Approved For Release 2001/04/02 CIA-RDP96-00788RO01 200010016-2
                               DATE 7A,_@
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      GRILL FLAME SECURITY AGREEMENT
                              P6_1 rCA understand that the highly
      T -_ --tion I have, or are about to
      sensltfve and class,@fied E@ 6rif5
      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 CInssified 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
      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 eq@loyment
      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.
           .1-take this obligation of.my...own-free will,. without, any mental.
      reservation or purpose of evasion. -
                      DATA REQUIRED BY THE PRIV ACY 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 FLA14E information
      through the use of their name and/or Social Security Number.
      3. Routine Uses: The Social Security Number js to be used
      to identify the individual, and the inforination 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-RDP96-00788ROO1200010016-2

      

Approved For Release 2001/04/02 CIA-RDP96-00788ROO1200010016-2
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
DAT's
WITNESS:
SIGNED:
NAME,, P.ANK/GRADE NAME,, RANk/-GkADE
...........
U917r7ORGANIZATY-off- Ufff-T-)'ORGANIZATION
POSITION POSITION
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Approved For Re.lease 2001/04/02 CIA-RDP96-00788ROO1200010016-2