Approved For Release 2000/08/07,: CIA-RDP96-00788ROO1200280037-0
  DATE.
  GRILL FLAME SECURITY AGREEMENT
  I understand that the highly sensitive
  and classified information I have, or a*94 about to receive as part of the
  GRILL FLAME Progrwri belongs to the United. States Government, I understand.
  that disc-losure 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.~
  conduct, or by airy 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 employmelft will -relieve me of
  my obli-ation under this agreement and that the provisions of -this agreement
  C~
  will remain binding upon me even after the termination of my services with
  tbe United States Govern.(,,ient.
  I tcake thjS obligation of my own free will-, without any mental reservation
  or pum)ose of evasion.
                             DATA REQUIRED BY THE PR_.r.VACY 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 Persons, November 22, 1943.
  2. Principal Purpose: To maintain a. record of -those individuals who have
  or have had access to GRILL FLAME informa~tion 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 Progran.
  4. Mandatory or Vol-antary Disclosure: Information is disclosed on a
  voluntary basis, b11t withholding information will render it impossible to
  grant an individual access -to or participation in the Program.
  Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280037-0

  
        Approved For Release 2000/08/07 CIA-RDP96-00788 ROO 1200280037-0
        GRILL FLA24E SECURITY AGREEMENT CONTINUATION PAGE
        DATE 28 FeP.~- 11
        WITNESS':
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        A) S " M
        UNIT/ORGANIZATION
        " Y"A
        62. it F
        POSITION
        SIGNED:
        np, .11
        P-A64er_
        Nt, RANK/GRAD'E
        UNYT/ORGANIZATIOf~
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        0 N
        Approved For Release 2000/08/07 CIA-RDP96-00788ROO1200280037-0