Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280038-9
DATE- I 5g~,,b
GRILL FLAME SECURITY AGREEMENT
if D6 P? j 4 5; f~O_V;I_e understand that the highly
sensitive and classified inro-rmation 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, 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 my obligation under this agreement and
that the provisior~s of this agreement will remain.binding
upon me even after the termination of my services with the
United States Government.
I'take 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. Autborityt National Records Act, 44 U.S.C. 3102; E.O.
9397, Numbering System for Federal Accounts Relating to
Ind.ividual Personsl, November 22, 1943.
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.
Approved For Release 2000/O8tOT___C IA-RDP96-00788 ROO 120-028.00-3-"-


  Approved For Release 2000/08/07 : CIA-RDP96-007-88ROO1200280038-9
  GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE'
  DATE / q FeL k1
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  .WITNESS:. SIGNED:
  LTC
  NAME,, RANK GRADE NAXEf RANK/GRADE
  At~" r - 40VwL0'F - . .
  fie2
  UNIT/-ORGANIZATION UNIT/ORGAN!ZATION
  POSITION
  Approved For Release 2000/08/07 CIA-AP96-00788R001200280038-9
  POSITION