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 Approved For Release 240WEVIN I UALi4p96-00789RO02600160013-3
                            DEFENSE INTELLIGENCE AGENCY
                            WASHINGTON, D.C. 20301-6111
 STATEMENT OF CONSENT
 DTA SUN STREAK PROJECT PARTICIPANT
 SG1J
 Date: ~V
 1. (SINOFORNIWNINTEL) I, voluntarily
 accept assignment to the ff-I-;A )uj-N ijxuint,.L (_DS-S_PT and fully
 understand that:
 a. (S/NOFORN/WNINTEL) The DIA and DoD Ceneral Counsels have
 determined that the DSSP constitutes experimentation on human
 subjects. As required by Procedure 13 of DoD Directive 5240.1-R.,
 approval for project activities has been granted by the Deputy
 Secretary of Defense.
 b. (S/NOFORN/WNINTEL) The aim of the DSSP is to develop highly
 skilled personnel who are capable of conducting professional level
 intelligence/counterintel.ligence operations through use of
 psychoenergetic methodology. Development of DSSP personnel will be
 accomplished with special training based on mission requirements.
 C. (C/NOFORN) Assignments in DSSP 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 DSSP mission and
 operational requirements. I understand that exemption,
 interruption, or delay in normal career development patterns--such
 as branch schooling and assignment opportLinities--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. (U) PSYCHOENERGETICS (PE) include various processes by which
 individuals psychically interact with objects, locations, and
 organisms.
 a. (U) 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.
 CLASSIFIED BY: DIA, DT
 Approved For Releasi' 11T1111M1V16011&0W-N I
                     11111a NTEL
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          Approved For Release 2 1A EW,.REIP96-00789ROO2600160013-3
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 b (S/NOFORN/WNTNTEL) T may temporarily choose not to perform
 PE at specific times, or permanently discontinue participation
 without prejudicial effect. Termination will be affected by
 notifying the DSSP Manager or in his absence, his designated acting
 DSSP Manager.
 3. (S/NOFORN/WNINTEL) As a participant in DSSP, and IAW
 I consent to tape recording, monitoring and transcribing of all
 operational. and training interviews in which I am involved as an
 integral part of the DSSP mission. I understand that these
 recordings are subject to being monitored and/or transcribed by
 third parties not otherwise involved in operations or training.
 waive any claim or right of ownership to all tape recordings and
 transcripts made in conjunction with DSSP, with the understanding
 that these tape recordings and transcripts are property of the
 United States Government.
 4. (S/NOFORN/WNINTEL) T further *consent to participate in any
 nonintrusive blomonftoring activities that are necessary for project
 mission accomplishment.
 5. (U) I hereby acknowledge
 my assignment to DSSP. Basic
 and their purposes, as well es
 benefits have been explained to
 time ask questions of project
 me. I further understand that
 and that at my request I may at
                     receiving formal counseling concerning
                      operational and training procedures
      attendant discomforts, risks, and
 me. I understand that I may at any
 personnel relating to areas unclear to
                     my participation in DSSP is voluntary
                      any time be reassigned without fear
  tb-,IyApe personnel action.
 FU
 Unit/OrganizaLion
 Position
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                      Approved For Release 20riwn -2r-W-Q6-00789ROO26.00160013-3
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Approved For Releaseqpi~EAMbX7gR-TDP96-00789ROO2600160013-3
DATA REQUIRED BY THE PRIVACY ACT OF 1974 (5 U.S.C. 552a)
Authority: Title 1-0, U.S.C. Section 3012.
2. Principal Purpose: To maintain a record of those individuals
who have executed statements of informed consent as participants in
DSSP.
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 -96-00789R002600160013-3