SURVEILLANCE CONSENT AUTHORIZATION (Sanitized)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100150046-3
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 46
• Publication Date: September 3, 1986
• Content Type: CONT

Approved For Release 2 11RM P96-00789R002100150046-3
71-'~ EeK
SURVETLL??J~CE CONSENT AUTHORIZATION
SG1J
WARNING NOTICE: INTELLIGENCE SOURCES AND METHODS INVOLVED
SG1J SGFOIA3
I , born on
training and operational missions. I understand that as a BEACON, I will serve as
the focus for Remote Viewers. In consenting to this statement I acknowledge that
this authorization:
do voluntarily consent to per-orm duties as a BEACON (U) for Project
a. Will only pertain to training and actual SUN STREAK (U) missions and only
with my prior consent and knowledge.
b. Can be entirely or selectively withdrawn without question or penalty. To
do so, I need only to orally inform my immediate supervisor, the unit operations
officer or the project manager that I wish to withdraw my consent without further
explanation.
c. Will suppose the possibility of inadvertent surveillance of my most intimate
and personal thoughts and that such inadvertent surveillance will not be reported
nor become a matter of any official records and that the nature of this inadvertently
collected information will be held in strictest confidence.
d. Will at no time be construed as authorization, implied or stated, to conduct
any type of physical, technical or yet to be defined form. of surveillance without my
prior knowledge and consent.
This statement of authorization is executed in the presence of the witness whose
signature appears on this 3`1 day of ~EPt rlaec , 19 cQ(, , without
reservation, amendment or restriction and without coercion or implied and/or stated
i.nducements.//END//
Approved For Release 200
WARN NUtiCE: SENSITIVO
-00789RO0210015O 46GSNCE SOURCF,,, Af(a
10EJHOD9 IN'VOLYEQ