CIA-RDP96-00788R001200010034-2

Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010034-2
SG11
DATE
7 OCT 82
GRILL FLAME SECURITY AGREEMENT
understand that the highly
I
(PLEASE PRINT)
sensitive and classified information I have, or am about to receive
as part of the GRILL FLAME Program belongs to the United States
Government. I understand that the disclosure of this information is
punishable under Title 18, Section 798, U.S.C., "Disclosure of
Classified Information," June 1948, as amended.
I do solemnly swear that I will never divulge, publish, or reveal
by word, conduct, or by any other means such classified information
or knowledge, except in the performance of my official duties, and
as specifically authorized in writing in each case by the appropriate
agency of the United States Government.
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 even after
the termination of my services with the United States Government.
I take this obligation of my own free will, without any mental
reservation or purpose of evasion.
DATA REQUIRED BY THE PRIVACY ACT OF 1974
(5 U.S.C. 552a)
1.
Authority:
National Records Act, 44 U.S.C. 3102; E.0. 9397,
Numbering System for Federal Accounts Relating to Individual Persons,
November 22, 1943.
2.
Principal Purpose: To maintain a record of those individuals
who have or have had access to GRILL FLAME information through the
use of their name and/or Social Security Number.
3.
Routine Uses: The Social Security Number is to be used to
identify the individual, and the information is to be retained
strictly within the program.
4. . Mandatory or Voluntary Disclosure: Information is disclosed on
a voluntary basis, but withholding information will render it
impossible to grant an individual access to or participation in the
Program.
Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010034-2

Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010034-2
GRILL FLAME SECURITY AGREEMENT CONTINUATION PAGE
DATE
7 OCT 82
SG11
WITNESS :
LR ROBERT JACHIM
NAME, RANK/GRADE
HQ INSCOM
UNIT/ORGANIZATION
PROJECT MANAGER
POSITION
SIGNED :
NAME, RANK/GRADE
9026 MIGP
UNIT/ORGANIZATION
POSITION
Deputy Commander
Approved For Release 2001/04/02 : CIA-RDP96-00788R001200010034-2