SGI J
I
'
"
Approved For Release 2001/03/07
: CIA-RI)P96-00789R0021 001 50040-9
"NAME
(last,
first,
middle
initial)
T™pAHT74Trnw
SGFOIA3
ORGANIZATION
SSPD, MI Bn(S)
,
902d MIG,
Ft Meade, MD
JOB TITLE
Secretary
.
T CERTIFY THAT THE ABOVE-NAMED
INDIVIDUAL MEETS
THE REQUIREMENTS
FOR ACCESS
TO CLASSIFIED DEFENSE
INFORMATION
INDICATED BELOW.
ACCESS AUTHORIZATION TO CLASSIFIED
INFORMATION
PROJECT AUTHORIZED:
SUN STREAK
Authorized
b y
QtC
0U7-0V
DATE:
16 MAI
BR IEFI NG
ACI<NOWLEDGEMENT
1.
I
acknowledge
I
have
been
briefed
concerning
the
project
indicated
above.
Having
received
highly
classified
information
relating
to
the
United
States
Government,
I
am
aware
the
unauthorized
disclosure
could
seriously
damage
the
national
security
and
the
transmission
or
revelation
of
such
information
to unauthorized
persons
could
subject me
to prosecu-
tion
under
the Espionage
Laws
(Title
18,
USC,
Sections
793,
794
and
798)
or
other
applicable
laws
including
the Uniform Code
of Military
Justice.
2.
I
do
solemnly
swear:
or
affirm
that
I
will
never
divulge,
publish,
or
reveal
by
word,
conduct,
or
any
other
means
such
information
or
knowledge
except
when necessary
to
do
so
in
the
performance
of
my
official
duties
in
connection with
the project
indicated above
and
in
accordance
with
the
laws
of
the
United
States,
unless
specifically
authorized
in writing
in
each
and
every
case
by
a
duly
authorized
representative
of
the
United
States
Government.
I
take
this
obligation
freely,
without
any
mental
reservation
or
purpose
of
evasion
and
in absence
of duress.
3.
I
acknowledge
that
information
I
receive
is
provided
only
to
persons
specially
approved
for
the
project
and
that
the
information
may
not
be
further
divulged
without
specific
prior
written
approval
from
the
Project
Headquarters.
All
access
is
restricted
to
"must-know"
based
upon
one's
present
position
of
functional
use.
4.
I
understand
that
in
the
event
I
am
reassigned
from
my
present
position,
I
will notify
the office granting
access
to
the
project
indicated
for
briefing
or
actions deemed necessary
at
the
time.
SG1J
SIGNATURE OF BRIEFING OFFICER
SIGNATURE OF
INDIVIDUAL BRIEFED
Approved For Release 2001/03/07
: CIA-RDP96-00789R0021 001 50040-9
Approved For Release 2001/03/07
: CIA-RDP96-00789R0021 001 50040-9
DEBRIEFING AGREEMENT
1.
I
hereby
reaffirm my
acknowledgement
of
being
briefed
on
the
DIA
SUN
STREAK Project,
the
text
of which
appears
on
the reverse
of
this
form.
I
certify
I
have
surrendered
and
no
longer
have
in
my
possession
or
custody
any classified
information
or material
acquired
as
a
result
of
this
association.
3.
I
further
acknowledge
and
agree
I
have
a continuing
individual respon
:
sibility
to
the United
States Government
for
the
protection
of
such
in
mation
and
termination
of
access
to
information
coftcernifig
is
P
J
does
not
relieve
me
of
my
obligations
under
this
oath
or
any
other
previously executed
agreements
or
those
imposed
by
law.
4.
I
take
this
obligation
freely,
without
any
mental
reservation
or
purpose
of
evasion
and
in absence
of
duress.
L
Ilf
I
I
SIGNATURE OF DEBRIEFER
SIGNATURE OF ACKNOWLEDGER
DATE:
AUTHORITY:
PRIVACY ACT STATEMENT
10 U.S.C.
8012;
44 U.S.C.
3101
and
EO
9397.
PRINCIPAL
PURPOSE:
FOR
GRANTING
ACCESS
TO
A
CLASSIFIED
PROJECT
AND
TO
AUTHORIZED ACCESS
TO PROJECT DOCUMENTATION.
ROUTINE
USE:
TO RECORD
PROJECT
ACCESS.
USE
OF
SSN
IS
NECESSARY
TO MAKE
POSITIVE
IDENTIFICATION OF THE
INDIVIDUAL AND RECORDS.
DISCLOSURE
IS VOLUNTARY:
FAILURE
TO
PROVIDE
THE
INFORMATION AND
SSN WILL
RESULT
IN ACCESS BEING DENIED.
Approved For Release 2001/03/07
: CIA-RDP96-00789R0021 001 50040-9