STATEMENT OF CONSENT: DIA SUN STREAK PROJECT PARTICIPANT

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Body:  Approved For Release 200
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 8002600160025-0
 DEFENSE INTELLIGENCE AGENCY
 WASHINGTON, D.C. 20301-6111
 STATEMENT OF CONSENT
 DIA SUN STREAK PROJECT PARTICIPANT
 SG1J
 Date: ?8 t4AQc'f  190
 1.   (S/NOFORN/WNINTEL)    I,                        voluntarily
 accept assignment  to the DI                    ME&S-TS-PT and fully
 understand that:
 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.
 b.   (S/NOFOR.N/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
 L~"SABLE TO FOREIGN NATIONALS DECLAS :   OAD
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 DP96-00789R002600160025-0
 1.b.   (S/NOFORN/WNTNTEL)   I may temporarily choose not  to perform
 PE    at  specific  times,  or  permanently  discontinue  participation
 without      prejudicial  effect.   Termination  will  be 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/NOFOR.N/WNINTEL)    I  further  consent  to  participate    in  any
 nonintrusive biomonitoring activities that are necessary for project
 mission accomplishment.
 5.   (1J) 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
 of adverse personnel action.
 SGFOIA3
 Signature:
 SGFOIA                                                                            3
 Approved For Release      &     I      96-00789R002600160025-0
 Approved For Release 20M109f0Y: CA RDP96-00789R002600160025-0
 DATA REQUIRED BY THE PRIVACY ACT OF' 1974 (5 U.S.C.   552a)
 1.   Authority:   Title 10, 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 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.
 L1P -007898002600160025-0
 Approved For Release 20    E                       PI