For Release 2000/08/09 CIA-RDP96-00792ROO0600160002-3
 DEFENSE INTELLIGENCE AGENCY
 WASHNGTON. D.C. 20301-6111
 STATEMENT OF CONSENT
 DIA SUN STREAK PROJECT PARTICIPANT
 Date:
 1. - (S/SK) 1, voluntarily accept
 assignment to the DIA SUN STREAK PROJECT (DSS ) and fully understand
 that:
 a. (S/SK) The DSSP is an experimental program that applies
 psychoenergetics research,to intelligence activities. Specifically,
 the mission of the DSSP is to collect intelligence information
 through the use of psychoenergetic technology. Psychoenergetics is
 the process by which an individual perceives, communicates with,
 and/or perturbs characteristics of a designated target, person, or
 event remote in space and/or time from that individual by mental
 means. Development and use of DSSP operational intelligence
 collection personnel will be accomplished in accordance with
 established procedures. The Deputy Secretary of Defense has granted
 approval for the conduct of DSSP activities in accordance with
 Procedure 13, DoD 5240.1-R.
 b. (C/NOFORN) Assignments in DSSP are governed by the type and
 degree of expertise required for the position, and are made
 according to individual capability and experience, regardless of
 rank or previous position. I understand that I may at any time ask
 nuestions of the Commander, Prototype Operational Group (POG), DSSP
 or other appropriate project personnel relating to areas unclear to
 me. Additionally, I, understand that my participation in DSSP is
 voluntary and that at my request I may at any time be reassigned
 without fear of adverse personnel action. The nature of my
 involvement in DSSP' along with associated records will be protected
 under project security measures.
 C. (S) Upon my assignment to the DSSP, the primary,
 consideration will be the Project's mission and operational
 requirements. I understand that this may consequently delay normal
 career development patterns such as branch schooling and assignment
 opportunities, and that these disruptions may prejudice future
 promotion and assignment potential; however, I have been assured
 that every effort will be made to preclude the adverse effects
 mentioned above on my career.
 d. (S/SK~ I understand that there is no demonstrated risk of
 permanent or, temporary injury (including physical, psychological
 CLASSIFID BY Mulitiple sources SPECIAL ACCESS REQUIRED
 DECLASSIFY ON OADR
 H A N D L E V I A S K E ET C H A N N E L S 0 N L Y
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     Approved For Release 2000108/0 R P96-00792ROO0600160002-3
     and/or damage to participants' reputation) to project personnel
     beyond risks to which they would ordinarily be exposed in their
     daily lives. However, I understand further that potential for
     injury during DSSP-related activities cannot be conclusively ruled
     out.
          f. (SISK) I may temp-orarily choose not to particpate in the
     project at specific times, or permanently discontinue participation
     without prejudicial effect. Termination or temporary declination
     will be affected by notifying the Commander, POG, DSSP or his
     designated representative.
     2. (SISK) As a participant in DSSP, and IAW DoD 5240.1-R, I
     consent to video and/or audio recording, monitoring and transcribing
     of all training and operational interviews in which I am in any way
     involved as part of the DSSP mission. I understand that these
     recordings are subject to being monitored and/or transcribed by
     third parties not otherwise involved in operations or training.
     3. (C/NOFORN) I hereby acknowledge receiving separate counseling
     concerning my assignment to DSSP. Fundamental training and
     operational procedures and their purposes, as well as any attendant
     discomforts, risks, and benefits have been explained to me.
     Signature (Witness)
     Name, Rank/Grade
     Social SecurM'Number
     Signature (Participant)
     Name, Rank/Grade
     Social Security NumEer
     DATA REQUIRED BY THE PRIVACYACT OF 1974 (5 U.S.C. 552a)
     1. Authority: Title 10, U.S.C. Section 8012; Title 44, U.S.C.,
     Section 3101 and EO 9397.
     2. Principal Purpose: To maintain a record of those individuals
     who have executed statements of informed consent as participants in
     DSSP.
     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 2000108109 : GMA-RD 00792ROO0600160002-3
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