Approved For Release 2000/08/08: CIA-RDP96-00789ROO2600160009-8
       STATEMENT OF CONSENT
       INSCOM CENTER LANE PROJECT PARTICIPANT
       IAGPA-F-SD
       Date:
       1. (S/CL-4/NOFORN) I, voluntarily accept assignment
       to the INSCOM CENTER LANE PROJECT (ICLP) and fully understand that:
            a. (S/CL-I/NOFORN)) The Army General Counsel has determined that ICLP
       constitutes experimentation on human subjects. As required by Procedure 13 of DoD
       Directive 5240.1-R, approval for project activities has been granted by Secretary
       of the Army.
            b. (S/CL-3/NOFORN) The aim of ICLP is to develop highly skilled personnel who
       are capable of conducting professional level intelligence/counterintelligence
       operations through use of psychoenergetic methodology. Development of ICLP
       personnel will be accomplished with special training based on mission requirements.
            c. (C/NOFORN) Assignments in ICLP are governed by the sensitivity and degree
       of expertise required for the position. I will be assigned in accordance with my
       capabilities and experience, regardless of my rank or previous position. Due to
       the nature of training involved, the duration of my participation is indefinite.
       Records of my involvement will be available to project personnel, but otherwise
       protected under project security measures.
            d. (C/NOFORN) The primary consideration in any career development or
       assignment action will be ICLP mission and operational requirements. I understand
       that exemption, interruption, or delay in normal career development patterns--such
       as branch schooling and assignment opportunities- -may prejudice future promotion
       and assignment potential. I have been assured, however, that every effort will be
       made to preclude the adverse effects listed above on my career.
       2. (S/CL-3/NOFORN) PSYCHOENERGETICS (PE) include various processes by which
       individuals psychically interact with objects, locations, and organisms.
            a. (S/CL-I/NOFORN) I understand that while there is no demonstrated risk of
       permanent or temporary injury (including physical, psychological and/or damage to
       participants' reputation) to project personnel beyond risks to which they would
       ordinarily be exposed in their daily lives, the potential for injury during some
       training cannot be conclusively ruled out.
       WARNING NOTICE:
                         CENTER LANE SPECIAL ACCESS PROGRAM
                RESTRICT DISSEMINATION TO THOSE WITH VERIFIED ACCESS
                                    CATEGORY CL-4
       NOT RELEASEABLE TO FOREIGN NATIONALS
       CLASSIFIED BY: CDR, INSCOM
       DECL: OADR
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       Approved For Release 2000/08/08 : CIA-RDP96-00789ROO2600160009-8
            b (S/CL-I/NOFORN) i may temporarily choose not to perform PE at specific
       times, or permanently discontinue participation without prejudicial effect.
       Termination will be affected by notifying the ICLP Manager or in his absence, his
       designated acting ICLP NIanager.
       3. (S/CL-3/NOFORN) As a participant in ICLP, and IAW AR 381-17, 1 consent to tape
       recording, monitoring and transcribing of all operational and training interviews
       in which I am involved as an integral part of the ICLP mission. I understand that
       these recordings are subject to being monitored and/or transcribed by third parties
       not otherwise involved in operations or training. I waive any claim or right of
       ownership to all tape recordings and transcripts made in conjunction with ICLP,
       with the understanding that these tape recordings and transcripts are property of
       the United States Government.
       4. (S/CL-3/NOFORN) I further consent to participate in any nonintrusive
       biomonitoring activities that are necessary for project mission accomplishment.
       5. (U) I hereby acknowledge receiving formal counseling concerning my assignment
       to ICLP. Basic operational and training procedures (both routine and experimental)
       and their purposes, as well as attendant discomforts, risks, and benefits have been
       explained to me. I understand that I may at any time ask questions of project
       personnel relating to areas unclear to me. I further understand that my
       participation in ICLP is voluntary and that at my request I may at any time be
       reassigned without fear of adverse personnel action.
       Signature:
       Name, Rank/Grade ot Witness
       Social Security NUmFe-r
       Unit/Organization
       Position
       Signature:
       Name, Rank/Grade ot Participa
       Social Security Number
       Lhit/Organization
       Position
       Approved For Release 2000/08/08 : CIA-RDP96-00789ROO2600160009-8