Management Plan System Security Plan Appendices.doc 

3.2 System Specific Appendices 

APPENDIX DESCRIPTION STATUS 

E2 Prior Security Assessment Report 

Matrix 

[System Name] SAR Matrix.doc 
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3.3 Acronym List 

TERM DEFINITION 

AO Authorizing Official 

ASSERT Automated Security Self-Evaluation and Remediation Tracking 

ATO Authorization to Operate 

BSM Boundary Scope Memo 

CIO Chief Information Officer 

CISO Chief Information Security Officer 

CONOPS Concept of Operations 

COTS Commercial off the Shelf 

CSAM Cyber Security and Asset Management 

CSO Component Security Officer 

FICAM Federal Identity, Credential, and Access Management 

FIPS Federal Information Processing Standard(s) 

FISMA Federal Information Security Management Act 

GMT Greenwich Mean Time 

HW Hardware 

ISA Interconnection Security Agreement 

ISSH Information System Security Handbook 

IT Information Technology 

MD Maryland 

MOA Memorandum of Agreement 

MOU Memorandum of Understanding 

NCC National Coordinating Center for Communications 

NIST National Institute of Standards and Technology 

OIG Office of Inspector General 

OIS Office of Information Security 

OMB Office of Management and Budget 

OS Operating System 

PIV Personal Identity Verification 

POA&M Plan of Action and Milestones 

POC Point of Contact 
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TERM DEFINITION 

PRIDE Project Resource Guide 

PSC Program Support Center 

RBD Risk-Based Decision 

SAM Security Authorization Manager 

SAR Security Assessment Report 

SBU Sensitive But Unclassified 

SDLC Systems Development Life Cycle 

SDLCM Systems Development Life Cycle Methodology 

SME Subject Matter Expert 

SO System Owner 

SP Special Publication 

SPM System Project Manager 

SRA Security Risk Assessment 

SSA Social Security Administration 

SSC Secure Standards Council 

SSP System Security Plan 

SW Software 

TIC Trusted Internet Connection 

TSL Transport Layer Security 

U.S.C. United States Code 

UTC Coordinated Universal Time 

VoIP Voice Over Internet Protocol 

VPN Virtual Private Network 

WAN Wide Area Network 
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3.4 Definitions/Glossary 

Term Definition 

Accreditation The official management decision given by a senior agency official to 

authorize operation of an information system and to explicitly accept the risk 

to agency operations (including mission, functions, image, or reputation), 

agency assets, or individuals, based on the implementation of an agreedupon set of security controls. 

Accreditation 

Boundary 

All components of an information system to be accredited by an authorizing 

official and excludes separately accredited systems, to which the information 

system is connected. 

Accreditation Package The evidence provided to the authorizing official to be used in the security 

accreditation decision process. Evidence includes, but is not limited to: (i) the 

system security plan; (ii) the assessment results from the security 

certification; and (iii) the plan of action and milestones. 

Assessment 

Procedure 

A set of activities or actions employed by an assessor to determine the extent 

to which a security control is implemented correctly, operating as intended, 

and producing the desired outcome with respect to meeting the security 

requirements for the system. 

Automated Information 

System (AIS) 

An assembly of computer hardware, software and/or firmware configured to 

collect, create, communicate, compute, disseminate, process, store, and/or 

control data or information. 

Certification The comprehensive evaluation of the technical and non-technical security 

features of an AIS and other safeguards, made in support of the accreditation 

process that establishes the extent to which a particular design and 

implementation meet a specified set of security requirements. 

Common Security 

Control 

Security control that can be applied to one or more agency information 

systems and has the following properties: (i) the development, 

implementation, and assessment of the control can be assigned to a 

responsible official or organizational element (other than the information 

system owner); and (ii) the results from the assessment of the control can be 

used to support the C&A processes of an agency information system where 

that control has been applied. 

Confidentiality Preserving authorized restrictions on information access and disclosure, 

including means for protecting personal privacy and proprietary information. 

[44 U.S.C., Sec. 3542] 

Configuration Control Process for controlling modifications to hardware, firmware, software, and 

documentation to ensure the information system is protected against 

improper modifications prior to, during, and after system implementation. 

[CNSS Inst. 4009] 
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Term Definition 

General Support 

System 

An interconnected set of information resources under the same direct 

management control that shares common functionality. It normally includes 

hardware, software, information, data, applications, communications, and 

people. [OMB Circular A-130, Appendix III] 

Information Owner Official with statutory or operational authority for specified information and 

responsibility for establishing the controls for its generation, collection, 

processing, dissemination, and disposal. [CNSS Inst. 4009] 

Information Security The protection of information and information systems from unauthorized 

access, use, disclosure, disruption, modification, or destruction in order to 

provide confidentiality, integrity, and availability. [44 U.S.C., Sec. 3542] 

Information Security 

Policy 

Aggregate of directives, regulations, rules, and practices that prescribe how 

an organization manages, protects, and distributes information. [CNSS Inst. 

4009] 

Information System A discrete set of information resources organized for the collection, 

processing, maintenance, use, sharing, dissemination, or disposition of 

information. [44 U.S.C., Sec. 3502] [OMB Circular A-130, Appendix III] 

Information Type A specific category of information (e.g., privacy, medical, proprietary, 

financial, investigative, contractor sensitive, security management), defined 

by an organization or in some instances, by a specific law, Executive Order, 

directive, policy, or regulation. [FIPS 199] 

Integrity Guarding against improper information modification or destruction, and 

includes ensuring information non-repudiation and authenticity. [44 U.S.C., 

Sec. 3542] 

Major Application An application that requires special attention to security due to the risk and 

magnitude of harm resulting from the loss, misuse, or unauthorized access to 

or modification of the information in the application. [OMB Circular A-130, 

Appendix III] 

Management Controls The security controls (i.e., safeguards or countermeasures) for an information 

system that focus on the management of risk and the management of 

information system security. [NIST SP 800-18] 

Minor Application An application, other than a major application, that requires attention to 

security due to the risk and magnitude of harm resulting from the loss, 

misuse, or unauthorized access to or modification of the information in the 

application. Minor applications are typically included as part of a general 

support system. 

Operational Controls The security controls (i.e., safeguards or countermeasures) for an information 

system that primarily are implemented and executed by people (as opposed 

to systems). [NIST SP 800-18] 

Plan of Action and 

Milestones 

A document that identifies tasks needing to be accomplished. It details 

resources required to accomplish the elements of the plan, any milestones in 

meeting the tasks, and scheduled completion dates for the milestones. [OMB 

Memorandum M-02-09] 
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Term Definition 

Risk The level of impact on agency operations, (including mission, functions, 

image, or reputation), agency assets, or individuals, resulting from the 

operation of an information system given the potential impact of a threat and 

the likelihood of that threat occurring. [NIST SP 800-30] 

Risk Assessment The process of identifying risks to agency operations (including mission, 

functions, image, or reputation), agency assets, or individuals by determining 

the probability of occurrence, the resulting impact, and additional security 

controls that would mitigate this impact. Part of risk management, 

synonymous with risk analysis, and incorporates threat and vulnerability 

analyses. [NIST SP 800-30] 

Risk Management The process of managing risks to agency operations (including mission, 

functions, image, or reputation), agency assets, or individuals resulting from 

the operation of an information system. It includes risk assessment; costbenefit analysis; the selection, implementation, and assessment of security 

controls; and the formal authorization to operate the system. The process 

considers effectiveness, efficiency, and constraints due to laws, directives, 

policies, or regulations. [NIST SP 800-30] 

Security Category The characterization of information or an information system based on an 

assessment of the potential impact that a loss of confidentiality, integrity, or 

availability of such information or information system would have on 

organizational operations, organizational assets, or individuals. [FIPS 199] 

Security Controls The management, operational, and technical controls (i.e., safeguards or 

countermeasures) prescribed for an information system to protect the 

confidentiality, integrity, and availability of the system and its information. 

[FIPS 199] 

Subsystem A major subdivision or component of an information system consisting of 

information, information technology, and personnel that performs one or more 

specific functions. 

System Security Plan Formal document that provides an overview of the security requirements for 

the information system and describes the security controls in place or planned 

for meeting those requirements. [NIST SP 800-18] 

System-specific 

Security Control 

A security control for an information system that has not been designated as 

a common security control. 

Technical Controls The security controls (i.e., safeguards or countermeasures) for an information 

system that are primarily implemented and executed by the information 

system through mechanisms contained in the hardware, software, or firmware 

components of the system. [NIST SP 800-18] 

Threat Any circumstance or event with the potential to adversely impact agency 

operations (including mission, functions, image, or reputation), agency assets, 

or individuals through an information system via unauthorized access, 

destruction, disclosure, modification of information, and/or denial of service. 

[CNSS Inst. 4009, Adapted] 
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Term Definition 

User Person or process accessing an AIS either by direct connections (e.g., via 

terminals), or indirect connections (e.g., prepare input data or receive output 

that is not reviewed for content or classification by a responsible individual). 

Vulnerability Weakness in an information system, system security procedures, internal 

controls, or implementation that could be exploited or triggered by a threat 

source. [CNSS Inst. 4009, Adapted] 

Vulnerability 

Assessment 

Formal description and evaluation of the vulnerabilities in an information 

system. [CNSS Inst. 4009] 
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3.5 Applicable Laws and References 

Applicable Laws or Regulations Affecting the System 

Federal Policies/Directives/Guidance 

Committee on National Security Systems (CNSS) Instruction 4009, National Information Assurance 

Glossary, June 2006 

Committee on National Security Systems (CNSS) Instruction 1253, Security Categorization and Control 

Selection for National Security Systems, October 2009 

Freedom of Information Act (FOIA) 

Federal Information Security Management Act (FISMA) of 2002 

Federal Information Security Modernization Act (FISMA) of 2014 

Federal Managers’ Financial Integrity Act (FMFIA) 

Federal Information Processing Standards (FIPS) 199, Standards for Security Categorization of 

Federal Information and Information Systems, February 2004 

FIPS 200, Minimum Security Requirements for Federal Information and Information Systems, March 

2006 

Homeland Security Presidential Directive (HSPD)-7, Critical Infrastructure Identification, Prioritization, 

and Protection 

Homeland Security Presidential Directive/HSPD-12, Policy for a Common Identification Standard for 

Federal Employees and Contractors 

Homeland Security Presidential Directive/HSPD-20, National Continuity Policy 

National Archives & Records Administration (NARA) 

National Institute of Standards and Technology (NIST) Special Publications (SP) 800-18, Revision 1, 

Guide for Developing Security Plans for Federal Information Systems, February 2006 

NIST SP 800-27, Revision A, Engineering Principles for Information Technology Security (A Baseline 

for Achieving Security), June 2004 

NIST SP 800-30, Revision 1, Guide for Conducting Risk Assessments, September 2012 

NIST SP 800-34, Revision 1, Contingency Planning Guide for Federal Information Systems, May 2010 

NIST SP 800-37, Revision 1, Guide for Applying the Risk Management Framework to Federal 

Information Systems: A Security Life Cycle Approach, February 2010 

NIST SP 800-39, Managing Information Security Risk: Organization, Mission, and Information System 

View, March 2011 

NIST SP 800-50, Building an Information Technology Security Awareness and Training Program, 

October 2003 

NIST SP 800-52, Guidelines for Selecting and Use of Transport Layer Security (TSL) Implementations, 

April 2014 

NIST SP 800-53, Revision 4, Security and Privacy Controls for Federal Information Systems and 

Organizations, April 2013 

NIST SP 800-53A, Revision 4, Assessing Security and Privacy Controls in Federal Information 
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Applicable Laws or Regulations Affecting the System 

Systems and Organizations: Building Effective Assessment Plans, December 2014 

NIST SP 800-59, Guideline for Identifying an Information System as a National Security System, 

August 2003. 

NIST SP 800-60, Revision 1, Guide for Mapping Types of Information and Information Systems to 

Security Categories, August 2008. 

NIST SP 800-64, Rev 2, Security Consideration in the Information System Development Life Cycle, 

October 2008 

NIST SP 800-70, Revision 3, National Checklist Program for IT Products: Guidelines for Checklist 

Users and Developers, March 2015 

NIST SP 800-122, Guide to Protecting the Confidentiality of Personally Identifiable Information (PII), 

April 2010 

NIST SP 800-126, Revision 1, The Technical Specification for the Security Content Automation 

Protocol (SCAP): SCAP Version 1.2, February 2011. 

Office of Management and Budget (OMB) Circular A-123 Management Accountability and Control, 

1995 

OMB Circular A-127 Financial Management Systems, 1993 

OMB Circular A-130 Management of Federal Information Resources, 2000 

NIST SP 800-144, Guidelines on Security and Privacy in Public Cloud Computing, December 2011 

NIST SP 800-145, The NIST Definition of Cloud Computing, September 2011 

NIST SP 800-146, Cloud Computing Synopsis and Recommendations, May 2012 

OMB Circular M-02-01, Guidance for Preparing and Submitting Security Plans of Action and 

Milestones, October 2001. 

Paperwork Reduction Act, May 1995 

Privacy Act of 1974, as amended 

Social Security Act of 2013 

SSA Departmental Guidance 

ISSH, Information System Security Handbook - http://eis.ba.ssa.gov/ssasso/issh/tableofcontents.htm

OIS Guidance, http://ois.ssahost.ba.ssa.gov/dspp/fisma/security_assessment_authorization.htm 

PRIDE, http://pride.ssahost.ba.ssa.gov/ 

CSAM, https://csamssa.justapps.doj.gov/CSAM/login.aspx?ReturnUrl=%2fCSAM%2fDefault.aspx 

ISAHB, Information Security Authorization Handbook (dated June 2014) 
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Appendix A. <Appendix Name>Appendix body 

 NOTE: Automatic section numbering (Heading 1, Heading 2, etc.) should not be 

applied to the appendix body. The numbering will be a continuation of the numbering 

from the body of the document, and will not accurately reflect the appendix location. 

 
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Appendix B. Acronym List 

 Make sure all acronyms within this document are included in the acronym list. Delete 

any that are not used. 

Acronym Definition 

AO Authorizing Official 

APM Application Portfolio Management 

APP Application 

BRM Business Reference Model 

BSM Boundary Scope Memorandum 

CSAM Cybersecurity Assessment and Management 

CSO Component Security Officer 

DB Database 

DBMS Database Management System 

DCS Deputy Commissioner for Systems 

FIPS Federal Information Processing Standard 

FISMA Federal Information Security Modernization Act 

FOUO For Official Use Only 

FTP File Transfer Protocol 

HW Hardware 

ID Identification 

IPSEC Internet Protocol Security 

ISA Interconnection Security Agreement 

IT Information Technology 

IV&V Independent Verification and Validation 

L2TP Layer 2 Tunneling Protocol 

MA Major Application 

MOA Memorandum of Agreement 

MOU Memorandum of Understanding 

NCC National Computer Center 

NIST National Institute of Standards and Technology 

NMS Network Management System 

OIS Office of Information Security 

OS Operating System 

PDA Personal Digital Assistant 
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Acronym Definition 

SAM Security Authorization Manager 

SBU Sensitive But Unclassified 

SCQ Significant Change Questionnaire 

SO System Owner 

SP Special Publication 

SSA Social Security Administration 

SSC Secondary Support Center 

SSP System Security Plan 

V-HW Virtual Hardware 

VPN Virtual Private Network 
EXHIBIT F



EXHIBIT G











EXHIBIT H
FD-258 (Rev. 5-15-17) 1110-0046

LEAVE BLANK

APPLICANT

TYPE OR PRINT ALL INFORMATION IN BLACK FBI LEAVE BLANK

LAST NAME FIRST NAME MIDDLE NAME NAM

ALIASES AKA

DATE OF BIRTH DOB

Month Day Year

SEX RACE HGT. WGT. EYES HAIR PLACE OF BIRTH POB

LEAVE BLANK

CITIZENSHIP CTZ

YOUR NO. OCA

O

R

I

CLASS

REF.

UNIVERSAL CONTROL NO. UCN

ARMED FORCES NO. MNU

SOCIAL SECURITY NO. SOC

MISCELLANEOUS NO. MNU

SIGNATURE OF PERSON FINGERPRINTED

RESIDENCE OF PERSON FINGERPRINTED

DATE

EMPLOYER AND ADDRESS

REASON FINGERPRINTED

SIGNATURE OF OFFICIAL TAKING FINGERPRINTS

 1. R. THUMB 2. R. INDEX 3. R. MIDDLE 4. R. RING 5. R. LITTLE

6. L. THUMB 7. L. INDEX 8. L. MIDDLE 9. L. RING 10. L. LITTLE

LEFT FOUR FINGERS TAKEN SIMULTANEOUSLY L. THUMB R. THUMB RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY

* See Privacy Act Notice on Back
FEDERAL BUREAU OF INVESTIGATION

UNITED STATES DEPARTMENT OF JUSTICE

CJIS DIVISION/CLARKSBURG, WV 26306

APPLICANT

THIS CARD FOR USE BY:

1. LAW ENFORCEMENT AGENCIES IN FINGERPRINTING APPLICANTS FOR LAW ENFORCEMENT POSITIONS.*

2. OFFICIALS OF STATE AND LOCAL GOVERNMENTS FOR PURPOSES OF EMPLOYMENT, LICENSING, AND

PERMITS, AS AUTHORIZED BY STATE STATUTES AND APPROVED BY THE ATTORNEY GENERAL OF THE

UNITED STATES. LOCAL AND COUNTY ORDINANCES, UNLESS SPECIFICALLY BASED ON APPLICABLE 

STATE STATUTES DO NOT SATISFY THIS REQUIREMENT.*

3. U.S. GOVERNMENT AGENCIES AND OTHER ENTITIES REQUIRED BY FEDERAL LAW.**

4. OFFICIALS OF FEDERALLY CHARTERED OR INSURED BANKING INSTITUTIONS TO PROMOTE OR MAINTAIN

THE SECURITY OF THOSE INSTITUTIONS.

1. PRINTS MUST GENERALLY BE CHECKED THROUGH THE APPROPRIATE STATE IDENTIFICATION BUREAU, AND ONLY THOSE

FINGERPRINTS FOR WHICH NO DISQUALIFYING RECORD HAS BEEN FOUND LOCALLY SHOULD BE SUBMITTED FOR FBI SEARCH.

2. IDENTITY OF PRIVATE CONTRACTORS SHOULD BE SHOWN IN SPACE “EMPLOYER AND ADDRESS”. THE

CONTRIBUTOR IS THE NAME OF THE AGENCY SUBMITTING THE FINGERPRINT CARD TO THE FBI.

UNIVERSAL CONTROL NUMBER, IF KNOWN, SHOULD ALWAYS BE FURNISHED IN THE APPROPRIATE SPACE.

3. MISCELLANEOUS NO. - RECORD: OTHER ARMED FORCES NO. PASSPORT NO. [FP], ALIEN REGISTRATION NO.

(AR), PORT SECURITY CARD NO. (PS), SELECTIVE SERVICE NO. (SS) VETERANS’ ADMINISTRATION CLAIM NO. (VA).

**

*

INSTRUCTIONS:

ARCHES HAVE NO DELTAS

FD-258 (REV. 5-15-17)

3. ARCH

THESE LINES RUNNING BETWEEN

DELTAS MUST BE CLEAR

CENTER

OF LOOP

2. WHORL

DELTAS

THE LINES BETWEEN CENTER OF

LOOP AND DELTA MUST SHOW

DELTA

1. LOOP

Please review this helpful information to aid in the successful processing of hard copy civil fingerprint submissions in order to prevent delays or 

rejections. Hard copy fingerprint submissions must meet specific criteria for processing by the Federal Bureau of Investigation.

Ensure all information is typed or legibly printed using blue or black ink.

Enter data within the boundaries of the designated field or block.

Complete all required fields. (If a required field is left blank, the fingerprint card may be immediately rejected without further processing.)

• The required fields for hard copy civil fingerprint cards are: ORI, Date of Birth, Place of Birth, NAM, Sex, Date 

fingerprinted, Reason Fingerprinted, and proper completion of fingerprint impression boxes.

Do not use highlighters on fingerprint cards. 

Do not enter data or labels within ‘Leave Blank’ areas.

Ensure fingerprint impressions are rolled completely from nail to nail.

Ensure fingerprint impressions are in the correct sequence.

Ensure notations are made for any missing fingerprint impression (i.e. amputation).

Do not use more than two retabs per fingerprint impression block.

Ensure no stray marks are within the fingerprint impression blocks.

Training aids can be ordered online via the Internet by accessing the FBI’s website at: fbi.gov, click on ‘Fingerprints’, then click on 

‘Ordering Fingerprint Cards & Training Aids’. Direct questions to the Biometric Services Section’s Customer Service Group at (304) 625-5590 or by email at <identity@fbi.gov>.

PRIVACY ACT STATEMENT

Authority: The FBI's acquisition, preservation, and exchange of fingerprints and associated information is generally authorized under 

28 U.S.C. 534. Depending on the nature of your application, supplemental authorities include Federal statutes, State statutes pursuant to

Pub.L. 92-544, Presidential Executive Orders, and federal regulations. Providing your fingerprints and associated information is voluntary; 

however, failure to do so may affect completion or approval of your application.

Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be predicated on fingerprintbased background checks. Your fingerprints and associated information/biometrics may be provided to the employing, investigating, or

otherwise responsible agency, and/or the FBI for the purpose of comparing your fingerprints to other fingerprints in the FBI's Next Generation 

Identification (NGI) system or its successor systems (including civil, criminal, and latent fingerprints repositories) or other available records of 

the employing, investigating, or otherwise responsible agency. The FBI may retain your fingerprints and associated information/biometrics in 

NGI after the completion of this application and, while retained, your fingerprints may continue to be compared against other fingerprints 

submitted to or retained by NGI.

Routine Uses:

 

During the processing of this application and for as long thereafter as your fingerprints and associated information/

biometrics are retained in NGI, your information may be disclosed pursuant to your consent, and may be disclosed without your consent as

permitted by the Privacy Act of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register, including the 

Routine Uses for the NGI system and the FBI's Blanket Routine Uses. Routine uses include, but are not limited to, disclosures to:

employing, governmental or authorized non-governmental agencies responsible for employment, contracting, licensing, security clearances, 

and other suitability determinations; local, state, tribal, or federal law enforcement agencies; criminal justice agencies; and agencies

responsible for national security or public safety.

1110-0046

Social Security Account Number (SSAN): Pursuant to the Privacy Act of 1974, any Federal, state, or local government agency that 

requests an individual to disclose his or her SSAN, is responsible for informing the person whether disclosure is mandatory or voluntary, by 

what statutory or other authority the SSAN is solicited, and what uses will be made of it. In this instance, the SSAN is solicited pursuant to 

28 U.S.C 534 and will be used as a unique identifier to confirm your identity because many people have the same name and date of birth. 

Disclosure of your SSAN is voluntary; however, failure to disclose your SSAN may affect completion or approval of your application.

PAPERWORK REDUCTION ACT NOTICE

According to the Paperwork Reduction Act of 1995, no persons are required to provide the information requested unless a valid OMB 

control number is displayed. The valid OMB control number for this information collected is 1110-0046. The time required to complete this 

information collected is estimated to be 10 minutes, including time reviewing instructions, gathering, completing, reviewing and submitting 

the information collection. If you have any comments concerning the accuracy of this time estimate or suggestions for reducing this 

burden, please send to: Department Clearance Officer, United States Department of Justice, Justice Management Division, Policy and 

Planning Staff, Washington, DC 20530.
EXHIBIT I
CONTRACTOR PERSONNEL ROLLOVER REQUEST FORM

Social Security Administration (SSA)      Center for Suitability and Personnel Security (CSPS)

March 2018

Submit this document to your designated contracting officer’s representative‐contracting officer’s technical

representative (COR‐COTR) via secure email.  The COR‐COTR must ensure the information is complete and

accurate (all fields are required) and then submit to ^DCHR OPE Suitability.   

Only use this form when contractor personnel already working on an SSA contract need to move to another SSA

contract.  The information on this form must be typed, complete, and accurate.  Failure to do so may result in a

delay in receiving a suitability letter.  The company point of contact (CPOC) and COR‐COTR will receive suitability

letters from the Center for Suitability and Personnel Security (CSPS) once the rollover is complete.

FULL NAME

SOCIAL

SECURITY

NUMBER

DATE OF BIRTH FROM TO ACTIVE ON BOTH  

CONTRACTS?

  LAST      FIRST    MIDDLE    000‐00‐0000    MM/DD/YYYY   CONTRACT NUMBER   CONTRACT NUMBER    YES   NO

CPOC INFORMATION:

NAME: ______________________________________      EMAIL ADDRESS: _________________________________

PHONE: _____________________________________      DATE OF SUBMISSION:_____________________________

COR‐COTR INFORMATION:

NAME: ______________________________________      EMAIL ADDRESS: _________________________________

PHONE: _____________________________________
EXHIBIT J
SYSTEM PLAN 

TYPE OF PROPOSED MAINFRAME PLATFORM_____________________________ 

TYPE OF PERSONAL COMPUTER_________________________________________ 

MEDIA TO BE USED FOR RECEIPT OF FILE TRANSMISSION_________________ 

FILE STORAGE MEDIUM_________________________________________________ 

MANAGED FILE TRANSFER PLATFORM SERVER INSTALLED?______________ 

AMOUNT OF AVAILABLE FILE STORAGE SPACE___________________________ 

TYPE OF PRINT STREAM MAIL RUN CONTROL SYSTEM____________________ 

TYPE OF NETWORK PLATFORM (i.e., NOVELL/NT/UNIX)____________________ 
EXHIBIT K
Exhibit K 

CONTACT INFORMATION

Print Management Branch 

Lead: 

Social Security Administration 

Cheryl Tarver, 

Room 3-B-9-D Annex Building, 

6401 Security Boulevard, Baltimore, MD 21235-6401 

Phone-(410)965-7253 Fax-(410)965-6400 

Cheryl.tarver@ssa.gov

Technical Advisor: 

Social Security Administration 

Ken Wetzelberger 

Room 3-B-9-G Annex Building, 

6401 Security Boulevard, Baltimore, MD 21235-6401 

Phone-(410)966-7109 Fax-(410)965-6400 

Kenneth.wetzelberger@ssa.gov 

Mail and Postage Policy Team 

Social Security Administration 

Attn: Renee Randall 

3-E-9-H Annex Bldg.,

6401 Security Boulevard, Baltimore, MD 21235-6401

Phone-(410)965-1391 Fax-(410)965-6400

Renee.Randaall@ssa.gov

Social Security Administration 

Attn: Tim Gimbel (Back-up) 

6401 Security Boulevard, Baltimore, MD 21235-6401 

Phone-(410)966-1738 Fax-(410)965-6400 

Tim.Gimbel@ssa.gov 

Help Desk 

1-877-697-4978 or 1-877-697-4889

GPO 

David Love 

202-512-0307

dlove@gpo.gov
EXHIBIT L
Exhibit L 

100% Accountability and Summary Reports 

Full Audit report must include the following information (reprints must have the same information): 

1. Program Number/Job Name/Print Order/File Date

2. PC#/Sequence numbers/Total Volume

3. Inserter ID and Operator

4. Date of insertion

5. Start and End time

6. Start and End Range (sequence numbers)

7. Total for each Start and End Range

8. Event (i.e. Processed, Spoiled, Diverted and reason: Missing Piece, Unverified, Misread etc.)

9. Status (i.e. Inserted, Routed to Reprint Area, etc.)

10. Totals

a. Machine inserted

b. Sent to Reprint

c. Reprints Recovered

d. Records Accounted For

e. Duplicates

f. Duplicated Verified

g. Records less duplicates

h. Reported Output

i. Variances
Example: 

Inserter ID Date Start Time End Time Start Range End Range Total EVENT STATUS

Inserter 1 05/10/12 10:31:04 AM 11:12:45 AM 19386 21567 2182 Standard Processing Inserted

Operator Joe 05/10/12 11:12:50 AM 11:12:50 AM 21568 1 Diverted Routed to Reprint

05/10/12 11:13:10 AM 11:28:06 AM 21569 22516 948 Standard Processing Inserted

05/10/12 11:28:07 AM 11:28:10 AM 22517 22518 2 Diverted/ leave count unverified Routed to Reprint

05/10/12 11:29:30 AM 11:29:35 AM 22519 22521 3 Diverted/missing piece Routed to Reprint

05/10/12 11:29:45 AM 11:30:15 AM 22522 1 Diverted/manual insertion of pub Manual Scan

05/10/12 11:30:34 AM 11:40:35 AM 22523 1 Diverted/misread Manual Scan

Inserter 2 05/11/12 8:12:50 AM 8:12:50 AM 21568 1 Standard Processing Inserted

(REPRINTS) 05/11/12 8:28:07 AM 8:28:10 AM 22517 22518 2 Standard Processing Inserted

Operator Sue 05/11/12 8:29:30 AM 8:29:35 AM 22519 22521 3 Standard Processing Inserted

26604

582

Reprints Recovered: 582

27186

16

16

27170

27170

0

TOTALS

Records Accounted for:

Duplicates:

Duplicates Verified:

Records Less Duplicates:

Reported Output:

Variance:

Audit Report

Program 123-S/SSA Notices Name/PO#54001/File Date

PC # and Sequence Numbers and Volume

Machine Inserted:

Sent to Reprints:
Exhibit L (cont’d) 

The Summary Report must include the following; Reprints must also have all of the same information: 

1. Job Name/Print Order

2. Piece Quantity

3. Sequence number range (Start and End Range)

4. Start date and time

5. End date and time

6. Total Processed Pieces

7. Total Reprints

8. Total Pieces Inserted

9. Total Variances

10. Job Complete or Incomplete

Summary Report 

Job Information Operation Information 

Job Name: XYZ Notice 

PO # 54001 Start Range: 1 

Piece Quantity: 35862 End Range 35862 

Job Status: Completed 

Start Date &Time: 05/10/12 10:29:54 

End Date & Time: 05/11/12 14:22:34 

Statistical Summary 

35537 Processed Pieces - Completed 05/10/12

10:29:54

325 Processed Reprints - Completed 05/11/12

14:22:34

35862 Total Pieces Inserted - 

0 Variances - 

Completed 05/11/12 

14:22:34 

Job Complete 
EXHIBIT M
Medicare Acknowledgement, Subsidy Determination, and IRMAA Non-BRI Notices Page 91 of 98 

584-S (09/18) EXHIBIT M Page 1 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0 
Medicare Acknowledgement, Subsidy Determination, and IRMAA Non-BRI Notices Page 92 of 98 

584-S (09/18) EXHIBIT M Page 2 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0
EXHIBIT M Page 93 of 98

Page 3 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0 
EXHIBIT M Page 94 of 98

Page 4 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0 
Page 95 of 98 EXHIBIT M

Page 5 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0 
EXHIBIT M Page 96 of 98

Page 6 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0 
EXHIBIT M Page 97 of 98

Page 7 of 7 

3PAO-Obligatinos-and-Performance-Guide v1.0 
EXHIBIT N

PERFORATED PAYMENT STUB TO BE SUPPLIED AT POSTAWARD
EXHIBIT O
EXHIBIT O

Mail Run Data File (MRDF)

Or Item Level Accountability File

Record Descriptions Position Length

Job ID 1 – 5 5 

Piece ID 6 – 11 6 

Total Pages 12 – 13 2 

Select Feeder 2 (0 = No Feed, 1 = Feed) 14 1 

Select Feeder 3 15 1 

Select Feeder 4 16 1 

Select Feeder 5 17 1 

Select Feeder 6 18 1 

Select Feeder 7 19 1 

Select Feeder 8 20 1 

Select Feeder 9 21 1 

Select Feeder 10 22 1 

Vertical Stacker 1 (Seal envelope, do not meter) 23 1 

Vertical Stacker 2 (Do not seal envelope, do not meter) 24 1 

Vertical Stacker 3 (Overweight) 25 1 

Vertical Stacker 4 (Trash) 26 1 

Sealer (0 = No Outsort, 1 = Outsort) 27 1 

Meter 1 (0 = Print, 1 = No Print) 28 1 

Meter 2 29 1 

Customer Name 30 40

 Address Line 1 70 40

 Address Line 2 110 40

 Address Line 3 150 40 

 Address Line 4 190 40

 Address Line 5 230 40

 Address Line 6 270 40

Zip Code 310 5 

+4 315 4 

+2 319 2 

Return Name 321 40

 Address Line 1 361 40

 Address Line 2 401 40

 Address Line 3 441 40

 Address Line 4 481 40

Account ID 521 16

Input File Name 537 44

IMBC Codes 581 65

Service Type 646 3 

IMBC SerialID 649 9 

Filler 658 3 

User Defined 661 29

 Vendor ID 690 4 

 Code Name 694 5 

 Total Documents 699 2 

End 701 1 

NOTE: There is one record for each mail packet.
EXHIBIT P
TODAY'S

DATE

METER

DATE

WORKLOAD MAILER

NUMBER / NAME

SSA PRINT ORDER # /

CONTRACTOR ORDER # FILE DATE

BEGINNING METER

BALANCE AMOUNT

METER REPLENISH‐

MENT AMOUNT (if

applicable) METER RATE

CERT. BULK

MAILING CHARGES

(if applicable)

TOTAL NUMBER

OF PIECES

METERED

SPOILED

POSTAGE /

POSTAGE

ERRORS

(actual cost)

TOTAL METER

POSTAGE USED

ENDING METER

BALANCE

AMOUNT

SSA POSTAGE METER ACTIVITY LOG

METER MANUFACTURER:METER SERIAL NUMBER:CONTRACT NUMBER:

NOTES