Approved For Release 20S 74: 96-00789ROO2100150048-1
   SURVFIL--L@NCE CMSENT A-7110RIZA11ON
   WARNING NOTICE: INTELLIGENCE SOURCES AND METBODS INVOLVED
   SG1J SGFOIA3
   born on
   do voluntarily consent to perform duties as a BEACON UJ for Project SUN STREAK (U)
   training and operational missions. I understand that as a BEACON, I will serve as
   the focus for Remote Viewers. In consenting to this statement I acknowledge that
   this authorization:
        a. Will only pertain to training and actual SUN STREAK (U) missions and only
   with my prior consent and knowledge.
        b. Can be entirely or selectively withdrawn without question or penalty. To
   do so, I need only to orally inform my immediate supervisor, the unit operations
   officer or the project manager that I wish to withdraw my consent without further
   eXplanation.
        c. Will suppose the possibility of inadvertent surveillance of my most intimate
   and personal thoughts and that such inadvertent surveillance will not be reported
   nor become a matter of any official records and. that the nature of this inadvertently
   collected information will be held in.strictest confidence.
        d. Will at no time be construed as authorization, implied or stated, to conduct
   any type of physical, technical or yet to be defined. form of surveillance without my
   prior knowledge and consent.
        This statement of authorization is executed in the presence of the witness whose
   day of , without
   appears on this 5M71 96025qW, 19 86
   reservation, amendment or restriction and without coercion or implied and/or stated
   inducements.//END//
   SG1J
                    .4" SENSITIya,
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                          Approved For Relea"A-. r4-RDP96-00789R0021 001'600494LYr-q
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