Dhs form 11000 6 2025

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The document is a Non-Disclosure Agreement (NDA) from the Department of Homeland Security, outlining the terms and conditions for individuals granted conditional access to sensitive information owned or produced by the U.S. Government. It details the responsibilities of the signatory regarding Protected Critical Infrastructure Information (PCII), Sensitive Security Information (SSI), and other Sensitive but Unclassified (SBU) information, emphasizing compliance with relevant laws and regulations, safeguarding protocols, and consequences for unauthorized disclosure.

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Send dhs form 11055 via email, link, or fax. You can also download it, export it or print it out.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field at the top of the form. This identifies you as the individual agreeing to the terms.
In the section for 'Authorized Entity', input the name of the organization you are associated with, ensuring accuracy for compliance.
Review each category of information listed (PCII, SSI, SBU) and place your initials next to those that apply to your access. This confirms your understanding and agreement.
Carefully read through the terms and conditions outlined in the agreement. Ensure you understand your responsibilities regarding information protection.
Complete the acknowledgment section by typing or printing your name, providing your address and telephone number, followed by your signature.
If applicable, have a witness complete their information and sign as well. This adds an extra layer of validation to your agreement.

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