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    Approved For Release 2000/11M, '-LwWI1dV6V-~89R002600160014-2
                              DEFENSE INTELLIGENCE AGENCY
                              WASHINGTON, D.C. 20301-6111
    STATEMENT OF CONSENT
    DIA SUN STREAK PROJECT PARTICIPANT
    25X9A5
    Date:
    1. (S/NOFORN/WNINTEL, voluntarily
    accept assignmetat to %J 5-S-SP) and fully
    understand that:
         a. (S/NOFORN/WNINTEL) The DIA and DoD General 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/counterintelligence 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 'he DSSP 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. (U) PSYCTJOENERGETICS (PE) include various processes by which
    individuals psychically interact with objects, locations, and
    organisms.
         a. (U)
    of permanent
    and/or damage
    beyond risks
    daily lives,
    conclusively
    I understand that while there is no demonstrated risk
    or temporary injury (including physical, psychological
         to participants' reputation) to project personnel
    to which they would ordinarily be exposed in their
    the potential for injury during some training cannot be
    ruled Out.
    CLASSIFIED BY: DIA, DT
                              DECLAS: OADR
    Approved For Release'206TWMW 00160014-2
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Approved For Release 2uvu~ts~NiWkIRIDLU-CID789ROO2600160014-2
b . (S/NOFORN/IPINI NT117L) 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 DSSP Managor 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 T am involved as an
integral parL of the DSSP mission. T understand that these
recordings are subject to being, monitored and/or transcribed by
third parties not oLherwise involved in operations or training. I
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) I further 'consent to participate in any
nonintrusive L)iomonitoring activities that are necessary for project
mission accomplishment.
5. (U) I hereby ,-icknowledge receiving formal. counseling concerning
my ass.ignment to DSSP. Basic operational and training procedures
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. .1 further undersLand that my participation in DSSP is Voluntary
and that at my request I may at any time be reassigned without fear
of adverse personnel. action.
25X9A5
Position
Approved For Release 2000/08/08 eA--RQU R002600160014-2
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25X9A5 Signature:

    *Ohii il~t6-O I
    Approved For Release 200 1 0789ROO2600160014-2
    DATA REQUTRED BY THE PRIVACY ACT OF 1974 (5 U.S.C. 552a)
    1. Authority: Title 10, 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, bLIt withholding information will render it
    impossible to grant an individual access to or participation in the
    program.
                     Approved For Release 2000/08/0,A~. R!jj2&WQB002600160014-2
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