Document Type: 
Document Number (FOIA) /ESDN (CREST): 
Release Decision: 
Original Classification: 
Document Page Count: 
Document Creation Date: 
November 4, 2016
Document Release Date: 
April 6, 2000
Sequence Number: 
Case Number: 
Publication Date: 
November 4, 1980
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PDF icon CIA-RDP96-00788R001200280026-2.pdf96.96 KB
Approved For Release 2000/08/07': CIA-RDP96-00788ROO1200280026-2 DATE'S GRILL FLAME SECURITY AGREEMENT I, L IL ~f ~//V`/,~(// understand that the highly sensitive and classified information 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 798, 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 employment will relieve-me of my obligation under this agreement and that the provisions of this agreement will remain.-h.inding 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 2000/08/07 : CIA-RDP96-00788ROO1200280026-2 Approved For Release 2000/08/07 : CIA-RDP96-00788R001200280026-2 GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE" DATE (I kR 9e) WITNESS LJNIT7QRGANI IiTTON SIGNED: NAME, RAN It/GRADE UNIT ORGANIZATION POSITION POSITION 2 Approved For Release 2000/08/07 CIA-RDP96-00788R001200280026-2