Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280025-3
     A'
     D
     TE:
     GRILL FLAME, SECURITY AGREEMENT
     qc--,vdo7s-01%( , understand that the highly sensitive
     and classified information I have, or a," about to receive as part of the
     GRILL FLPJ~Y, 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 !948 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
     authori-7,ed 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 takethis obligation of my own free will, without any mental reservation
     or purpore of evasion.
        DATA REQUIRED BY THE PRIVACY ACT OF 1974
     1 (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, 1-943.
     2. Princilpal Purpose: To maintain a record of -the-,(-, individuals who have
     or have had access -to GRILL FLAME information -through the use of their name
     and,/o-- 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 Progrmn.
     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 Prograni.
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     Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280025-3
     GRILL FLilfl.E SECURITY AGREEKENI? CONTINUATTOU PAGE
     DATE 19 o 7
     WITNESS:
     NAM , R-92'K/GRADE
     SIGNED -
                  I-Tc
     JU R-ANK/GRADE
                                   A/ S e-.)
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     UNIT/ORGANIZATION UNIT/ORGANIZATION
     POSITION
     POSITION
     Approved For Release 2000/08/07 CIA-RDP96-00788ROO1200280025-3