Approved For Release 2000108/07 : CIA-RDP96-00788ROO120028DDDS-&-' DATE: -SAC 140-AILV 191 GRILL FLAME SECURITY AGREEMENT k0 understand that -the highly sensitive and. classified information I hbve, or a*4 about to receive as part of the GRILL FjJ04_F,' Program belongs to the United. States Government. I understand that disclosure of this information is punishable under Title 18, Section 798, U.S.C. "Disclasure of Classified Information," June a.948 as amended. I do solemnly swear that I will never di-\rulge, 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 any 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 teke 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, Numberinc, CD Systen, for Federal Accounts Relating to Individual Persons, November 22, 1943. 2. Principal Purpose: To maintain a record of t1iose individuals who have or have hacl 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 -v.ithholding information will. render it impossible to grant an individual access to or participation in -the Program. Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280005- Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280005-5 GRILL FUU41E SECURITY AGREEMENT CONTINUATION PAGE DATE, It 75 h M WITNESS: A SIGNED: 16 M A (X Lr ~TK-~JGEADEI NAIvM,, RANK GRADE LX S Al T P D I T A TJNIT/ORGANIZA,L'ION kill plal~vr- TO-E,,- T -T: -[C) I ~j 10 es :[I:PD POSITION Approved For Release 2000/08/07: CIA-RDP96-00788ROO1200280005-5