HomeMy WebLinkAboutContract 46645 CITY SECRETAW
Memorandum of UnderstandiniommCT N0. -
CONFIDENTIAL AGREEMENT
I. PARTIES
This Memorandum of Understanding (MOU) is made and entered into this ISVday of
Gl , 2015, by and between the Texas Department of Public Safety ("DPS")
and the QJE of Fort Worth acting by and through its duly authorized Assistant Ci
Manager (hereinafter "Requesting Agency")
II. INTRODUCTION
DPS serves as the point of contact ("POC") with the Social Security Administration
("SSA") for all local law enforcement agencies regarding the provision of alias Social
Security Numbers ("SSNs") in Texas. As the POC, DPS is responsible for the evaluation,
submission, coordination and management of all requests made by any local law
enforcement agencies for alias SSNs.
III. PURPOSE
The purpose of this MOU is to establish an agreement between the Requesting Agency and
the DPS regarding alias SSNs to enable Requesting Agency to use alias SSNs for law
enforcement purposes.
IV. RESPONSIBILITIES OF THE PARTIES
4.0 Requesting Agency shall:
4.01 Designate a POC to facilitate, coordinate and manage all alias SSNs associated with
its personnel.
4.02 Provide the POC contact information to DPS and notify DPS if the designated POC
changes.
4.03 Submit the following information:
4.03.1 External Agency Information Form;
4.03.2 Social Security Administration Form SS-5;
4.03.3 Appropriate Individual Alias SSN Application;
4.03.4 Proof of Citizenship (Birth certificate or U.S. Passport);
4.03.5 Proof of Identity(Driver's License or U.S. Passport);
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
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Memorandum of Understanding
CONFIDENTIAL AGREEMENT
4.03.6 Proof of Employment(Law Enforcement Identification);
4.03.7 Any required payment in the amount designated in the application packet; and
4.03.8 Correspondence on Requesting Agency letterhead signed by the agency head or
designee containing the following:
4.03.8.1 Statement that the request for an alias SSN has been approved and is for a
lawful purpose in furtherance of authorized law enforcement investigations;
4.03.8.2 Disclosure of the true identity associated with the alias SSN; and
4.03.8.3 A copy of the legal authority/authorities which empowers the agency to conduct
the type of law enforcement investigations for which the alias SSN is being
requested.
4.0 Immediately notify DPS POC of any activity that could affect the provision of
alias SSNs to Requesting Agency personnel under the terms of this MOU such
as suspension, termination, retirement or reassignment.
4.05 Maintain files related to the use of the assigned alias SSNs by Requesting
Agency personnel.
4.06 Immediately provide the institution's name and account number associated with
any alias SSN that is issued to Receiving Agency if used to open bank accounts,
credit cards or any other similar financial matters.
4.07 Immediately notify DPS POC of any earnings of which Receiving Agency
becomes aware, that are posted to an alias SSN that is issued to Receiving
Agency, and of any benefits of which Receiving Agency becomes aware that are
being claimed on an alias SSN that is issued to Receiving Agency.
4.08 Comply with any SSA requests to reconcile earnings on alias SSNs issued to
Receiving Agency with the Internal Revenue Service.
4.09 Limit the number of active alias SSNs assigned to each true identity to the
minimum required for operational needs.
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Memorandum of Understanding
CONFIDENTIAL AGREEMENT
4.010 Immediately notify DPS POC if, after receipt of an alias SSN, Receiving Agency
determines that the alias SSN will never be used, that the SSN will no longer
be used, or that the SSN has been misused.
4.011 Prohibit the use of alias SSNs by contractors or informants.
4.012 Respond to any requests for information regarding the issuance of alias SSNs
within 30 calendar days of the date of the request.
4.1 DPS shall:
4.10 Review requests for alias SSNs for completeness and to ensure that they
comply with SSA requirements.
4.11 Provide reasons for SSA's approval or disapproval of requests for alias
SSNs to Requesting Agency.
4.12 Maintain secure files related to the use of SSNs by Requesting Agency.
4.13 Assist SSA with information requests related to alias SSNs assigned to
Requesting Agency.
4.14 Ensure appropriate use of alias SSNs through oversight, training, periodic
inspection and monitoring of the use of, and any activities associated with alias
SSNs to minimize the risk of fraud and other inappropriate uses.
4.15 Maintain alias SSNs and any associated cards in a secure location until they
are no longer required.
V. FEES
5.0 DPS will pass all costs and fees assessed by SSA to process the issuance of alias
SSNs to Requesting Agency.
5.1 DPS will state in the application packet that is forwarded to Requesting Agency
the amount of such costs and fees.
5.2 Requesting Agency agrees to submit a voucher made payable to DPS or SSA as
applicable for the amount of costs and fees as provided by the terms stated in the
application.
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CONFIDENTIAL AGREEMENT
VI. REVOCATION
6.0 DPS reserves the right to revoke the use of an alias SSN, if, in its sole discretion,
DPS determines that the alias SSN is being used inappropriately, if a Receiving
Agency personnel, who is using the alias SSN, has his/her privileges revoked by
Receiving Agency or if Receiving Agency fails to comply with DPS requests for
information within 30 calendar days of the date of request.
6.1 DPS will provide written notice to Receiving Agency of the revocation and
Receiving Agency will immediately cease use of the alias SSN.
6.2 DPS will return the affected alias SSN to SSA with a request that the SSN be de-
activated.
6.3 If applicable, DPS will notify any other state entities that the SSN is no longer
active.
VII. RIGHT TO INSPECT
7.0 At any time, DPS shall have the right to inspect, examine and to make copies of all
files and related records (in whatever form they may be kept, whether written,
electronic or other)pertaining to alias SSNs issued to Receiving Agency.
7.1 Requesting Agency agrees to establish and maintain a file system that readily
identifies all uses of the alias SSN and the true identity associated with a particular
alias SSN and includes a photocopy of the alias SSN card, the SS-5 form, the
Individual Alias SSN Application, proof of citizenship, proof of identity, proof of
employment, letter requesting the issuance of the alias SSN and a copy of the
payment check.
7.2 Requesting Agency agrees to maintain such records, together with any supporting
or underlying documents and materials for a period of five (5) years after an alias
SSN has been deactivated.
7.3 On no less than an annual basis, DPS will contact Requesting Agency to determine
whether any issued alias SSNs must be de-activated. If it is determined that an alias
SSN must be de-activated, DPS will take the steps necessary to de-activate the SSN.
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CONFIDENTIAL AGREEMENT
VIII. CONFIDENTIALITY
8.0 Requesting Agency will cause any personnel of Requesting Agency to keep, at
all times, SSA's provision of alias SSNs, the use of alias SSNs by any other
state and local law enforcement agencies and the existence of this MOU,
confidential to the maximum extent allowable by law.
8.1 Neither Requesting Agency nor any of its personnel will, without the prior written
approval of an appropriate officer of DPS or as required by law: (i) release any
information about SSA's provision of alias SSNs, the use of alias SSNs by any
other state and local law enforcement agencies and the existence of this MOU to
any person or entity other than to Requesting Agency personnel known to need
access to such matters in order to perform their duties.
8.2 Upon termination of this MOU, Requesting Agency will return all records and
copies of any information related to SSA's provision of alias SSNs, the use of
alias SSNs by DPS and other state and local law enforcement agencies and the
existence of this MOU, in whatever form then existing, to an appropriate officer
of DPS. Such termination, even if occasioned by wrongful action by DPS, will not
affect Requesting Agency's or their personnel's continuing obligations to
maintain confidentiality.
8.3 Requesting Agency agrees to immediately report to DPS any unauthorized
disclosure or release of such information of which Requesting Agency becomes
aware when such disclosure or release is in violation of the terms of this Paragraph
8.
IX. RELEASE OF INFORMATION
9.0 Requesting Agency agrees to immediately notify DPS of any and all requests for
information that are received by Requesting Agency related to the SSA's
provision of alias SSNs, the use of alias SSNs by any other state and local law
enforcement agencies and the existence of this MOU. Such requests for
information include, but are not limited to, requests under the Texas Public
Information Act.
9.1 Requesting Agency agrees to comply with the confidentiality provisions of this
MOU by timely submitting requests it receives to the Texas Attorney General in
compliance with law so as to protect confidential information.
9.2 Requesting Agency will not make any disclosures or statements to the public or
third party entities regarding the SSA's provision of alias SSNs, the use of alias
SSNs by DPS any other state and local law enforcement agencies and the
existence of this MOU without prior, written approval from DPS.
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Memorandum of Understanding
CONFIDENTIAL AGREEMENT
X. MISCELLANEOUS
10.0 This memorandum is not intended to and does not create any contractual rights or
obligations with respect to the signatory agencies or any other person.
10.1 Any dispute arising hereunder will be submitted in writing to the DPS POC for
final resolution.
10.2 This memorandum may be executed in counterparts.
10.3 This MOU is in effect upon the last signature and will remain in effect subject to
annual review unless terminated by either party after such party provides 90 days
advance, written notice to the other party.
IN WITNESS WHEREOF, the undersigned parties hereby acknowledge the foregoing
as the terms and conditions of their understanding.
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Memorandum of Understanding
CONFIDENTIAL AGREEMENT
APPROVED AS TO FORM AND LEGALITY
CITY OF FORT WORTH:
By:
Rudolph Ja n
Interim Assistant City Manager
Date: 5 --'Y - /j
APPROVAL RECOMMENDED:
By:(J4�v tjf/l_t
Rhonda K. Robertson
Chief of Police
Date: 04'-5:)- `0
0 G
ATTEST: _!iO
o —!
By: ` ' Z
Mary J. We �,o �C
City Secretary
APPROVED AS TO FORM AND LEGALITY:
By: �I Ui1U6z--L
Victoria D. Honey
Assistant City Attorney
ENO M&C �,1rIQUIRED
7OFFIC71AL RECORD
RETARYPage 7 of 7 RTH,TX