Enter the information below to certify you have destroyed all data received and any personally identifiable information connected with the Data Use Agreement (DUA) in accordance to the expired DUA or when the data is no longer needed for the purposes of the DUA, whichever comes first.
NOTE ! Do not submit any Sensitive Personally Identifiable Information (SPII) through this form. View a list of SPII examples.
List the reports, records and/or file names that will be destroyed and describe the details of the data destruction methods used. This includes data on electronic media and hard copy materials used (i.e. paper). Do not enter any Sensitive Personally Identifiable Information (SPII) in this section.