GRILL FLAME SECURITY AGREEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200280005-5
• Release Decision: RIFPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: April 6, 2000
• Sequence Number: 5
• Publication Date: November 1, 1979
• Content Type: STATEMENT

Approved For Release 2000/08/07 : CIA-RDP96-00788R00120028-Cry
DATE : Z AC M h.IA i el l
GRILL FLJARE SECURITY AGREEMENT
I, _hI~R1a~ 1~?~c-`-9, ~ understand that the highly sensitive
and. classified information II h .ve, or a about to receive as part of the
GRILL FLAME Program belongs to the United. States Government. I understand
that disclosure of this information is punishable under Title 18, Section
798, U.S.C. "Disclosure of Classified Information," June 1.948 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
any 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
Systermfor Federal Accounts Relating to Individual Persons, November 22, 1943.
2. Principal Purpose: To maintain a record of those individuals who have
or have had access to GRILL FLAME' information through the use of their name
arid./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.
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-RDP96-00788R001200280005-
 Approved For Release 2000/08/07 : CIA-RDP96-00788R001200280005-5
GRILL FLAME SECURITY AGREEM NT CONTINUATION PAGE
DATE 1U Sk H19
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NAME, ANK/GRADE
UN T/ORGGANIZATION
NS loll PI_ aArr
POSITSOTI Pile, f
rYt A (X% N t, _ a L.rC
NAME, RANK/GRADE
u SAZT D ETA
UNIT/ORGANIZATION
POSITION
Approved For Release 2000/08/07 : CIA-RDP96-00788R001200280005-5