SECURITY TERMINATION STATEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200290005-4
• Release Decision: RIPPUB
• Original Classification: C
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: April 10, 2000
• Sequence Number: 5
• Publication Date: September 11, 1980
• Content Type: STATEMENT

Approved For Release 2000/08/07 : CIA-RDP96-00788R001200?~9 O0 -4
SECUR.tW`'tk4M-TT' t STAT:
Is the undersigned, fully realize the importance defense National Security
the requirement for the safeguarding of classified
the fulfillment of this obligation, I certify that*
as I understand the appropriate provisions of the Espionage Laws and
federal , nal Statutes applicable to the safeeguard:9x of classified
defense information or material.
b. I have surrendered and no longer have in my possessit ; or custody
t GRI"
any classified defense iMformaticn or material concerting Projec
FLAME (U).
c. I will not communicate or transmit in any
information concerning Project GRILL FLAME {U)
or age nOy.
r, classified defense
unauthorized person
d. I will report to the Assistant Chief of Staff t Intelligence, HQ,
Department of the Army, or his authorized representative, without delay,ANY
incident wher n an attempt is made by an unauthorized person to solicit
classified defense information concerning Project GrIfl Dame (U
e,. I k/have not received an oral debriefing.
gan F stso 4sident Office, PSF
Name Printed)
SAIL, SFRC
USA `1 A SI EC SPT BN$,,.PSFjk. GA
ISGCM
can-erg za L on
SGFOIA3
Approved For Release 2000/08/IIT: CIA=RDP96 U0788R001200290005-4