4rr-qo
Approved For Release 2 .05ECI R -9196-00789ROO2100150047-2
SURVEILTANCE CONSENT A-U117H01,1ZATION
WARNING NOTICE: INTELLIGENCE SOURCES AND METHODS INVOLVED
SG1J SGFOIA3
born on
do voiuntariiy coilsenL to peiiurm duties as a BEACON (U for Project bUN @;TXEAK M
training and operational missions. I understand that as a BEACON, I will serve as
the focus for Remote Viewers. In consenting to this statement I acknowledge that
this authorization:
a. Will only pertain to training and actual SUN STREAK (U) missions and only
with my prior consent and knowledge.
b. Can be entirely or selectively withdrawn without question or penalty. To
do so, I need only to orally inform my immediate supervisor, the unit operations
officer or the project manager that I wish to withdraw my consent without further
explanation.
c. Will. suppose the possibility of inadvertent surveillance of my most intimate
and personal thoughts and that such inadvertent surveillance will not be reported
nor become a matter of any official records and that the nature of this inadvertently
collected information will be held in strictest confidence.
d. Will at no time be construed as authorization, implied or stated, to conduct
any type of physical, technical or yet to be defined form of surveillance without my
prior knowledge and consent.
This statement of authorization 3JS executed in the presence of @he witness whose
signature appears on this /101 day of 19 without
reservation, amendment or restriction and withodt coercion or implied and/or stated
inducements.//END//
SG1J
wARNING NOTICE: SENSITIVE
;N-1 ELLIGENCE SOURCES AND
                       Approved For Release 20010/Uofl@-00789RO021 004,gdW@fLVED
0 C.