Denition
“Protected Personal Information” means collectively Personal Information and Identity Information, as
dened by RCWs 46.04.209, 19.255.005 and 42.56.590, authorized for disclosure by the federal Driver Privacy
Protection Act and state law.
“Subrecipient” means any entity outside your immediate organization that receives or has access to
protected personal information including, but not limited to subsidiaries, subcontractors, requesters or agents.
“Bona Fide Research Organization” means an entity, such as a university, that conducts non-commercial
research using established scientic methods. There must be an intention to publish the research ndings for
wider scientic and public benet, without restrictions or delay.
“Oshoring” means the electronic or hardcopy transmission, accessing, viewing, capturing images, storage or
processing of protected personal information outside the United States.
Answer the following
1. Are you requesting Protected Personal Information?................................... Yes No
2. Have you read the contract template? .............................................. Yes No
3. Will you redisclose or sell Protected Personal Information to any Subrecipients?............. Yes No
4. Are you a consumer reporting agency? ............................................ Yes No
3 –Driver data records
Data type
Abstract driver record (ADR) (select all that apply)
Employment Insurance Transit Volunteer organization Transportation network companies Monitoring
Governmental Other, list:
NOTE: If requesting ADRs, you must set up a banking account for automatic withdrawals.
Aggregate data – List data elds needed (i.e. name, address, height, weight, etc.)
Purpose for the data
Research Governmental Statistical reports Other
If requesting Protected Personal Information, what law allows DOL to share this information with you?
Explain, including citations to applicable law.
If “Research” was selected, answer the following:
1. What is the public benet?
2. Have you submitted your research to an Institutional Review Board? ..................... Yes No
If “Yes,” what is the status?
NOTE: You may be required to provide us a copy of the results when the research is completed.
3. Will you redisclose or publish the data, or contact individuals about the data? ............. Yes No
4. Are you a Bona Fide Research Organization? ....................................... Yes No
If “Statistical reports” was selected, answer the following:
1. Will you redisclose or publish the data, or contact individuals about the data? .............. Yes No
2. Who will you provide the reports to and for what purpose?
Detailed description of why you need the data and how you will use the data
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