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DATE 04 49
GRILL FLAME SECURITY AGREEMENT
understand that the highly
itive and -classified information I have, or are about to
sensi
receive as part of the GRILL FLAME Program belongs to the
United States Government. I understand that the disclosure
of -this information is punishable under Title 18, Section
798,@U.S.C.,, "Disclosure of Classified Information," June 1948,
as amended.
I do solemnly swear that I will never divulge, publish '.or
reveal-by word, conduct, or by any other means such classified
information or knowledge, except in the performance of my
official*duties, and as specifically authorized in writing
in each case by the appropriate agency'of the United States
Government.
1--understand that no change in my assignment or employment
will relieve-@me of my obligation under this agreement and
that the provision's of this agreement will remain..binding
upon me even after the termination of my services with the
United States Government.
I take this obligation.of my own free will, without,-any mental,
reservation or purpose of evasion.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
(5 U-S.C.... 552a)
1. Authority: National Records Act, 44 U.S.C. 3102; E.O.
9397, Numbering System for Federal Accounts Relating to
Individual Personsl, November 22, 1943.
2. Principal Purpose: To maintain a record of those individ-
uals who have or have had access to GRILL FLAME information
through the use of their name and/or Social Security Number.
3. Routine Uses: The Social Security Number is to be used
to identify -the individual, and the information is to be
retained strictly within the Program.
4. Mandatory or Voluntary Disclosure: Information is
disclosed on a voluntary basis, but withholding information
will render it impossible to grant an individual access to
or participation in the Program.
Approved For Release 2003/09/10 : CIA-RDP96-00788RO01 200280001 -9
Approved For Release 2003/09/10 : CIA-RDP96-00788ROO1200280001-9
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE'
2... 45 N
DATE_
WITNESS:
'e
1 y4l @541PM A 4N R R D -E
SIGNED:
Approved For Release 2003/09/10 61A-RDP96-00788RO01 200280001-9