r
        Approved For Release. 2001/03/aZ,LI.6A.4kE~P96-00789ROO2100150014-8
        DATE:-
        GRILL FLAME VOLUNTEER SECURITY AGREEMENT SGFOIA3
        1. (U) Il SSAN:-
        understand'that the highly sensitive and classified informat-Lon.1 lldvt@ Ul
        am about to receive as part of the GRILL FLAME Program belongs to the
        United States Government. I understand that disclosure of this information
        is punishable under Title 18, Section 798, U-S-C. "Disclosure of Classified
        Information," June 1948 as amended.
        2. (U) I do solemnly swear that I will never divulge, publish, or reveal
        by word, conduct, or by any other means GRILL FLAME classified information
        or kno@rledge, 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.
        3. (U) I understand that no change in my assignment or employment will
        relieve me of my obligation under this agreement and that the provisions
        of this agreement will remain binding upon me even after the termination
        of my.services with the United States Government.
        4.-(s) I take this obligation of my own free will, without any mental
        reservation or purpose of evasion. I understand that as a GRILL FLAME
        volunteer the fact that I possess psychic abilities is classified and I
        cannot divulge this fact by word, conduct, or by any other means.
        WITNESS:
                  /Z
        NAME, RANK/GRADE
        UNIT/ORGANIZATION
        SIGNED:
             4 Z1-/ -4 A, 4) & 61ye-" jv-@, <!@ Is -
        @AME, RANK/GRADE
        UNIT/ORGANIZATION
                                              Ale
        12, JF 7
        POSITION POSITION
        Approved For Release 2001/03/07 CIA-RDP96-00789ROO2100150014-8

        Approved For Release 2001/03/07: CIA-RDP96-00789ROO2100150014-8
                                  DATA MQUIRIM BY 'I''IIE P111VACY ACT OF 1974
                                     (5 U.S.C. 552a)
        1. Puthority: iiati .onal Records Act, 44 u.s.c. 3102; E.O. 9397, Nwaberint',
        System for Fcder,-.tl Accounts Relating to Inaividual Persons, November 22, 1943.
        2. Principal Purpose: To maintain a record of those individuals who have
        or have had access to GRILL'FLAME information throuah the use of their name
        and/or Social Secur'ity Number.
        J
        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. 141andatory or Voluntary Disclosure: Information is disclosed on a
        vol-antary bazis, but withholding information will render it impossible to
        grant an individual access to or participation in the Program.
        Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150014-8