Certificate for NAO 216-100


This is to certify that:

1. As a (temporary) (full-time) (contractual) employee of the ______________________________________, I have need for access to and for usage of certain written records, data files, and data banks pertaining to fisheries matters; and that:

2. I am fully aware of the civil and criminal penalties prescribed by law for Federal employees who would misuse or otherwise violate the confidentiality of such data; and that

3. To gain the necessary access and usage, I request that I be considered as a Federal employee, for the sole purpose of the laws regarding confidentiality of data, but that no remuneration or other benefit shall accrue as a result.



Signature of Employees


Signature of Witness

Approved until otherwise notified; as per conditions of the Agreement of Access dated ________________________, of which this certificate is made a part.


Signature of Contractor's Representative


Printed Name and Title of Contractor's Representative