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           DATE, V/ I -
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      GRILL FLAME SECURITY AGREEMENT
        understand that the highly
      sensitive and cla@_slfied information I have, or are about to
      receive as part of the GRILL FLAME Program belongs to the
      United States Government. I understand that the disclosure
      of this information is punishable under Title 18, Section
      798,'U.S.C., "Disclosure of Classified Information," June 1948,
      as amended. .
      I do solemnly swear that I will never divulge, publish, or
      reveal, by word, conduct, or by any other means such classified
      information or knowledge, except in the performance of my
      off icial- duties, and as specifically authorized in writing
      in each case by the appropriate agency'of the United States
      Government.
      I,'understand that no change in my assignment or employment
      will relieve-me of iny oblIgation under this agreement and
      that the provision's of this agreement will remain. binding
      upon me even after the termination of my services with the
      United States Government.
           .1-take this obligation of..my...own-free will, without.any mental.
      reservation or purpose of evasion. -
                        DATA REQUIRED BY THE PRIVACY ACT OF 1974
                                    (5 U.S.C., 552a)
      1. Authority: National Records Act, 44 U.S.C. 3102; E.O.
      9397, Numbering System for Federal Accounts Relating to
      Individual Personsl, November 22, 1943.
      2. Principal Purpose: To maintain a record, of those individ-
      uals who have or have had access to GRILL FLAME information
      through the use of their name and/or Social Security Number.
      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.
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GRILL FLA14E SECURITY AGREEMENT CONTINUATION PAGE'
DATS rl
WITNESSt,
SIGNED:
NAME, RANK7GW-ADE NAMLfo RANKIGRADE
UNIT/00AR -f OR--- UNIT/ORGANIZATION
POSITIN POSITION
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