Approved For Release 2000168/07 : CIA-RDP96-00788ROO120028DO20.&-~
       DATE: /~ Q,-7
       GRILL FLAME SECURITY AGREEMENT
       understand that -the highly sensitive
       and classified inf~4rmaaV&i~o-n have, or a" about to receive as part of the
       GRILL FLAIME Program belongs to the United. States Government. I understand
       that disclosure of this information is pnnishable under Title 18, Section
       798, U.S.C. "Disclosure of Classified Information," June 1948 as amended.
       I do solemnly swear that I will never diirulge, 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 Governmen t .
       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'rpe even after the termination of my services with
       the United States Gove-nment.
       I take this obligation of my own free will, without any mental reservation
       or pur-nose of evasion.
                            DATA REQUIRED BY THE PRIVACY ACT OF 19711
                                   (5 U.S.C. 552a)
       1. Aathority: National. Records Act, 44 U.S.C. 3102; E.O. 9397, Numbering
       System Lor Federal Accounts Relating to individual Persons, November 22, 19~3-
       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.
       11. 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.
       Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280020-8

       
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    GRILL F VE 0-CURITY AGREEMENT CONTIHUATION PAGE
    DATE,_/,4
    WITNESS: S GN
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    POSITION
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    Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280020-8