STATEMENT OF CONSENT: DIA SUN STREAK PROJECT PARTICIPANT

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 Approved For Release 200%(~8k0>               60023-2
 STATEMENT OF CONSENT
 DIA SUN STREAK PROJECT PARTICIPANT
 1.   (S/NOFORN/WNINTEL)                                                 voluntarily
 accept  assignment       to  the                                        and  fully
 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/NOFORN/WNINTEL)    The aim of the DSSP is to develop highly,
 skilled personnel who  are capable of conducting  professional  level
 intelligence/counterintelligence  operations   through              the  use of
 psychoenergetics  methodology.    Development  of DSSP  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   I
 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.
 NOT R F.ASABLE TO FOR ION NATIONALS
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160023-2
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160023-2
 h.    (S/NOFORN/WNINTEL)    I may  temporarily choose  not     to
 participate  in  the  project    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  DoD
 Directive  5240.1-R, I  consent   to  tape  recording, monitoring  and
 transcribing  of  all training and    operational  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
 noninstrusive  biomonitoring  activities     that are  necessary   for
 project mission accomplishment.
 5.   (U)   I hereby acknowledge receiving formal counseling concerning
 my assignment to DSSP.       Basic training and operational 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  the  Commander,  POG,  or  other  appropriate
 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.
 SG1J
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160023-2
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160023-2
 DATA REQUIRED BY THE PRIVACY ACT OF 1974  (5 U.S.C.   552a)
 1.   Authority:   Title  10,  U.S.C.  Section  801.2;  Title   44,  U.S.C.,
 Section 3101 and EO 9397.
 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.
 Approved For Release 2000/08/08 : CIA-RDP96-00789R002600160023-2