Approved For Release 2GO11.0-3107 :JCIA-RDP96-00789ROO2100150051-7
     DATE: a FE8 79
     GRILL FLAME VOLUNTEER SECURITY AGREEMENT SGFOIA3
     1. (U) I ) Z;@Czz@ SSAN:
     understand that the highly sensitive and classified information I have or
     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 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.
     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:
     SIGNED:
     NAME, RANK@GRADE NAA, RANK/GRADE 'I
     ,0,8 h, k @@tl 1 &0 )V?
     r F'7
               UNIT/ORGANIZATION
     'ri
     P^Oje-c@ OfWte&
     POSITION
     g-o 4 -90,gd
     UNIVORGANIZATION
     Sel7i@,, in-u-q P
     POSITION 411
     Approved For Release@90,YOWO,?@: CIA-RDP96-00789ROO2100150051-7

     Approved For Release 2001103107 : CIA-RDP96-00789ROO2100150051-7
                  DAILA E@',QUIRED BY 9 ''HE PRVIACY ACT OF 1974
                                 (5 U.S.C. 552a)
          I'a
     -1 - Aut tiol-IR" Records Act, 44 u.s.c. 310P2c;rES,0.ns. 9N3o9Tv~eribNLwrnbe2r2i,iilpglt3.
     System for.Pederal Accounts Rol-aUng to Individual
                  r
     2. P-rincipa-, Puv@)ose: To maintain a record of' those individuals who, have
     or hFLve had acces5 to GRILL-FLIM information through the use of their name
     and/or COC4aj
                                       Security Wunber.
                                        J
     3. Poutine Ulses: The Social Security Number is to be used to identify L-he
     individual, and the information is to be retained strictly within the Program.
                                   U
     Mandatory or Vol-untary Discl.osure: Information is disclosed on a
     vol'Unt-ary basis, but wiLhholding information wil-J. render it impossible to
     grant an individual access to or participation in the Pro-ram.
     Approved For Release 2001103107 : CIA-RDP96-00789ROO2100150051-7