GRILL FLAME SECURITY AGREEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200010044-1
• Release Decision: RIFPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: December 7, 1998
• Sequence Number: 44
• Publication Date: May 1, 1981
• Content Type: CONT

Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010044-1
DATE L MP1Y 1961.
I, - ROEF- T Y. JACVA , understand that the highly
sens1Trve andd classiried 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 uncl.r 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.
I1understand 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 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-RDP96-00788R001200010044-1
 Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010044-1
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
DATE 1.. MA,( l g8.L
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UNIT ORGANIZAATIOI
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POSITION
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UNIT ORGANIZATION
POSITION
Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010044-1