Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150026-5
   DATE: 02 October 1981
   GRILL FLAME VOLUNTEER SECURITY STATEMENT SGFOIA3
   1. (U) I, ROBERTCOWART                     SSAN;
   C.                             '           
                                              

   understand that highly sen@    ai-n-d-c-11 i n f o r m a t i o
   the             .-v _e         -as-s-i     n I h a v e o r a
                                  f1i c-d     m
                                              

   about to receivepart of the    FLAME Programbelongs to the United
   as              GRILL                      
                                              

   States Government.I understand   disclosure  this information is
                   that           of          pun-
                                              

   ishable under   18, Section    U.S.C. "Disclosure
   Title           798,           of Classified
                                  Infor-      
                                              

   mation," June   s amended.                 
   1940 a                                     
                                              

   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 knowledge, except in the performance of my official duties, and as spec-
   ifically authorized in writing in each case by the appropriate agency of the
   United States Government.
   .3. (U) I understand that no change in my assignement or employment will re-
   lieve 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. (U) I take this obligation of my own free will, without any mental reservation
   or purpose of evasion.
         WITNESS SIGNED:
   44-,@Zown/@s I
   JOSEPH W. MCMONEAGLE, CW2 ROBERT C. COWART, CPT
   NAME, RANK/GRADE NAME, RANK/GRADE
   DET G, USAOG DET G, USAOG
   UNIT/ORGANIZATION UNIT/ORGANIZATION
   ANALYST ANALYST
   POSITION POSITION
   Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150026-5

   

   Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150026-5
                                      DATA I@UQUIIIED BY (J'IIE P13IVACY ACT OF 19'(4
                                  (5 U.S.C. 552a)
   I. Autbority: National Records Act, 44 U.S.C. 3102; E.O. 9397, Nwnbcrinr,
   System for Federal Accounts Relating to Individual Persons, Novciaber 22, 103.
   2. Principal Purpose: To maintain a record of those individuals who have
   oil ha%re had access to GRILL'FIAME information throug'.1i 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 Prog
   41 _,ram.
   4. Mandatory or Voluntary Disclosure: Information is disclosed an a
   voluntary ba@@is, but withholding information will. render it impossible to
   grant an individutl access to or participation in the Program.
   t@
   Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150026-5