Approved For Release 20011MIDT:
       DATE: -7
       GRILL FLAME VOLUNTEER SECURITY AGREEMENT
       SGFOIA3
       i (u) I, SSAN:-
       understand that the highly sensitive and classified information I have or
       am about to receive as part of the GRILL FLAME, Program belongs to the
       United States Government. I understand that disclosure of this information
       is punishable under Title 18, Section 798, u.s.c. "Disclosure of Classified
       Information," June 1948 as amended.
       2. (U) I do solemnly swear that I will never divulge, publish, or reveal
       by word, conduct, or by any other means GRILL FLAME 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.
       3. (U) I understand that no change in my assignment or employment will
       relieve me of my obligation under this agreement and that the provisions
       of this agreement will reiiain binding upon me even after the termination
       of my services with the United States Government.
       4. (S) I take this obligation of my own free will, without any mental
       reservation or purpose of evasion. I understand that as a GRILL FLAME
       volunteer the fact that I possess psychic abilities is classified and I
       cannot divulge this fact by word, conduct, or by any other means.
       WITNESS:
       NAME, RANk/GRADE
       -PPPA
            UNIT/ORGANIZATION
       pmm& 19 0,
       n*i.e-
       POSITION
                    SIGNED:
       CX1 V 1 7
       NAME, RANK/GRADE/
       UNIT/ORGANIZATION
       POSITION
       Approved For Release @91 XNQT@ CIA-RDP96-00789ROO2100150028-3

            Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150028-3
                       DATA REQUIRED BY THE' Pl@'FVACY ACT OF, 19'T4
                                      (5 U.S.C. 552a)
            I . Put"nority: National Records Act, h4 U.S.C. @)102; E.O. 9397, N-wiibcring
            Syste.m I'or TFed.eral Acc(--)unts Reltating to Individual Pcrsons, November 22, 1.943.
            2. Principal PurT)ose: To maintain a record of' -those individuals who have
                 or have had access to GRILL'FLAME information through the use, of -their name
            L; -
            and/or 10-4al Security Number.
            3. R o ia t i n e Uls e s -The Social Security Number is to be used to identify -the
            individual, and the information is -to be retained strictly within -the Program.
            4. Manditory or Voluntary Disclosure: Information is disclosed on a
            volunt-iry basis, but withholding information will. render it impossible to
            grant an individual racce,,is -to or participation in -the Program.
            U
            Approved For Release 2001/03/07 : CIA-RDP96-00789ROO2100150028-3