i. INSTRUCTIONS
a) Provide all necessary information in this form. Indicate “NA” for the fields that are not applicable. Do not leave any
field blank.
i) Ensure to complete Section I: Program, Project, Process, Measure, System or Technology (PPPMST)
Summary and Section II: Threshold Analysis.
ii) If there is no personal data exposure based on your answers in Section II, no need to accomplish Sections III-
XI. Sign and submit this form (See item d below).
iii) If there is personal data exposure based on your answers in Section II, accomplish all succeeding Sections.
Sign and submit this form (See item d below).
b) Attach data flow diagram / data map to illustrate flow of personal data in the data processing operation covered
by this privacy impact assessment (PIA).
c) To facilitate the review of the PIA, attach or email all relevant documents such, but not limited to, the following:
• Project charter
• Draft contract
• Presentation materials about the PPPMST
• Data Subject – refers to an individual whose personal, sensitive personal, or privileged information is processed.
• De-identification of Personal Data – refers to the process of removing any personal information from a record or
data set, those information that identifies an individual, or for which there is a reasonable expectation that the
information could be used, either alone or with other information, to identify an individual
• External Party – refers to all individuals and organizations – including, but not limited to subsidiaries, affiliates,
contractors, suppliers, vendors and service providers, that are not within the Company.
• Internal Party – includes all individuals, business units or groups that are within the Company.
• Natural Individual – a person (in legal meaning, one who has his own legal personality) that is an individual human
being, as opposed to a legal person, which may be a private (i.e., business entity or non-governmental
organization) or public (i.e., government) organization.
• Personal Data – refers to all types of personal information.
• Personal Information – refers to any information, whether recorded in a material form or not, from which the identity
of an individual is apparent or can be reasonably and directly ascertained by the entity holding the information, or
when put together with other information would directly and certainly identify an individual.
• Personal Information Controller (PIC) – refers to a natural or juridical person, or any other body who controls the
processing of personal data, or instructs another to process personal data on its behalf. The terms excludes (i) a
natural or juridical person, or any other body, who performs such functions as instructed by another person or
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organization; or (ii) a natural person who processes personal data in connection with his personal, family, or
household affairs.
• Personal Information Processor (PIP) – refers to any natural or juridical person or any other body to whom a
personal information controller may outsource or instruct the processing of personal data pertaining to a data
subject.
• PPPMST - Program, Project, Process, Measure, System or Technology
• Privacy Impact Assessment - is a process undertaken and used to evaluate and manage impacts on privacy of a
particular program, project, process, measure, system or technology product of a PIC or PIP program, project,
process, measure, system or technology product of a PIC or PIP. It takes into account the nature of the personal
data to be protected, the personal data flow, the risks to privacy and security posed by the processing, current
data privacy best practices, the cost of security implementation, and, where applicable, the size of the
organization, its resources, and the complexity of its operations.
• Sensitive Personal Information – refers to personal information about an individual’s race, ethnic origin, marital
status, age, color, and religious, philosophical or political affiliations; about an individual’s health, education,
genetic or sexual life of a person, or to any proceeding for any offense committed or alleged to have been
committed by such individual, the disposal of such proceedings, or the sentence of any court in such proceedings;
issued by government agencies peculiar to an individual which includes, but is not limited to, social security
numbers, previous or current health records, licenses or its denials, suspension or revocation, and tax returns;
and specifically established by an executive order or an act of Congress to be kept classified.
• Unique Identifier – may refer to a numeric or alphanumeric string that provides the capability to uniquely identify
a wide variety of items. For example, an employee number matched with a corresponding unique employee is
considered as a unique identifier.
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I. PPPMST SUMMARY
If the following information is available in the project charter, draft contract, or other materials that you have submitted
together with the PIA Form, no need to fill up the table below. In each field, just indicate the reference document/s.
Date of PPPMST
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Mark “X” in the appropriate box. If you answer yes to any of the questions below, complete all succeeding Sections
of this form. If you answer No to all of the questions below, sign and submit this form.
Item
Question Yes No N/A Remarks
No.
1 Will the data processing operation involve the ☐ ☐ ☐
collection of personal data about natural individuals?
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Mark “X” in the appropriate box for the personal data that the PPPMST will collect, use, store, retain, disclose, and/or
dispose.
Item
Personal Data Yes No
No.
1 Name
2 Business Address
3 Home Address
4 Email Address – Business
5 Email Address – Personal
6 Telephone No. – Business
7 Telephone No. – Home
8 Age
9 Date of Birth
10 Marital Status
11 Color, Race, or Ethnic Origin
12 Religion
13 Education
14 Photo
15 Biometrics
16 Political Association
17 Philosophical Beliefs
18 Health Records (previous or current)
19 Sexual life / preference / practice
20 Offence committed or alleged to have been committed, the disposal of such
proceedings, or the sentence of any court in such proceedings
21 Document issued by government agencies peculiar to an individual:
• Unique identifiers (e.g. TIN, UMID ID number, driver's license number, passport
number, GSIS/SSS number, voter's registration number, etc.)
• Licenses or its denials, suspension, or revocation
• Tax returns
22 Document/Information specifically established by an executive order or an act of
Congress to be kept classified
23 Others ( indicate below as many as will be collected, used, stored, retained,
disclosed, and/or disposed):
• (Add as many as will be collected.)
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Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. Do not leave any item blank.
Item
Question Answer
No.
1 From whom will the personal information and/or
sensitive personal information be collected?
Specify.
Notes:
• Purpose must not be contrary to law, morals,
or public policy.
• The processing of personal data must be
authorized by a specific law or regulation.
Specify applicable law or regulation.
• The collection of personal data must be for a
declared, specified, and legitimate purpose.
• Processing of personal data should be
adequate, relevant, suitable, necessary, and
not excessive in relation to a declared and
specified purpose.
Note:
• There must be express consent from the
individual.
• Consent should be time-bound in relation to
the declared, specified, and legitimate
purpose.
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Item
Question Answer
No.
6 Are the data subjects aware of the nature,
purpose, and extent of the processing of his
personal data, including the risks and safeguards
involved in the processing of his personal data?
Describe briefly.
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Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. Do not leave any item blank.
Item
Question Answer
No.
1 Where is the personal data currently being
stored or where will it be stored?
Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. Do not leave any item blank.
Item
Question Answer
No.
1 How will the personal data be used and what is
the purpose of their processing?
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Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. do not leave any item blank.
Item
Question Answer
No.
1 How long are the personal data being retained?
Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. do not leave any item blank.
Item
Question Answer
No.
1 Will the personal data be disclosed / shared with
internal and/or external parties?
Specify.
Specify.
Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. do not leave any item blank.
Item
Question Answer
No.
1 How will the personal data be disposed?
Specify.
Describe briefly.
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X. DATA SECURITY
Provide your answers to all questions or indicate the reference document/s (Provide a copy of the reference
document/s). Indicate “NA” for the fields that are not applicable. do not leave any item blank.
Item
Question Answer
No.
1 Have you consulted IT / Information Security
(InfoSec) regarding the PPPMST?
Describe briefly.
Describe briefly.
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Describe briefly.
Describe briefly.
Specify where.
Describe briefly.
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A. Impact Criteria
Impact
Rating Types Description
A small minority of data subjects will be affected or may encounter a
1 Low
few inconvenience that is acceptable to the data subject
A subset of data subject will be affected or may encounter significant
2 Moderate
inconveniences.
Affects all or majority of data subjects will be affected or may
encounter that could result to discrimination, identity theft or fraud,
3 High
reputational damage public shaming, or any other significant
economic or social disadvantage
B. Likelihood Criteria
Likelihood
Rating Types Description
Not expected, but there is a slight possibility it may occur at some
1 Low
time but inaction will result to eventual data leakage.
Casual occurrence or it might happen at some time since the threat
2 Moderate
source is not significantly motivated
Frequent occurrence or there is a strong possibility that it might
3 High occur. High leakage potential or non-compliance with required
organization-wide controls.
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C. Risk Summary
Summarize your risk assessment in the table below using the Impact Criteria in Item XI-A and Likelihood Criteria in Item XI-B. To get the risk rating: Risk =
Impact x Likelihood. Add additional rows as necessary.
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The table below shall be accomplished by the DPO and/or COP, and/or relevant subject matter resources (SMRs).
Add additional rows as necessary.
Status
Target (Completed; Work
Ref# Recommended action item/s Responsible
Completion in Progress; Not
yet Started)
1
2
3
4
5
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