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         Approved For Release 2001/03/0 : CIA-RDP96-00789ROO2100150071-5
         DATE:
         GRILL FLAME SECURITY AGREEMENT
         ').ku @ders
         I, J03rPH LJ, V\A0-M0JF-AGL-E_, understand that the highly sensitive
         and classified information I have, or ajj 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.
         I do solemnly swear that I will never divulge, publish, or reveal by word,
         conduct, or by any other means such 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.
         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.
         I take this obligation of my own free will, without any mental reservation
         or purpose of evasion.
                         DATA REQUIRED BY THE PRIVACY ACT OF 1974
                                     (5 U.S.C. 552a)
         .1. Authority: National Records Act, 44 U.S.C. 3102; E.O. 9397, Numbering
         System for Federal Accounts Relating to Individual Persons, November 22, 1943.
         2. Principal Purpose: To maintain a record of those individuals who have
         or have had access to GRILL FLAME information through 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 Program.
         4. Mandatory or Voluntary Disclosure: Information is disclosed on a
         voluntary basis, but withholding information will render it impossible to
         grant an individual access to or participation in the Program.
         P
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   GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
   DATE 9 FE P,
   WITNESS:
   NAME, K-AN/GRADE
      UNIT/bRGANIZATIOV
   -Lf4s
   Pavie-J JqctL
   POSITION
   SIGNED:
   NAA, 4@@/GRADE
   IT/ORGAXIZATION
     a7-
   /@aJ2=-7
   POSITION
   Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150071-5