Additional Information
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PRIVACY ACT STATEMENT
The data collected on employment forms is maintained for “Statistical Use Only” and is protected in accordance with
the Privacy Act (93-579), OMB Circular A-108, and DoD Directive 5400.11. Unauthorized disclosure of this information
constitutes a violation of the Privacy Act and may result in a fine up to $5000. Race questions comply with OMB
Standards for Maintaining, Collecting and Presenting Data for Race and Ethnicity, dated 30 October 1997 (62 FR 58782-
58790).
PRIVACY ACT STATEMENT:
Authority to request the employment information is derived from 5 U.S.C. 301, 10 U.S.C. 5031, Executive Order 9397,
and DoD Instruction 1402.5. Implementing Public Law 101-647, Section 231, and Public Law 102-190, Section 1094.
PRINCIPAL PURPOSE:
Employment forms will be used by officials of the Department of the Navy to obtain background clearance information
regarding prospective child development employees/family child care providers/youth programs personnel for use in
the employment/certification process.
ROUTINE USES:
No information will be disclosed outside the Department of Defense.
DISCLOSURE:
Completion of Employment forms is voluntary, however, if the requested information is not provided, employment
and/or certification may be denied. Providing false information can result in adverse action up to and including
removal.
RIGHT TO CHALLENGE:
You have the right to challenge the accuracy of records under the provision of DoD Directive 5400.11.
PLEASE DO NOT EMAIL EMPLOYMENT FORMS, LIST OF REFERENCES AND/OR STATEMENT OF
ADMISSIONS. ALL DOCUMENTS MUST BE SUBMITTED IN PERSON TO THE OFFICE.
The Yokosuka Co-Op Preschool is located at Portable Building D/9000T
Office Hours are Monday through Friday from 0800-1330
Mailing Address: PSC 473 BOX 151 FPO AP 96349-00151
If you would like more information, please call:
INTL. TEL.: 011-81-468-16-4436 LOCAL TEL.:0468-16-4436 DSN TEL: 243-4436
INTL. FAX.:011-81-468-96-4436 LOCAL FAX:0468-96-4436 DSN FAX: 241-4436
The data collected on employment forms is maintained for “Statistical Use Only” and is protected in accordance with
the Privacy Act (93-579), OMB Circular A-108, and DoD Directive 5400.11. Unauthorized disclosure of this information
constitutes a violation of the Privacy Act and may result in a fine up to $5000. Race questions comply with OMB
Standards for Maintaining, Collecting and Presenting Data for Race and Ethnicity, dated 30 October 1997 (62 FR 58782-
58790).
PRIVACY ACT STATEMENT:
Authority to request the employment information is derived from 5 U.S.C. 301, 10 U.S.C. 5031, Executive Order 9397,
and DoD Instruction 1402.5. Implementing Public Law 101-647, Section 231, and Public Law 102-190, Section 1094.
PRINCIPAL PURPOSE:
Employment forms will be used by officials of the Department of the Navy to obtain background clearance information
regarding prospective child development employees/family child care providers/youth programs personnel for use in
the employment/certification process.
ROUTINE USES:
No information will be disclosed outside the Department of Defense.
DISCLOSURE:
Completion of Employment forms is voluntary, however, if the requested information is not provided, employment
and/or certification may be denied. Providing false information can result in adverse action up to and including
removal.
RIGHT TO CHALLENGE:
You have the right to challenge the accuracy of records under the provision of DoD Directive 5400.11.
PLEASE DO NOT EMAIL EMPLOYMENT FORMS, LIST OF REFERENCES AND/OR STATEMENT OF
ADMISSIONS. ALL DOCUMENTS MUST BE SUBMITTED IN PERSON TO THE OFFICE.
The Yokosuka Co-Op Preschool is located at Portable Building D/9000T
Office Hours are Monday through Friday from 0800-1330
Mailing Address: PSC 473 BOX 151 FPO AP 96349-00151
If you would like more information, please call:
INTL. TEL.: 011-81-468-16-4436 LOCAL TEL.:0468-16-4436 DSN TEL: 243-4436
INTL. FAX.:011-81-468-96-4436 LOCAL FAX:0468-96-4436 DSN FAX: 241-4436
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