6209.13,27.1,Ex.01-05 Page 1 of 6 FSH 6209.13 - FREEDOM OF INFORMATION ACT/PRIVACY ACT HANDBOOK WO AMENDMENT 6209.13-94-1 EFFECTIVE 12/8/94 27.1 - Exhibit 01 United States Forest R-3 Department of Service Agriculture Reply to: 6270-2 Date: October 1, 1993 Subject: Request for Amendment of Records To: Joan Doe Timber Management Staff We have considered the information in our record system you cited for amendment, as well as the additional information you submitted. We have found insufficient justification to amend your records. (Cite the reason for the refusal to amend.) The Privacy Act of 1974 (Public Law 93-579) accords you the right to request a review of this refusal to amend. If you desire to request this review, please follow these steps: 1. Request a review by writing to the Chief, USDA, Forest Service, P.O. Box 96090, Washington, DC 20090-6090. 2. Ensure the accuracy of the information you wish substituted in your record. Please attach any additional information that would help us in reviewing the accuracy of the record. You will receive notification of our receipt of your request for review within 10 working days after its arrival at the above address. The reviewing official will conduct an independent review and respond to your request within 20 working days. /s/ Dale J. Fabian DALE J. FABIAN Director, Procurement & Property Enclosure 27.1 - Exhibit 02 United States Forest R-3 Department of Service Agriculture Reply to: 6270-2 Date: October 1, 1993 Subject: Request of Samuel Shovel To: John Jones Engineering Staff The above-named requester has asked that we disclose to him information in records we hold concerning you. The attached copy of the Privacy Act Information Request Form provides more details about the request. The Privacy Act of 1974 (5 U.S.C. 552a) requires that we obtain your written consent prior to disclosing the requested records. Please indicate below if you consent to the requested disclosure, sign and date one copy of this letter, and return it to us. /s/Dale J. Fabian DALE J. FABIAN Director, Procurement & Property Enclosure (X) I consent to the requested disclosure. ( ) I do not consent to the requested disclosure. /s/John Jones October 1, 1992 (Signature) (Date) 27.1 - Exhibit 03 United States Forest Cibola Department of Service National Forest Agriculture Reply to: 6270-2-2 Date: October 1, 1993 Subject: Amendment of Record To: Regional Forester, R-3 Our records indicate that the record pertaining to James Williams entitled, "Employee Performance Appraisal," was disclosed to you on September 18, 1992. This letter notifies you of a correction of that record. The record has been changed as follows: A corrected copy of the second is attached. Obliterate or destroy the incorrect information contained in the record we previously furnished to you. Maintain and use the record only in its corrected form. /s/Chester P. Smith CHESTER P. SMITH Forest Supervisor Enclosure 27.1 - Exhibit 04 United States Forest R-3 Department of Service Agriculture Reply to: 6270-2-2 Date: October 1, 1993 Subject: Amendment of Employee Performance Appraisal To: Joan Doe Timber Management Staff We have verified the information submitted by you and have incorporated it into the record system named above--amending the incomplete or inaccurate information previously in the system. The record now includes the information listed on the lower part of this letter. Thank you for aiding us in maintaining a complete and accurate record of your transactions with us. We assure you that all reasonable efforts will be made to keep the record accurate and to forestall any further need on your part to amend this record. /s/Dale J. Fabian DALE J. FABIAN Director, Administrative Services (Amended Information) 27.1 - Exhibit 05 United States Forest R-3 Department of Service Agriculture Reply to: 6270-2-2 Date: October 1, 1993 Subject: Statement of Disagreement To: Samuel Shovel Information Systems Staff We have received your Statement of Disagreement relating to our record entitled, "Physical capacity and career desires of the employee." The part of the record with which you have disagreed with has been clearly noted. We will require that disclosure of the disputed record to users be accompanied by a copy of your Statement of Disagreement. You also have the right, under section 3(g) of the Privacy Act of 1974 (Public Law 93-579), to bring a civil action against this agency to require amendment of the record. The United States district court has jurisdiction over these suits. Thank you for your interest in maintaining accurate information in our records. I regret we could not reach an agreement on the content of information in the record. /s/Dale J. Fabian DALE J. FABIAN Director, Administrative Services