Approved For Release 2001/04/02 : CIA-RDP96-00788ROO1200010033-3
           DATE C7
           GRILL FLAME SECURITY AGREEMENT
                I F understand that the highly
           'P
           se s t ve _-4@Wified in rmation I have, or are about to
           Ze ve
           5, i@vt @ea s i
           r I , ve as part of the GRILL FLAME Program belongs to the
           United States Government. I understand that the disclosure
           of this information is piinishable 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, publisb, -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.
           I-@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, 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.
           Approved For Release 2001/04/02 : CIA-RDP96-00788ROO1200010033-3

Approved For Release 2001/04/02 : CIA-RDP96-00788ROO1200010033-3
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
DAT
WITNESS:.
br (21
NAMEj RANK GRADE
(,cm
URIT/ORG NIZATION
   6yu CL
POSITION
SIGNED
NAME,, RANK/GRADE
UNIT OffG-ANIZATION
  em J
POSITION
Approved For Release 2001/04/02 CIA-RDP96-00788ROO1200010033-3