Document Type: 
Document Number (FOIA) /ESDN (CREST): 
Release Decision: 
Original Classification: 
Document Page Count: 
Document Creation Date: 
November 4, 2016
Document Release Date: 
December 7, 1998
Sequence Number: 
Case Number: 
Publication Date: 
September 4, 1981
Content Type: 
PDF icon CIA-RDP96-00788R001200010005-4.pdf127.68 KB
Approved For Release 2001/04/02 : CIA-RDP96-00T88R001200010005-4 DATE understand that the highly sensitive and c ass a in ormation 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 796, ' 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 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 employe sent will 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-RDP96-00788R001200010005-4 Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010005-4 GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE DATE J I l WITNESS: NAME, RANK/GRADE UNIT/ORGANIZATION SIGNED: Q,/d e NAME, RANK GRADE UNITY ly T I U. IT' C. ORGANIZATION Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010005-4