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: 
September 1, 1980
Content Type: 
PDF icon CIA-RDP96-00788R001200280031-6.pdf99.99 KB
Approved For Release 2000/08/07 : CIA'-RDP96-00788R001200280031-6 17 - 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-binding upon me even after the termination ofmy 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) I, /Z ,9f 2:'-/l , 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. 1. Authority: 'National Records Act, 44 U.S.C. 3102; E.O. 9397, Numbering System for Federal Accounts Relating to Individual Personsl, November 22, 1.943. 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-RDP96-00788R001200280031-6 Approved For Release 2000/08/07 : CIA-RDP96-00788R001200280031-6 GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE DATE _,f CT. > l`~ G7 WITNESS. g)-A~ (L4 Crc. j D $r'I. vl~+rw r UNItTbi ANcam'z?.'i'1:ON UNIT ORGANAT+.ON Approved For Reida`se`2000/08/07: CIA RDP96~007$ p0120028,OQ. -6