BRIEFING ACKNOWLEDGEMENT FORM (BLANK)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002600220028-0
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 1
• Document Creation Date: November 4, 2016
• Document Release Date: November 3, 1998
• Sequence Number: 28
• Content Type: FORM

NAME (las~pp~OV~~ ~Fc34'il~~l~:~ds~'~0`(~/b~/08 : G~~c~'~T~SNI89R0026
GFADF SSN: JOR TITLE
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I CERTIFY THAT THE ABOVE-NAMED INDIVIDUAL MFETS THE RFQI~IREMFNTS FOR ACCF.~.S
TO CLASSIFIED DEFENSE INFOR~9ATION INDICATED BELOW.
ACCESS ACiTHORIZATIC~N TO CLASSIFIED INFORMATION
PROJECT AUTHORIZED: SUN STREAK DATE:
Authorized by
BRIEFING ACKNOWLEDGEMENT
1. I acknowledge I have been briefed concerning the project indicated
above. Having received highly classified information relating to the
united States Government, I am aware the-unauthorized disclosure could
seriously damage the national security and the transmission or revelation
of such information to unauthorized persons could subject me to prosecu-
tion under the Espionage Laws (Title lE, USC, Section= 793, 794 and 798) or
other applicable laws including the Uniform Code of Military Justice.
2. I do solemnly swear or affirm that I will never divulge, publish, or
reveal by word, conduct, or any other means such information or knowledge.
except when necessary to do so in the performance of my official duties in
connection with the project indicated above and in accordance with the law
of the United States, unless specifically authorized in wri.zing in each an
.every case by a duly authorized representative of the United States
!Government. I take this obligation freely, without any mental reservation
~or purpose of evasion and in absence of duress.
3. I acknowledge that informatior- I receive is proc?ided only to persons
special~,y approved for the project and that.the information may not be
further divulged without specific prior written approval from the Project
Headquarters. All access is restricted to "must-know" based upon one's
present. position of functional use.
9. I understand that in the event I am reassigned from my present
position, I will notify the office granting access to the project indicate
for briefing on actions deemed necessary at the time.
SIGNATURE 4F BRIEFING OFFICER ~SIG2:ATUF.E OF INDIVIDUAL BRIEFED
Apprgved For Release 2000/08/08 :CIA-RDP96-007898002600220028-0