GRILL FLAME SECURITY AGREEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200280011-8
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: September 5, 2003
• Sequence Number: 11
• Publication Date: December 19, 1979
• Content Type: STATEMENT

Approved For Release 1003/0009 : CIA-RDP96-00788 R001200280011-8
DATE X' ( ?_-r--
GRILL FLAME SECURITY AGREEMENT
SG1I
II `.understand that the highly
sensitive ana Hon 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.-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 foumberoisitotbebused
to identify the individual, and 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 2003/09/09 : CIA-RDP96-00788R001200280011-8
 Approved For Release 2003/09/09 : CIA-RDP96-00788R001200280011-8
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE"
WITNESS:
NAME, R C/GRADE ,
J?rID C s ?p r- lot) ri)) V.
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UNIT/ORGANIZATION
POSITION
UNIT/ORGANIZATION
POSITION
2
Approved For Release 2003/09/09 : CIA-RDP96-00788R001200280011-8
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