Approved For Release 2001-104102 : CIA-RDP96-00788ROO1200010030-6
  DATE
  SG1J
  GRILL FLAME SECURITY AGREEMENT
           understand that the highly
  sensitive and classitied inf6_rW_a_tion 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 vin(ler Title 18, Section
  798, -U.S.C., "Disclosure of Classified information," JLme 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
  official" duties, and as specifically authorized in writing
  in each case by the appropriate agency'of the United States
  Government.
  1-@understand that no change in my assignment or employment
  will relieve.me of my 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.
  I'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, 1.943.
  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.
  Approved For Release 2001/04/02 : CIA-RDP96-00788ROO1200010030-6

  

    Approved For Release 2001/04/02 : CIA-RDP96-00788ROO1200010030-6
    GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
    DATE
    SG1J
    WITNESS: SIGNED:
    @NAYI@E.@X G@RADE@@-@,-
    NAME, RANK7G -RAD If N X GRADE
                                     'Die? I)C7
    UNIT
    UNIT/ORGANIZATION ORGANfZATION
    POS10rION
    POSITION
    2
    Approved For Release 2001/04/02 CIA-RDP96-00788ROO1200010030-6