CIA-RDP96-00789R002100150026-5

Approved For Release 2001/03/07 : CIA-RDP96-00789R002100150026-5
DATE:
02 October 1981
GRILL FLAME VOLUNTEER SECURITY STATEMENT
SGFOIA3
1. (U) I,
ROBERT C. COWART
SSAN:
understand that the highly 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 disclosure of this information is pun-
ishable under Title 18, Section 798, U.S.C. "Disclosure of Classified Infor-
mation," June 1948 as amended.
2. (U) I do solemnly swear that I will never divulge, publish, or reveal
by word, conduct, or by any other means GRILL FLAME classified information
or knowledge, except in the performance of my official duties, and as spec-
ifically authorized in writing in each case by the appropriate agency of the
United States Government.
3. (U) I understand that no change in my assignement or employment will re-
lieve 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.
4. (U) I take this obligation of my own free will, without any mental reservation
or purpose of evasion.
WITNESS:
SIGNED:
Robert C. Camarão
JOSEPH W. MCMONEAGLE, CW2
ROBERT C. COWART, CPT
NAME, RANK/GRADE
NAME, RANK/GRADE
DET G, USAOG
DET G, USAOG
UNIT/ORGANIZATION
UNIT/ORGANIZATION
ANALYST
ANALYST
POSITION
POSITION
Approved For Release 2001/03/07 : CIA-RDP96-00789R002100150026-5

Approved For Release 2001/03/07 : CIA-RDP96-00789R002100150026-5
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 2001/03/07 : CIA-RDP96-00789R002100150026-5
.