CJIS Security Addendum Acknowledgement Form
Complete this form to acknowledge your responsibilities and obligations under the CJIS Security Addendum. All fields are required.
Full Name
*
First Name
Last Name
Employer/Agency Name
*
Your Role/Title
*
Work Email Address
*
example@example.com
I attest that I have completed CJIS Security Awareness Training.
*
Yes
No
I acknowledge and agree to comply with all CJIS security responsibilities.
*
Yes
No
I understand and agree to maintain the confidentiality of CJIS-protected information.
*
Yes
No
I agree to comply with access control and incident-reporting requirements under the CJIS Security Policy.
*
Yes
No
I acknowledge my obligation to return or revoke access to CJIS information and systems as required.
*
Yes
No
Signature (Draw your signature below)
*
Submit Acknowledgement
Submit Acknowledgement
Should be Empty: