GRILL FLAME SECURITY AGREEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200280013-6
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: April 6, 2000
• Sequence Number: 13
• Publication Date: June 30, 1980
• Content Type: STATEMENT

Approved For Release 2000/08/07 : CIA=RDP96-00788R001200280013-6
DATEn
re ive 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.
sen t ve nd clash information I have, or are about to
I, 2..-. C= understand that the highly
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 ...awn . 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 Personal, 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-RDP96-00788R001200280013-6
 Approved For Release 2000/08/07 : CIA-RDP96-00788R001200280013-6
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
DATE
NAME, RANK GRADE
UNIT ORGANIZA' ION
POSITION
UNIT ORGANIZATION
CQ.2
POSITION
Approved For Release 2000/08/07 : CIA-RDP96-90788 R001200280013-6
WITNESS ,b