Privacy Threshold Assessment (PTA) for changes or annual re-certification
Use this form to tell GSA’s Privacy Office about changes to an information technology (IT) system, application or project that collects, maintains or disseminates information or to re-certify it on an annual basis. The GSA Privacy Office will evaluate the proposed change or re-certification and contact you and other system representatives, as necessary. Contact
with any questions.
1. System or application name (ensure this matches records in GEAR:
) If the system or application name is changing, also notify the GEAR Maintenance team in OCISO.
2. Has the system or application undergone any significant privacy changes (for ex. changes in the number, type, or category of individuals about whom records are maintained or new uses of such information)?
Yes. Please describe the changes in detail below.
No, in accordance with GSA Policy (CIO P 1878.2A) I certify that the system or application has not undergone any significant privacy changes during the past year.
3. Describe any system or application changes in detail. If you have questions about whether particular changes are significant, contact
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