Data Classification Form Instructions

Name:

Provide the first and last name of data owner and an

alternate point of contact (POC) for this data.

Department:

Provide the name of the college, department, and/or

business unit which is responsible for this data.

Day Phone:

Provide the daytime phone number of the data owner or

alternate POC.

E-Mail:

Provide the E-Mail address of the data owner or alternate

POC

Description and location:

Provide a detailed description of the data and the

physical location of the data.

Regulated Data Elements

Select all of the data element types which are applicable

to this data. For definitions of each data element type see
the definitions document.

Categories

Select A, B, C, or D for the most appropriate/accurate

response for each of the four rows.

Overall Classification:

Using the responses identified under categories, where A

is highest and D is lowest, select the highest category
which applied to this data.

This data is classified as sensitive:

If overall classification is A or B, check Yes; otherwise,

check No.

Date:

Provide the date the Data Classification Form is

completed.

Version: 1.2

Revision Date: 06/02/2006

Data Classification Form

Name of
data
owner:

College:
Department:
Business
Unit:

Name of
alternate
POC:
Day Phone:

E-Mail:

Description
and location:

Regulated Data Element Types

HIPAA

GLB

FERPA

PCI

Financial

Categories
Category
A

Category
B

Category
C

Category
D

There is a legal or
contractual requirement to
protect data

No legal or contractual
requirement but there is an
obligation to protect data

Data is somewhat sensitive

but there is no obligation
to protect it

Data is not sensitive

There is a high level of

risk to reputation

There is a medium level of

risk to reputation

There is a low level of risk

to reputation

There is no risk to
reputation

Accuracy of data is
essential to business
functions

Accuracy is important to
business functions

Accuracy is only
somewhat important to
business functions

Accuracy has no bearing

on business functions

Business can not continue

without data

Business can continue

without data but would be
impacted

Business can continue and

would only be minimally
impacted by loss of data

Business would continue

as normal with loss of data

Data Classification
Overall Classification:
This data is classified as sensitive:

Version: 1.2

B
YES

C
NO

D
Date:

Revision Date: 06/02/2006