Approved For Release 20011031.07-- Q1 IA-RDP96-00789ROO2100150069-8
 DATE: 80m-P-UAqY 19-18
 GRILL FLAME VOLUNTEER SECU2IT7 AGREEMENT SGFOIA3
 l. (U) I, -- M AURIC-c- (I. a I LAG7S ', SSAN: -5
 understand that the highly sensitive and classifieu jni orma i, -Lon i nave 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.
  WITNE-8:
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 NAME, RANK/GRADE
 UNIT/OP/,ANIZATIbN
 0,5 -;r/p"q
 POSITION
                SIGNED:
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 C LA3 0 t,.-) Z. Pt R,#A-2
 NAME, RANK/GRADE
 Us A I I PD/ I rA(=/ I Ov,%OtA
 UNIT/ORGANIZATION
 POSITION
 Approved For Release 200PP10-7,: CIA-RDP96-00789ROO2100150069-8

       Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150069-8
         DATA 1,'jEQUIRFD BY TIfE Pl"@'TVACY I@C T OF 19'(4
       (5 U.S.C. 552a) '
        1. Puthority: Nationall Records Act, 44 U.S.C. 3102; E.O. 9397, Niunbering
       p
       System for `ederal Accounts r%elating to Individual Persons, November 22, 19113.
       2. PrinciDal PurDose: To maintain a record of' those individuals who have
       or have had access to GRILUFLME information through the use of their name
       and/or @1@ 0 C 4 @jl Security Vi-mber.
       3. Rout-ine Ulses 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
       volunta,ry basis, but withholding information will render it impossible to
       grant an individual access to or participation in -the Program.
       U
       Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150069-8