[Privacy Act Issuances (2003)]
[From the U.S. Government Publishing Office, www.gpo.gov]
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION
TABLE OF CONTENTS
Payroll records--FMSHRC-1
General finance and accounting records--FMSHRC-2
General information personnel files--FMSHRC-3
Property management system--FMSHRC-4
Administrative law judge caseload report--FMSHRC--5
FMSHRC-01
System name: Payroll records--Federal Mine Safety and Health
Review Commission.
System location:
United States Department of Agriculture, National Finance Center,
copies held by FMSHRC. USDA holds records for the Commission under
interagency agreement.
Categories of individuals covered by the system:
Employees and members of the Commission.
Categories of records in the system:
Varied payroll records, including, among other documents, time
and attendance cards; payment vouchers; comprehensive listing of
employees; health benefits records; requests for deductions; tax
forms and W-2 forms; overtime requests; leave data; retirement
records. Records are used by the Commission and GSA employees to
maintain adequate payroll information for the Commission employees,
and otherwise by the Commission and GSA employees who have a need for
the record in the performance of their duties.
Authority for maintenance of the system:
31 U.S.C. ``Money and Finance'', generally.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses:
See Appendix A.
Records also are disclosed to GAO for audits; to the Internal
Revenue Service for investigation; and to private attorneys, pursuant
to a power of attorney.
A copy of an employee's Department of the Treasury Form W-2, Wage
and Tax Statement, also is disclosed to the State, city, or other
local jurisdiction which is authorized to tax the employee's
compensation. The record will be provided in accordance with a
withholding agreement between the State, city, or other local
jurisdiction and the Department of the Treasury pursuant to 5 U.S.C.
5516, 5517, or 5520, or, in the absence thereof, in response to a
written request from an appropriate official of the taxing
jurisdiction to the Executive Director, Federal Mine Safety and
Health Review Commission, Room 612, 1730 K Street NW, Washington, DC
20006. The request must include a copy of the applicable statute or
ordinance authorizing the taxation of compensation and should
indicate whether the authority of the jurisdiction to tax the
employee is based on place of residence, place of employment, or
both. Pursuant to a withholding agreement between the city and the
Department of the Treasury (5 U.S.C. 5520), copies of executed city
tax withholding certificates shall be furnished the city in response
to written request from an appropriate city official to the Executive
Director.
(1). To the Office of Child Support Enforcement, Administration
for Children and Families, Department of Health and Human Services
Federal Parent Locator System (FPLS) and Federal Tax Offset System
for use in locating individuals and identifying their income sources
to establish paternity, establish and modify orders of support and
for enforcement action;
(2). To the Office of Child Support Enforcement for release to
the Social Security Administration for verifying social security
numbers in connection with the operation of the FPLS by the Office of
Child Support Enforcement;
(3). To Office of Child Support Enforcement for release to the
Department of dTreasury for purposes of administering the Earned
Income Tax Credit Program (Section 32, Internal Revenue Code of 1986)
and verifying a claim with respect to employment in a tax return.
Disclosures to consumer reporting agencies:
Disclosures may be made from this system to ``consumer reporting
agencies`` as defined in the Fair Credit Reporting Act (15 U.S.C.
1681a(f) or the Federal Claims Collection Act of 1966 (31 U.S.C.
3701(a)(3)).
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Paper and microfilm.
Retrievability:
Social Security number, name, block number, symbol number.
Safeguards:
Stored in guarded building; released only to authorized
personnel, including among others, GSA liaison staff and finance
personnel; and the Commission administrative staff.
Retention and disposal:
Disposition of records shall be in accordance with the HB GSA
Record Maintenance and Disposition System (OAD P 1820.2).
System manager(s) and address:
Administrative Officer, Federal Mine Safety and Health Review
Commission, Room 640, 1730 K Street, NW, Washington, DC 20006.
Notification procedure:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record access procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Contesting record procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record source categories:
The subject individual; the Commission.
FMSHRC-02
System name: General Finance and Accounting Records--Federal
Mine Safety and Health Review Commission.
System location:
The Commission.
Categories of individuals covered by the system:
Employees and members of the Commission.
Categories of records in the system:
SF-1038, Application and account for advance of funds; vendor
register and vendor payment. Information is used by accounting
technicians to maintain adequate financial information and by other
officers of the Commission who have a need for the records.
Authority for maintenance of the system:
31 U.S.C. ``Money and Finance'', generally.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses:
See Appendix. Records also are released to GAO for audits; to the
IRS for investigation; and to private attorneys, pursuant to power of
attorney.
Disclosures to consumer reporting agencies:
Disclosures may be made from this system to ``consumer reporting
agencies'' as defined in the Fair Credit Reporting Act (15 U.S.C.
1681a(f) or the Federal Claims Collection Act of 1966 (31 U.S.C.
3701(a)(3).
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Paper and tape.
Retrievability:
Manual and automated by name.
Safeguards:
Stored in guarded building; released only to authorized
personnel.
Retention and disposal:
Disposition of records shall be in accordance with the HB GSA
Records Maintenance and Disposition System (OAD P 1820.2).
System manager(s) and address:
Administrative Officer, Federal Mine Safety and Health Review
Commission, Room 640, 1730 K Street, NW, Washington, DC 20006.
Notification procedure:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record access procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Contesting record procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record source categories:
The subject individual; the Commission.
FMSHRC-03
System name: General Informal Personnel Files--Federal Mine
Safety and Health Review Commission.
System location:
The Commission.
Categories of individuals covered by the system:
The Commission members, staff and consultants, past and present.
Categories of records in the system:
Biographic information, correspondence with members of the
Commission.
Authority for maintenance of the system:
Title 5, U.S.C. ``Government Organization and Employees'',
generally.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses:
Disclosures to consumer reporting agencies:
Disclosures may be made from this system to ``consumer reporting
agencies'' as defined in the Fair Credit Reporting Act (15 U.S.C.
1681a(f) or the Federal Claims Collection Act of 1966 (31 U.S.C.
3701(a)(3). Also, see Appendix.
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Paper.
Retrievability:
Manual by name.
Safeguards:
Stored in lockable file cabinets, released only to authorized
personnel, including among others, GSA liaison staff and the
Commission administrative staff.
Retention and disposal:
Retained until no longer needed, then discarded.
System manager(s) and address:
Administrative Officer, Federal Mine Safety and Health Review
Commission, Room 640, 1739 K Street, NW, Washington, DC 20006.
Notification procedure:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 485.
Record access procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Contesting record procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record source categories:
The subject individual; the Commission.
FMSHRC-04
System name: Property Management System--Federal Mine Safety and
Health Review Commission.
System location:
The Commission.
Categories of individuals covered by the system:
The Commission members and staff.
Categories of records in the system:
Description, value and location of furnishings and equipment.
Authority for maintenance of the system:
Title 40 U.S. C. 483 ``Property Utilization'' and 31 U.S.C.
``Money and Finance'', generally.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses:
See Appendix. Records are also released to GAO for audits.
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Paper and tape.
Retrievability:
Manual and automated by name.
Safeguards:
Stored in guarded building; released only to authorized personel.
Retention and disposal:
Disposition of records shall be in accordance with the HB GSA
Records Maintenance and Disposition System (OAD P 1820.2).
System manager(s) and address:
Administrative Officer, Federal Mine Safety and Health Review
Commission, Room 640, 1730 K Street NW, Washington, DC 20006.
Notification procedure:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record access procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Contesting record procedures:
Contact Executive Direcor or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record source categories:
The subject individual; the Administrative Office of the
Commission.
FMSHRC-05
System name: Administrative Law Judge Caseload Report, Federal
Mine Safety and Health Review Commission.
System location:
The Commission.
Categories of individuals covered by the system:
Administrative Law Judge of the Commission.
Categories of records in the system:
Caseload assignments.
Authority for maintenance of the system:
Title 30 USC 823(d)(1) ``Proceedings; rules of procedure; review;
record'' and Title 5 U.S.C. 3105 ``Appointment of administrative law
judges''.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses:
Chief Administrative Law Judge and Commission for case
assignment; also, see Appendix.
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Paper.
Retrievability:
Manual by month, year and name.
Safeguards:
Stored in guarded building; released only to authorized
personnel.
Retention and disposal:
Indefinite.
System manager(s) and address:
Chief Administrative Law Judge, Federal Mine Safety and Health
Review Commission, Room 642, 1730 K Street, NW, Washington, DC 20006.
Notification procedure:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record access procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Contesting record procedures:
Contact Executive Director or refer to the Commission access
regulations contained in 29 CFR part 2705.
Record source categories:
The subject individual; the Commission.
Appendix--Federal Mine Safety and Health Review Commission
(``Agency'')
In the event that a system of records maintained by this Agency
to carry out it functions indicates a violation or potential
violation of law, whether civil, criminal or regulatory in nature,
and whether arising by general statue or particular program statute,
or by regulation, rule or order issued pursuant thereto, the relevant
records in the system of records may be referred, as a routine use,
to the appropriate agency, whether federal, state, local or foreign,
charged with the responsibility of investigating or prosecuting such
violation or charged with enforcing or implementing the statute or
rule, regulation or order issued pursuant thereto.
A record from this system or records may be disclosed as a
``routine use'' to a federal, state or local agency maintaining
civil, criminal or other relevant enforcement information or other
pertinent information, such as current licenses, if necessary to
obtain information relevant to an Agency decision concerning the
hiring or retention of an employee, the issuance of a security
clearance, the letting of a contract or the issuance of a license,
grant or other benefit.
A record from this system of records may be disclosed to a
federal agency, in response to its request, in connection with the
hiring or retention of an employee, the issuance of a security
clearance, the reporting of an investigation of an employee, the
letting of a contract, or the issuance of a license, grant or other
benefit by the requesting agency, to the extent that the information
is relevant and necessary to the requesting agency's decision in the
matter.
A record from this system of records may be disclosed to the duly
authorized official engaged in investigation or settlement of a
grievance, complaint, or appeal filed by an employee. A record from
this system of records may be disclosed to the United States Office
of Personnel Management in accordance with that agency's
responsibility for evaluation and oversight of federal personnel
management.
A record from this system of records may be disclosed to officers
and employees of a federal agency for purposes of audit.
The information contained in this system of records will be
disclosed to the Office of Management and Budget in connection with
the review of private relief legislation as set forth in OBM Circular
No. A-19 at any stage of the legislative coordination and clearance
process as set forth in that Circular.
A record from this system of records may be disclosed as a
routine use to a Member of Congress or to a Congressional staff
member in response to an inquiry of the Congressional office made at
the request of the individual about whom the record is maintained.
A record from this system of records may be disclosed to officers
and employees of the General Service Administration in connection
with administrative services provided to this Agency under agreement
with GSA.
FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION
Title 29--Labor
CHAPTER XXVII--FEDERAL MINE SAFETY AND HEALTH REVIEW COMMISSION
PART 2705--PRIVACY ACT IMPLEMENTATION
Sec.
2705.1 Purpose and scope.
2705.2 Definitions.
2705.3 Procedures for requests pertaining to individuals' records in a
records system.
2705.4 Times, places, and requirements for the identification of the
individual making a request.
2705.5 Access of requested information to the individual.
2705.6 Request for correction or amendment to the record.
2705.7 Agency review of request for correction or amendment of the
record.
2705.8 Appeal of an initial adverse agency determination on correction
or amendment of the record.
2705.9 Disclosure of record to a person other than the individual to
whom the record pertains.
2705.10 Fees.
Authority: 5 U.S.C. 552a: Pub. L. 93-579.
Source: 49 FR 38542, Oct. 1, 1984.
Sec. 2705.1 Purposes and scope.
The purposes of these regulations are to:
(a) Establish a procedure by which an individual can determine if the
Federal Mine Safety and Health Review Commission, hereafter the
``Commission'', maintains a system of records which includes a record
pertaining to the individual; and
(b) Establish a procedure by which an individual can gain access to a
record pertaining to him or her for the purpose of review, amendment
and/or correction.
Sec. 2705.2 Definitions.
For the purpose of these regulations--
(a) The term ``individual'' means a citizen of the United States or an
alien lawfully admitted for permanent residence;
(b) The term ``maintain'' includes maintain, collect, use of
disseminate;
(c) The term ``record'' means any item, collection or grouping of
information about an individual that is maintained by the Commission,
including, but not limited to, his or her employment history, payroll
information, and financial transactions and that contains his or her
name, or the identifying number, symbol, or other identifying particular
assigned to the individual, such as social security number.
(d) The term ``system or records'' means a group of any records under
control of the Commission 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; and
(e) The term ``routine use'' means, with respect to the disclosure of
a record, the use of such record for a purpose which is compatible with
the purpose for which it was collected.
Sec. 2705.3 Procedure for requests pertaining to individuals'
records in a records system.
An individual shall submit a request to the Executive Director to
determine if a system of records named by the individual contains a
record pertaining to the individual. If a record pertaining to the
individual does exist in the specified system of records and the
individual wishes to review that record he or she shall submit a request
to the Executive Director of the Commission which states the
individual's desire to review his or her record.
Sec. 2705.4 Times, places, and requirements for the indentification
of the individual making a request.
An individual making a request to the Executive Director of the
Commission pursuant to Sec. 2705.3 shall present a written request at
the Commission Office, 1730 K Street NW, Room 612, Washington, DC 20006,
on any business day between the hour of 8:30 a.m. and 5 p.m. The
individual submitting the request should present himself or herself at
the Commission's offices with a form of identification which will permit
the Commission to verify that the individual is the same individual as
contained in the record requested.
Sec. 2705.5 Access to requested information to the individual.
As soon as practicable after verification of identity the Commission
shall disclose to the individual the information contained in the record
which pertains to that individual.
Sec. 2705.6 Request for correction or amendment to the record.
The individual shall submit a written request to the Executive
Director which states the individual's desire to correct or to amend his
or her record and details the specific corrections or amendments sought.
This request is to be made in accord with provisions of Sec. 2705.4.
Sec. 2705.7 Agency review of request for correction or amendment of
the record.
Within ten working days of the receipt of the request to correct or to
amend the record, the Executive Director will acknowledge in writing
such receipt and promptly either--
(a) Make any correction or amendment to that portion of the record
which the individual believes is not accurate, relevant, timely, or
complete; or
(b) Inform the individual of the Executive Director's refusal to
correct or to amend the record in accordance with the request, and the
procedures established by the Commission for the individual to request a
review of that refusal.
Sec. 2705.8 Appeal of an initial adverse Commission determination on
correction or amendment of the record.
An individual who disagrees with the refusal of the Executive Director
to correct or to amend his or her record may submit a request for a
review of such refusal to the Chairman, Federal Mine Safety and Health
Review Commission, 1730 K Street NW, Room 610, Washington, DC 20006. The
Chairman will, not later than thirty working days from the date on which
the individual requests such review, complete such review and make final
determination unless, for good cause shown, the Chairman extends such
thirty-day period. If, after his or her review, the Chairman also
refuses to correct or to amend the record in accordance with the
request, the individual may file with the Commission a concise statement
setting forth the reasons for his or her disagreement with the refusal
of the Commission and may seek judicial review of the Chairman's
determination under 5 U.S.C. 552a(g)(1)(A).
Sec. 2705.9 Disclosure of record to a person other than the
individual to whom the record pertains.
The Commission will not disclose a record to any individual other than
the individual to whom the record pertains without receiving the prior
written consent of the individual to whom the record pertains, unless
the disclosure has been listed as a ``routine use'' in the Commission's
notices of its system of records, or falls within one of the special
disclosure situations listed in the Privacy Act of 1974 (5 U.S.C.
552a(b)).
Sec. 2705.10 Fees.
If an individual requests copies of his or her record, he or she will
be charged a reasonable fee, excluding the cost of any search for review
of the record, in advance of receipt of the pages.