Approved For Release 2001/04/02 :'C IA-RDP96-00788 ROO 1200010056-8
 DATE 2-0 NML .1982_
 GRILL FLAME SECURITY AGREEMENT
                                    understand that the highly
 sen mation I have, or are about to
                               srt;
 aiv
 receive as part of the G ILL 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.p "Disclosure of Classified informat'Jon," June 1948,
 as amended.
 I do soleimily 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.
 1-@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 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 @s 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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Approved For Release 2001/04/02 : CIA-RDP96-00788ROO1200010056-8
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
DATE 2D
SGFOIA3
WITNESS:, SIGNED:
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                                 7
flmBo lumi GRADE NAME,, RANK/GRADE
IAQ I QS ccN-1
 Z ATT -off UNIT/ORGANIZATION
0 POSITION
ZHITION
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2
Approved For Release 2001/04/02 CIA-RDP96-00788ROO1200010056-8