CIA-RDP96-00789R002100150057-1

Approved For Release 2001/03/07 - CIA-RDP96-00789R002100150057-1
CLORET
DATE
23 March 1981
GRILL FLAME VOLUNTEER SECURITY AGREEMENT
SGFOIA3
1. (U) I, LAWRENCE J. RICHARD
,
SSNE
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 punishable under
Title 18, Section 798, U.S.C. "Disclosure of Classified Information," 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 specifically authorized in
writing in each case by the appropriate agency 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 even after the termination of my services with the
United States Government.
4. (S) I take this obligation of my own free will, without any mental reservation
or purpose of evasion. I understand that as a GRILL FLAME volunteer the fact that
I possess psychic abilities is classified and I cannot divulge this fact by word,
conduct, or by any other means.
WITNESS:
Anderies A. atwater.
CPT
SIGNED:
Lawrence, Richard SFC/F7
NAME, RANK/GRADE
NAME, RANK/GRADE
H. USAINTSCOM
COD USAINSCOM CONUS MIGP
UNIT/ORGANIZATION
UNIT/ORGANIZATION
Trawing/Concepts
POSITION
POSITION
Analyst
Approved For Release 2001/03/07
01 /03107 |CIA-RDP96-00789R002100150057-1

1
Approved For Release 2001/03/07 : CIA-RDP96-00789R002100150057-1
DATA REQUIRED BY THE PRIVACY ACT OF 1974
(5 U.S.C. 552a)
1.
Authority: National Records Act, 44 U.S.C. 3102; E.O. 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-RDP96-00789R002100150057-1