HRO 29 (11/25/2014)
INFORMATION SECURITY POLICY
ACKNOWLEDGEMENT
Purpose: Use this form to acknowledge receipt of and compliance with the Virginia DMV's Information Security
Policy.
Instructions: Give completed form to HR Consultant or HRO, Room 124.
EMPLOYEE INFORMATION
EMPLOYEE NAME EMPLOYEE DMV ID NUMBER
EMPLOYEE TITLE EMPLOYEE DEPARTMENT/LOCATION
SIGNATURE
DATE (mm/dd/yyyy)
EMPLOYEE CERTIFICATION
As an employee of the Department of Motor Vehicles (DMV), I certify that I have been informed of the Information
Security Policy and I agree to adhere to its provisions as related to my position which include, but may not be limited to
the following:
• I will not create, access, alter, delete, or release any DMV records except as necessary to perform assigned
duties.
• I will protect confidential and personal information, whether on paper, microfilm or computer files, by
following security procedures as established by my assigned work area.
• I will not disclose customer information except when specifically allowed by the Code of Virginia, the Fair
Credit Reporting Act, and DMV rules, regulations and operating procedures.
• I will follow all identification procedures and requirements before conducting transactions that alter an
individual's records or affect an individual's eligibility status for licensing or other DMV services.
• I will disclose confidential or personal information to another DMV employee only if that employee has an
official need to know in connection with his or her job duties.
• I will immediately report any knowledge of a violation of this policy to my immediate supervisor.
• I will safeguard information obtained through the National Criminal Information Network, the National Driver
Registry, CDLIS and any other sources from disclosure to unauthorized parties.
• I will complete an application and pay appropriate fees for personal transcripts or any other DMV services.
• I will complete the on-line Acceptable Use Policy - User Agreement Acknowledgment Training through the
DMV Knowledge Center within 5 days of employment.
• I will complete the on-line Information Security Awareness Training through the DMV Knowledge Center
within 30 days of employment.
I understand that my failure to comply with this policy may result in disciplinary action or termination. I also understand
that I may incur civil penalties and/or criminal prosecution as noted in the Virginia Computer Crimes Act of 1987 and
applicable state and federal laws.
