App~oved For Release 2000/08/07 : CI'A-RDP96-00788ROO1200280041-5
   DATE 0 3
   GRILL FLAME SECURITY AGREEMENT
   4,3atf,26w understand that the highly
   T
   sensI-tTve -and cli-s-si-fl-e-cT-i'r~f-c~rr-nation 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 1948r
   as amended.
   I do-soleimly swear that I will never 6ivulge, publish, or
   reveaI 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.
   1-,.understand that no change in my assignment or employment
   will relieve.-me of my obligation under this agreement and
   -that the provision's of this agreement will xemain-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. Authority: National Records Act, 44 U.S.C. 3102; E.O.
   9397, Numbering System for Federal Accounts Relating to
   individual 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 2000/08/07 : CIA-RDP96-00788ROO1200280041-5.

     Approved For Release 2000/08/07 CIA-RDP96-00788ROO1200280041-5
     GRILL FLAME STECURITY AGREEMENT CONTINUATION PAGE
     DATE 0-3 8
     WITNESS: SIGNED:
     NAME.. RANK/-6MDE NAME,, RAXk/GRADE
                         ---54ORd
     UNYT210i~GANTZATION UNIT ORGANIZATION
     ~7
     POSITION SITION
     Approved For Release 2000108107: CIA-RDP96-Oa88ROO1200280041-5