STATEMENT OF CONSENT: DIA SUN STREAK PROJECT PARTICIPANT

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Body:  Approved For Release              -00789R002600160012-4
 DEFENSE INTELLIGENCE AGENCY
 WASHINGTON, D.C. 20301-6111
 STATEMENT OF CONSENT
 DIA SUN STREAK PROJECT PARTICIPANT
 SG1J
 a.    (S/NOFORN/WNINTEL) The  DIA and  DoD  General  Counsels  have
 determined  that  the  DSSP  constitutes  experimentation  on  human
 subjects.   As required by Procedure  13 of DoD Directive 5240.1-R,
 approval  for project  activities   has  been  granted  by the Deputy
 Secretary of Defense.
 understand that:
 Date:                11-10
 1.   (S/NOFORN/WNINTEL)   I,                                           voluntarily
 accept assignment  to the DIA                                   and  fully
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 b.   (S/NOFORN/WNINTEL)   The aim of  the DSSP is  to develop highly
 skilled personnel who are capable of conducting professional                 level
 intelligence/counterintelligence   operations through           use  of
 psychoenergetic methodology.   Development of DSSP personnel will be
 accomplished with special training based on mission requirements.
 c.    (C/NOFORN)    Assignments in   DSSP  are  governed    by  the
 sensitivity and degree of expertise required  for  the position.                 I
 will be assigned in accordance with my capabilities and experience,
 regardless of my rank or previous position.   Due to the nature of
 training involved,  the duration of my participation       is  indefinite.
 Records of my  involvement will be available to project personnel,
 but otherwise protected under project security measures.
 d.    (C/NOFORN) The    primary  consideration  in  any      career
 development  or  assignment action  will  be  DSSP  mission  and
 operational  requirements.     I   understand that  exemption,
 interruption,  or delay  in normal career development patterns--such
 as  branch  schooling and   assignment  opportunities--may    prejudice
 future promotion and  assignment   potential.   I       have been assured,
 however,  that every effort will be made  to  preclude the      adverse
 effects listed above on my career.
 2.  (U)   PSYCHOENERGETICS  (PE)  include various  processes  by  which
 individuals    psychically  interact  with  objects,  locations,    and
 organisms.
 a.    (U)  I understand that while there   is no demonstrated risk
 of permanent or temporary injury  (including physical,  psychological
 and/or  damage  to  participants' reputation)  to    project  personnel
 beyond risks   to which  they would   ordinarily be  exposed  in  their
 daily lives, the potential for injury during some training cannot be
 conclusively ruled out.                           CLASSIFIED BY:  DIA, DT
 Il III 1 LL
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 h.   (S/NOFORN/WNINTEL)   I may temporarily choose not  to perform
 PE    at  specific  times,  or  permanently  discontinue  participation
 without    prejudicial  effect.   Termination  will  he   affected  by
 notifying the DSSP Manager or     in his absence, his designated    acting
 DSSP Manager.
 3.    (S/NOFORN/WNINTEL) As a participant  in DSSP,  and  IAW
 I  consent  to  tape  recording,  monitoring  and  transcribing  of all
 operational and   training  interviews  in which I am  involved     as an
 integral  part  of  the  DSSP  mission.    I. understand that  these
 recordings  are  subject  to being monitored   and/or  transcribed  by
 third parties not otherwise involved  in operations or     training.   I
 waive any claim or right of ownership to all       tape recordings and
 transcripts made  in  conjunction with DSSP,   with the understanding
 that  these tape  recordings  and  transcripts are   property  of  the
 United States Government.
 4,   (S/NOFORN/WNINTEL)   I  further 'consent  to  participate in  any
 nonintrusive biomonitoring activities that are necessary for project
 mission accomplishment.
 5.   (U)  I hereby acknowledge receiving formal counseling concerning
 my assignment  to DSSP.   Basic  operational. and  training procedures
 and  their  purposes,  as well as  attendant  discomforts,  risks, and
 benefits have been explained to me.   I understand that I may at any
 time ask questions of project personnel relating to areas unclear to
 me.   I further understand that my participation in DSSP is voluntary
 and that at my request I may at any time be reassigned without fear
 ofSI        personnel action.
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 Unit Organization
 Position
 Unit/Organization
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 Approved For Releas -JMOM/Of~:"MP!-RDP96-00789ROO2600160012-4
 DATA REQUIRED BY THE PRIVACY ACT OF 1.974 (5 U.S.C.   552a)
 1.   Authority:   Title 1.0, U.S.C. Section 3012.
 2.   Principal Purpose:   To maintain  a record of  those individuals
 who have executed statements of informed consent as participants  in
 DSSP.
 3.   Routine Uses:   The  Social.  Security  Number  is to he 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.
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 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160012-4
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160012-4