CIA-RDP96-00789R002100150018-4

NAME ( last, Approved For
For le initial)
Release 2003/09/09 : CIA-RDP96-00789R002100150018-4
COLEMAN, ARLILLIAN
ORGANIZATION
DOD-IG
Telephone Number
693-0123
GRADE
q SGFOIA3
SSN:
JOB TITLE
AUDITOR.
I CERTIFY THAT THE ABOVE-NAMED INDIVIDUAL MEETS THE REQUIREMENTS FOR ACCESS
TO CLASSIFIED DEFENSE INFORMATION INDICATED BELOW.
ACCESS AUTHORIZATION TO CLASSIFIED INFORMATION
PROJECT AUTHORIZED :
SUN STREAK
DATE:
8 Cups 88
Authorized by
Du Varona (DT)
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 18, USC, Sections 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 laws
of the United States, unless specifically authorized in writing in each and
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 information I receive is provided only to persons
specially 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.
4.
I
understand that
in
the event I am reassigned from my present
position, I will notify the office granting access to the project indicated
for briefing on actions deemed necessary at the time.
SIGNATURE OF BRIEFING OFFICER
SIGNATURE OF INDIVIDUAL BRIEFED
april 8,1988 arlillian Coleman
DATE
8APR 88
SG1J
r
porfier
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Approved For Release 2003/09/09 : CIA-RDP96-00789R002100150018-4
DEBRIEFING AGREEMENT
1.
I hereby reaffirm my acknowledgement of being briefed on the DIA SUN
STREAK Project, the text of which appears on the reverse of this
form.
2.
£
I certify I have surrendered and no longer have in my possession or
custody any classified information or material acquired as a result of this
association.
3.
I further acknowledge and agree I have a continuing individual respon-
sibility to the United States Government for the protection of such infor-
mation and termination of access to information concerning this project
does not relieve me of my obligations under this oath or any other
previously executed agreements or those imposed by law.
4.
I
take this obligation
without any mental
reservation or
purpose of evasion and in absence of duress.
SG1J
SIGNATURE OF DEBRIEFER
SIGNATURE OF ACKNOWLEDGER
arlillian Coleman
DATE:
13 Apr 88
PRIVACY ACT STATEMENT
AUTHORITY : :
10 U.S.C. 8012; 44 U.S.C. 3101 and EO 9397.
PRINCIPAL
PURPOSE:
FOR GRANTING ACCESS TO A
CLASSIFIED
PROJECT AND
-
AUTHORIZED ACCESS TO PROJECT DOCUMENTATION.
ROUTINE USE:
TO RECORD PROJECT ACCESS.
USE OF SSN IS
NECESSARY TO MAKE
POSITIVE IDENTIFICATION OF THE INDIVIDUAL AND RECORDS.
DISCLOSURE IS VOLUNTARY :
FAILURE TO
PROVIDE THE
INFORMATION AND SSN WILL
RESULT IN ACCESS BEING DENIED.
:
Approved For Release 2003/09/09 : CIA-RDP96-00789R002100150018-4