Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280043-3
       GRILL FLAME SECUTHIff AGREEMENT
       understand that the highly sensitive
       arid. class-.i~_ij,~_information I have., or atj about to receive as part of the
       GRILL FTAlvr_C~ ProCraia belongs to -the United. States Government. I understana
       that disclosure of this information is punishable under Title 18, Section
       798, U.S.C. "Disclosures 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 ny 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 emp.10yinent will relieve me of
       my obligation under this agreement and that the provisions of this agreement
       will rerain 'binding upon ne even after the termination of my scrvices with
       the LInited. Stater, Govermqient.
       I take this obligation of my own free will, without any mental reservation
       or purpose of evasion.
                                 DATA REQUIEED BY THE PRIVACY ACT OF 1974
                                      (5 U-S-C., 552a)
       1. Authority: 11T~ttionai Records Act, 44 U.S.C. 3102; E.O. 9397, Numbering
       System for Federal Accounts Relating -to Individual Persons, November 22, 1943.
       2. Princi.~)al Purpose: To maintain a record of -those individuals who have
       or hav~~ 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. Mamdatory or Voluntary Disclosure: Information is disclosed on a
       voluntary basis, but withholding information will rcnder it impossible -to
       grant an individual access to or participation in the Program.
       Approved For Release 2000/08/07 : CIA-RDP96-00788ROO1200280043-3

       
    Approved For Release 2000/08/0.7 : CIA-RDP96-00788ROO1200280043-3
    GRILL FLAKE SECURITY AGREEIv1NT CONTINUATION 11AGE1
    DATE 2
         WITIU'SS
    K/G E
    j - 7-
    UNIT/ORGANIZA!210N
    L-L
    POSITION
    SIGNED:
    NAMME, ~,DE
    NAME, ~-&
    C-.
    UNIT ORGANIZATION
    POSITION
    Approved For Release 2000/08/07 CIA-RDP96-00788ROO1200280043-3