Approved For Release 2000/08/07': CIA-RDP96-00788ROO1200280026-2
DATE
GRILL FLAME SECURITY AGREEMENT
                  understand that the highl
y
sensitive and classified information 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, publish, or
.reveal,by word,.C'onduct, 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.
1-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 wi-111 remain.. b-inding
upon me even after the termination of my services with the
United States Government.
I` take this obligation of my -own f ree wil-1,, without- -any i~iental.
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 Personsl, November 22, 194-3.
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 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.
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   Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280026-2
   GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE'
   DATE i I k ~-
   WITNESS: SIGNED:
   L'T <-- NAME, RAN GRADE
   4N,
   UNIT7-0f~-C-,ANI ZhT-T6N---'-- UNIT ORGANIZATION
   64
   ii-os-I-TION POSITfO-N
   Approved For Release 2000/08/07 CIA-RDP96-00788ROO1200280026-2