TERMINATION SECRECY AGREEMENT
CIA-STARGATE
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This document is a termination secrecy agreement from the US Army Intelligence and Security Command. It states that the individual acknowledges their exposure to classified sensitive information related to "Grill Flame" and agrees not to publish or reveal this information. They also certify that they no longer possess any classified information related to Grill Flame and that they have a continuing responsibility to protect it even after their association with the government ends. Additionally, the document informs the individual that their Social Security Account Number is being solicited voluntarily for identification purposes.
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Body: Approved For Release 2000/08/07 : CIA-RDP96-00788R001200290004-5
DEPARTMENT OF THE ARMY
US ARMY INTELLIGENCE AND SECURITY COMMAND
FORT GEORGE G. MEADE, MARYLAND 20755
TERMINATION SECRECY AGREEMENT
CLASSIFIED. SENSITIVE GRILL FLAME INFORMATION
of evasion 'and in the absence of duress.
SG1J
1. I acknowledge that by virtue of my._duties,'T*havereceived or been
exposed to classified sensitive Grill Flame information,~the unauthorized
disclosure or negligent handling of which could adversely affect the
interests of the United States Government. I am aware that the unauthorized
disclosure of classified information is prohibited by the Espionage
Laws (Title 18, U. S. Code, Sections 792-798) and the Internal Security Act
of 1950, Section'-19, P. L. 831, (81st Congress) and that a violation of
these laws may subject me to prosecution by the U...S.. Government.
2. I hereby reaffirm my?-pledge that I will. never publish or reveal, by
any means classified sensitive Grill Flame information. I agree further
that I do not now, nor:.wi11.I. ever,-possess, any right, interest, title or
.claim whatsoever to such information. I recognize the full.and vested
property right of the United States in such.matters.
3. I,-'certify that I have surrendered and no:longer have in my possession
or custody any classified Grill Flame information or material acquired
as a result of this association.
4. .I further,. acknowledge and agree that I have a continuing individual
responsibility to'tho.United States Government for-the protection of
classified sensitive Grill Flame information and that the termination from
this relationship: with my-employer-and/or the United States Government does
not relieve-me of my obligations under this agreement or any, other previously
executed Secrecy Agreements. I:understand that I will not be relieved of
these obligations except when specifically advised in writing by the
sponsoring activity of the U. S. Government.
5. I understand that this document mayhe,retained by the U. S. Government
for its future use in any manner wi-thif:the.scope of this, agreement.
6. I take this obligation freely, without any mental reservation or purpose
DATE f~ a ; /'?12
WITNE S' S GNATURE
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Apprb~i or~a~ 7(00/08/07: CIA-R
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Approved For Release 2000/08/07 : CIA-RDP96-00788R001200290004-5
The Privacy Act, Public Law 93-579, requires that
Federal Agencies inform individuals when they are asked to
provide their Social Security Account Number (SSN) whether
the disclosure is mandatory or voluntary, by what authority
such number is solicited, and what uses will be made of the
SSN. Disclosure by you of your SSN-is voluntary. The
authority for this solicitation is Executive Order 9397.
The SSN is used as an identifier in removing your authorized
access to classified information. Failure to provide this
SSN may-delay-the processing required in accessing authority
removal.
Approved For Release 2000/08/07 : CIA-RDP96-00788R001200290004-5