Part VI: Performance Agreement CertificationThe signatures below certify that the supervisor has developed the performance agreement in consultation with the executive. The supervisor has discussed the agreement with the executive and provided examples of behaviors that would/would not meet the performance standards. The discussion occurs at the beginning of the performance rating period. The executive is given a copy of the agreement, and the original is placed in the executive’s Employee Performance File.[Fields are provided for:] Employee’s Signature and DateRating Official’s Signature and DateReviewing Official’s Signature (Optional) and DatePart VII: Progress Review Certification[Fields are provided for:] Employee’s Signature and DateRating Official’s Signature and DateReviewing Official’s Signature (Optional) and DatePrivacy Act NoticeThe Privacy Act of 1974 requires that when we ask you to provide information about yourself, we must tell you: our legal right to ask for the information; the principal purpose(s) for which the information is intended to be used; what could happen if we do not receive any or all of the information; and whether your response is voluntary or mandatory. This statement is being provided pursuant to the Privacy Act of 1974, as amended, for individuals who have been requested to submit a statement of accomplishment/self-assessment. The authority to solicit this information is derived from 5 USC 4301, et seq., and 5 CPR Part 430, Performance Management. In order to allow you the opportunity to provide input into the evaluation process, management may request this information from you. Your supervisory officials will consider the information you furnish in preparing an evaluation of your performance or conducting periodic progress reviews.The information contained in your performance evaluation may be disclosed to Department employees who have a need for the record in their official duties. Disclosures may also be made when appropriate, under routine uses published in the Federal Register for Privacy Act system of records, OPM/GOVT-2, Employee Performance File System of Records. Under the appropriate circumstances, disclosure may be made to the Office of Personnel Management, the Equal Employment Opportunity Commission, the General Accounting Office and others. Failure to furnish any or all of this information may result in your supervisors preparing your evaluation, or conducting a progress review, without considering information you may feel is relevant or significant.