Approved For Release 2001104102 : CIA-RDP96-00788ROO1200010090-0
  DATE Z 11
  GRILL FLAME SECURITY AGREEMENT
  is DORETHA SPRIGGS - , understand that the highly
  senETENe -and 6 iir@it ion I have, or are about to
  receive as part of the GRILL FLAME Program belongs to the
  United States Government. I understand that the 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, publisb, -or
  reveal. by word, conduct, or by any other means such classified
  information or knowledge, except in the performance-", I my
  off icial'- duties, and as specifically authorized in wriftiw
  in each case by the appropriate agency'of the United Stat
  Government.
  I.,understand that no change in my assignment or empiloywent
  will relieve.-ma of my obligation under this agreement and
  that the provision's of this agreement will remain- binding
  upon me even after the termination of my set-vices with the
  United States Government.
  .1-take this obligation of-my,own-free will, without, any nental.
  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 Personsll November 22, 1943.
  2. Principal Purpose: To maintain a record of those individ-
  uals 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 Oisclosure: Information is
  disclosed on a voluntary ba *9, but withholding Information
  will render it impossible ton\cfrant an>individual access to
  or participation in the Progr@@_____.,
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  Approved For Release 2001/04/02 CIA-RDP96-00788RO01 200010090-0
  GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
  DATE
       WITNESS,4. SIGNED:
  L-TL
     kG. ~@U-
  ,---TmK GRADE NA14 E, R K
  A Q
       UNIT ORU-NI-Z--A-T-y0-R-- UWi-!@TdiZ-AKf iK!f 1-69
  c4p-
  POSITION POSITION
  2
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