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PRIVACY ACT STATEMENT

Authority:    The Federal Property and Administrative Services Act of 1949 (40 U.S.C 471 et seg.) and Federal property Regulations (41 C.F.R. 101-20.111 and 101-20.117).

Purpose:    The principal purpose of the Parking Permit Application is to allocate and to provide administrative controls over allocated parking permits in facilities under the jurisdiction of the Department of State.

Routine Uses:    In response to specific inquiries, names, zip codes, and work telephone numbers from vanpool/carpool parking permit applications may be disclosed for the purpose of making ridesharing arrangements. Information from vanpool/carpool parking permit applications may be disclosed to other federal agencies for the purpose of verifying vanpool/carpool eligibility for a parking permit and to the Department of Justice where there is reason to believe an individual has violated the law to enable prosecuting such violation. The submission of this application is required to park at the Shultz Center.

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WARNING:    Whoever, in any matter within the jurisdiction of any department or agency of the United States knowingly and willfully falsifies, conceals or covers up by any trick, scheme, or device a material fact, or makes any false, fictitious, or fraudulent statement of entry, shall be fined not more than $10,000 or imprisoned not more than five years or both (18 U.S.C 1001, dated June 25, 1948, c. 645, 62 Stat. 749).

TAX LIABILITY:    As part of the Energy Policy Act of 1992 (Public Law 102-486) employees who receive subsidized parking from their employers must pay income tax on the value above $230 a month, i.e., the excess value must be included in the employee's gross income. (FMP/F/DSP/OCP)

TRANSIT BENEFITS:    "Individuals applying for or receiving transit passes e.g., "METROCHEKs" under executive order 13150 are not eligible for parking under the Department of State parking program, unless they are passengers of a registered vanpool as defined in policy guidance dated August 2, 2000." Please contact HR/ER/EP for specific information regarding vanpools.

This issuance of a permit does NOT guarantee parking will be available.

I have read and understand the above warning and also understand that any misrepresentation made by me may be reported to Diplomatic Security Office of the Inspector General and/or Personnel for appropriate action. In addition, all parking privileges will be lost for 3 years.

DISCLAIMER FOR DAMAGE/LOSS/THEFT:    The Department of State is not responsible for the theft from, loss, or damage of vehicles parked in Department facilities and/or items left in vehicles. Employees park at their own risk.