1. USER: ____________________________ (organization/person who will use or have access to data)
Responsible Official: _______________________ Telephone: _________________________________
E-mail: ___________________________________ FAX: ____________________________________
Company Name: ____________________________________________________________________
2. Access is requested and protection is certified for the following restricted-release data:
_____ International Passenger Origin-Destination Survey.
3. Access is presumed via the DOT-OST-R-BTS Product Distribution Center in Washington, D.C. If not, provide in an accompanying letter the name of each INTERMEDIARY you selected to access the DOT data. The accompanying letter should also describe the intended use of the data and indicate an understanding of and agreement to abide by the restrictions placed on the use of the data.
4. I certify that the individual and/or the organization granted data access will protect the restricted data from unauthorized use or disclosure. Data will not be released unless approved in advance in writing by the Assistant Director for Airline Information, BTS. The signatory certifies to abide by the rules and guidelines governing protection and use of the data that are stated or referenced herein. I understand that failure to protect these data from unauthorized use or disclosure could result in the loss of rights and privileges to access any restricted-release data, and may subject me and/or my organization to civil and/or criminal penalties provided by Federal law.
SIGNED ________________________________ DATE ___________________________________
5. Mail form to: William Chadwick, Director, Office of Airline Information, Bureau of Transportation Statistics, RTS-42, Research and Innovative Technology Administration, E34, U.S. Department of Transportation, 1200 New Jersey Avenue, SE, Washington, D.C. 20590-0001
THE SIGNATORY OF THIS CERTIFICATION
1. Citizenship: Agrees as user of international data, to meet the U.S. Citizenship definition in 14 CFR 204.2(c): “Citizen of the United States means (1) an individual who is a citizen of the United States or one of its possessions, or (2) a partnership of which each member is such an individual, or (3) a corporation or association created or organized under the laws of the United States or of any State, Territory, or possession of the U.S., of which the president and two-thirds or more of the board of directors and other managing officers are such individuals and in which at least 75 percent of the voting interest is owned or controlled by persons who are citizens of the U.S. or one of its possessions.”
2. Protection: Agrees to be responsible for safe, secure storage and disposal of restricted-release data in a manner that will safeguard against unauthorized access, use or disclosure. The means I/we will use to secure these data have been briefly explained in our letter requesting access.
3. Disclosure: Agrees not to disclose the restricted data in any level of detail, from basic to summary, to any person or party not covered by this agreement. Any proposed deviation from this restriction, at any level of detail, must be approved in advance in writing by the Assistant Director for Airline Information, BTS.
4. Penalties: Agrees not to violate these restrictions subject to the following penalties:
a. Loss of rights and privileges to access any restricted-release data.
b. Civil penalties and/or Criminal penalties as provided by Federal law.
5. Intermediary(ies): Agrees, to protect, use, and disclose data in compliance with these guidelines and limitations. Intermediaries are persons or organizations who have been specifically asked by users, and individually approved by OAI, to serve as an agent for the purpose of acquisition of restricted-release data or performing special data-related services. Intermediaries will be notified by OAI of the users they are authorized to service. Intermediaries desiring themselves to use restricted-release data must obtain their own user approval from the Assistant Director for Airline Information, BTS.
6. DOT Regulations: Agrees to abide by all of the requirements stated in this certification as well as those in the following applicable DOT regulations:
a. 14 CFR 241.19-7(d) -- Passenger origin-destination survey.
Also, users and intermediaries will be subject to any other terms or conditions specifically stated or referred to in an access approval letter.
7. Questions or Information on Additional Certifications: Call (202) 366-5235.