TERMINATION SECRECY AGREEMENT

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00788R001200290002-7
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: April 10, 2000
• Sequence Number: 2
• Publication Date: April 1, 1982
• Content Type: STATEMENT

Approved For Release 2000/08/07 : CIA-RDP96-00788R001200290002-7
DEPARTMENT OF THE ARMY
US ARMY INTELLIGENCE AND SECURITY COMMAND
FORT GEORGE G. MEADE, MARYLAND 20755
TERMINATION SECRECY AGREEMENT
CLASSIFIED SENSITIVE GRILL FLAME INFORMATION
acknowledge that by virtue of my duties, I have received or'been
exposed-'to classified sensitive Grill Flame information,, the_--un'authorized
disclosure or negligent handling of which could adversely affect the
interests of the United StatesGovernment.:.I am aware that the unauthorized
disclosure of classified`' hfbrmation is prohibited by the Espionage
aurs (Title' 18;'U. S. Code, Sections 792-798) and the Internal Security Act
"Of-1950,-Section 19, P. L. 831, (81'st Congress)_and that a violation of
these laws may subject me to prosecution by the U. S. Government
2. 1 hereby reaffirm-my pledge that !"will never publish or reveal-by
any means classified sensitive Grih-Flame information. I agree further
that I do not now,-nor-will I ever,-.pbssess.any right, interest,_.title or
claim whatsoever;to such information.- I recognize the-,full-and vested
.,property right of the United States in such matters.
3. I certify that 'I have-surrendered and no longer have in my possession
or custody any classified Grill Flame information or material acquired,
as a result-of this association.
.4.. I further acknowledge and-agree that I have a continuing individual
responsibility to the United States Government for the protection of
classified sensitive Grill-Flame information:andthat the 'termination from
this relationship with my employer and/or the-United States_Government'does
not relieve me of my obligations under this agreement or any-other previously
.executed Secrecy Agreements. I understand that I will not be relieved of
these.obligations except when specifically advised in writing by the
sponsoring activity of the U. S. Government.
5. I'understand that, this document may be retained by the U. S,Government
for its future use irf any manner within the scope of this agreement:
6. I take this obligation freely, without any mental reservation or purpose
of evasion and. . in the absence of, duress..
DATE -q TA' h 2.. SIGNATURE i ,
PRINTED NAME & SSN (See Reverse)
A9,a / 4, 4?wsT or* * =
SGFOIA3
4 i ed'WWWe1e 2000/08/07 : CI` 9 W-8b~ 88 R001200290002-7
JDscY4 e,.). Mc_Akt)A36A-LL_C- 5S 40, 942
 Approved For Release 2000/08/07 : CIA-RDP96-00788R001200290002-7
The Privacy Act, Public Law 93-579, requires that
Federal Agencies inform individuals when they are asked to
provide their Social Security Account Number (SSN) whether
the disclosure is mandatory or voluntary, by what authority
such number is solicited, and what uses will be made of the
SSN. Disclosure by you of your SSN-is voluntary. The.
authority for this solicitation is Executive Order 9397.
The SSN is used as an identifier in removing your authorized
access to classified information. Failure. to provide this
SSN may-delay-the processing:required in-accessing authority
removal.
Approved For Release 2000/08/07 : CIA-RDP96-00788R001200290002-7