GRILL FLAME VOLUNTEER SECURITY AGREEMENT (LAWRENCE J. RICKARD)

• Document Type: CREST
• Collection: STARGATE
• Document Number (FOIA) /ESDN (CREST): CIA-RDP96-00789R002100150057-1
• Release Decision: RIPPUB
• Original Classification: S
• Document Page Count: 2
• Document Creation Date: November 4, 2016
• Document Release Date: December 4, 1998
• Sequence Number: 57
• Publication Date: March 23, 1981
• Content Type: CONT

Approved For Release 2~0;'N~~~~:C~1~-,~DP96-007898002100150057-1
r K-- ~,
vA~! E_ ~ 3 /t'~Rw~/ ~al
GRILL FLAME VOLUNTEER SECURITY AGREEMENT S G F OIA3
1. (U) I , ~iAtt/'pp!_'n/c?~ ~ ~ic /T'~~~ . .... ~, SSN
understand that the highly sensitive and classified in orma~~.on gave ar ~~
am about to receive as part of the GRIL.I_ FLAME Program belongs to the United States
Government, :C understand that disclosure of this information is punishable under
1-it.le 18, Section ~9C, U.S,C. "G~iscl.osure of Classified Information," June 19413 as
amended.
2. (U) T do solemnly swear that I will never divulge, publish, or reveal by
word, conduct, or by any other means GRILL F~LAh9E classified information or knowledge,
except in tl~e performance of my official .duties, and as specifical.Iy authorized in
writing in each case by the appropriate agcancy of the United States Government.
3. (U) 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 oven after the termination of my services with the
United States Government.
4. (S) I take tf7is obligation of my own Free will, without any mental reservation
or purpose off' evasion, I understand that as a GRILL FLAME volunteer the fact that
T possess psychic abilities is classified and I cannot divulge this fact by word,
conduct, or by any other means.
NAME, RANK/Gi~ADE
t1~lIT%ORGANIZATION ~~~
~b ~_ ~s~.7~vs~p.tit cdNvs ~~~'i~
s~.. ...._a .aK,.._,...~..,.~._._~....a
UNIT ORGANIZATION
POSITIPIN
Approved For Release 240:~3~ ~IR~P96-007898002100150057-1
 Approved For Release 2001/03/07 :CIA-RDP96-007898002100150057-1
[DATA REQUIRED 13Y TF~E f"RIUAC~' ACT Of~ 1974
(S U.S.C. 552a)
1? Authority: National Rewords Act, 44 U.S.C. 3102; E.U. 9397, Nurnberi.ng
Syater~~ for rcderal Accounts Relat.inci to Individual Persons, November 22, 1943.
7_. Prinwi`~al Purpose: To maintain a record of tho;~e individuals who have
or hav~.~ had access to GRIt_L FLAME information t:hrow.rgh the use of th~:ir Home
and/or Socir3l Srctarity Numl~er<
3. Routine Uses: Tf~e Social Security Number is to be used to identify the
iruJiv.i.dual, and tt7c information is to be retained strictly Within the Pro~z?am.
4. Mandatory or Voluntary Disclosure: Information is disclosed on a
ualuntary basis, taut withholding information will render it impossible to
grant a.n individual access 'to or participation in the Program.
Approved For Release 2001/03/07 :CIA-RDP96-007898002100150057-1