326 Ind. Admin. Code 17.1-9-1
Authority: IC 13-14-8; IC 13-14-11-5; IC 13-19-3-1
Affected: IC 5-14-3-10; IC 13-14-11-5
Sec. 1.
CONFIDENTIALITY AGREEMENT
FOR STATE EMPLOYEES
I understand that I will have access to certain confidential information submitted to the Indiana Department of Environmental Management pursuant to state or federal statute or rule. This access has been granted in accordance with my official duties as an employee of the state of Indiana.
I understand that confidential information may not be disclosed except as authorized by rules of the board as contained in 326 IAC 17.1. My obligation not to disclose such confidential information includes disclosure to any other employee, officer, or authorized representative of the state or of the United States unless such employee, officer, or authorized representative is concerned with carrying out or implementing IC 13 or when the information is relevant in any proceeding related to enforcement.
I understand that, under Indiana statute IC 5-14-3-10, I am liable for a possible fine of up to five thousand dollars ($5,000) or imprisonment for up to one (1) year, or both, if I knowingly or intentionally disclose confidential information to any person not authorized to receive it.
I understand that I may be subject to disciplinary action for violation of this agreement with penalties up to and including dismissal.
I understand that this agreement is enforceable by the state of Indiana and by the person who submits confidential information.
I agree that I will treat any confidential information furnished to me as confidential as established by the department.
(Signature) __________________ _____________
Name (Typed) Date
CONFIDENTIALITY AGREEMENT
FOR CONTRACTED EMPLOYEE OR OFFICER
I understand that as an employee or officer of _________, a contractor performing work for the Indiana Department of Environmental Management, I will have access to certain confidential information. This access has been granted to me in order that I can perform my work under the contract.
I understand that such confidential information may not be disclosed by me except as authorized by a state or federal statute or rule. My obligation not to disclose such confidential information includes disclosure to any employee of the Indiana Department of Environmental Management, any employee or officer of any contractor, or any subcontractor unless such employee or officer has executed a confidentiality agreement.
I understand that, under Indiana statute IC 5-14-3-10, I am liable for a possible fine of up to five thousand dollars ($5,000) or imprisonment for up to one (1) year, or both, if I knowingly or intentionally disclose confidential information to any person not authorized to receive it. In addition, I understand that I may be subject to disciplinary action for violation of this agreement up to and including dismissal.
I understand that this agreement is enforceable by the state of Indiana and by the person who submits confidential information.
I agree that I will treat any confidential information furnished to me as confidential as established by the department.
(Signature) __________________ _____________
Name (Typed) Date
326 IAC 17.1-9-1