Template Version Number: 01-2021
18
Points of Contact and Signatures
Na me: Donald Ulrich
Office: Off ice of the Chief Information Officer
(OCIO)
Phone: (571) 272-1093
Ema il: Donald.Ulrich@uspto.gov
I certify that this PIA is an accurate representation of the security
controls in place to protect PII/BII processed on this IT system.
Signa ture: __________________________________
Da te signed: ________________________________
Chief Information Security Officer
Na m e: Tim othy S. Goodwin
Office: Office of the Chief Information Officer (OCIO)
Phone: (571) 272-0653
Em a il: Timothy.Goodwin@uspto.gov
I certify that this PIA is an accurate representation of the security
controls in place to protect PII/BII processed on this IT system.
Signa ture: ___________________________________
Da te signed: _________________________________
Na m e: Heaton John
Office: Office of General La w (O/GL)
Phone: 703-756-1240
Ema il: Ricou.Heaton@uspto.gov
I certify that the appropriate authorities and SORNs (if applicable)
are cited in this PIA.
Signa ture: __________________________________
Date signed: ________________________________
Bureau Chief Privacy Officer and Co-
Authorizing Official
Na me: Henry J. Holcombe
Office: Office of the Chief Information Officer (OCIO)
Phone: (571) 272-9400
Ema il: Ja mie.Holcombe@uspto.gov
I certify that the PII/BII processed in this IT system is necessary, this
PIA ensures compliance with DOC policy to protect privacy, and the
Bureau/OU Privacy Act Officer concurs with the SORNs and
authorities cited.
Signa ture: __________________________________
Da te signed: ________________________________
Na me: David S. Gooder
Office: Office of The Commissioner for Tra demarks
(T/COM)
Phone: (571) 270-0980
Ema il: Da vid.Gooder@uspto.gov
I certify that this PIA accurately reflects the representations made
to me herein by the System Owner, the Chief Information Security
Officer, and the Chief Privacy Officer regarding security controls
in place to protect PII/BII in this PIA.
Signa ture: __________________________________
Da te signed: ________________________________
This page is for internal routing purposes and documentation of approvals. Upon final
approval, this page must be removed prior to publication of the PIA.
Digitally signed by Users, Ulrich,
Donald
Date: 2023.08.15 16:33:25 -04'00'
Digitally signed by Users,
Goodwin, Timothy
Date: 2023.08.17 15:50:46 -04'00'
Digitally signed by John Ricou
Heaton
Date: 2023.08.15 10:06:15 -04'00'
Digitally signed by Users,
Holcombe, Henry
Date: 2023.08.17 16:25:52 -04'00'
Digitally signed by Users, Gooder,
David S.
Date: 2023.08.29 12:39:12 -04'00'