Mey ] ene Ee TE ET RE a ST NN Be 8 REIT I ETOP CR 8 Approved For Release SEG FRET coroozoo: 500160009-1 DEFENSE INTELLIGENCE AGENCY WASHINGTON, D.C. 20301-6111 STATEMENT OF CONSENT DIA PROJECT PARTICIPANT Date: 1. (S/NOFORN/WNINTEL) TI, ee ae voluntarily accept assignment to the DIA ~~ and fully understand that: -— a. (S/NOFORN/WNINTEL) un. L_ Counsels have determined that the DDAP constitutes experimentat.on on human subjects. As required by Procedure 13 of DoD Directive 5240.1-R, the Deputy Secretary of Defense has granted approval for the conduct of DDAP activities. , b. (S/NOFORN/WNINTEL) The mission of the DDAP is to collect intelligence information through the use of pscychoenergetic methodology. Development and use of DDAP operational intelligence collection personnel will be accomplished with special training based on mission requirements in accordance with established procedures. C. (C/NOFORN) Assignments in DDAP 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 DDAP 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. 1 have been assured, however, that every effort will be made to preclude the adverse effects listed above on my career. e. (S/NOFORN/WNINTEL) I understand that 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. However, I understand further that potential for injury during some training cannot be conclusively ruled out. CLASSIFIED BY: DIA/DT DECLAS: OADR Approved For Release 2009/09/00 H0CIN-RIDPSE DU78BR001500160009-1 - VARMING NOTICES SENSITIVE ore me) or CLLIGENCE SOURCES, ANDI
LRT NTE! RE NESE APE EP NR A AA YR PA ARC SS SNORT GS TAD A ER BER _ << ee eee Eee Approved For Release SEG FRET. soreonoots00:60000-1 £. (S/NOFORN/WNINTEL) I may temporarily choose not to particpate in the project at specific times, or permanently discontinue participation without prejudicial effect. Termination will be affected by notifying the Commander, Prototype Operational Group (POG), DSSP, or his designated representative. 2. (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. 3. (C/NOFORN) 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. JI 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. “Signature (Witness) - Signature (Participant) retirement commen nt ani Ane orem i S49 irwetpannintatanitine Barithbeet ACE RR RNR ne 7 NR A Name, Rank/Grade Name, Rank/Grade Social Security Number ~~ Soctal Security Number Approved For Release 2003/09/09 : CIA-RDP96-00788R001500160009-1 SECRET
od EGR. coreeroots001s0008- Approved For Release hod DEFENSE INTELLIGENCE AGENCY WASHINGTON, D.C. 20301-6111 STATEMENT OF CONSENT DIA SUN STREAK PROJECT PARTICIPANT Date: lL. (S/NOFORN/WNINTEL) I, oe a voluntarily accept assignment to the DIA SUN STREAK PROJECT (DSSP) 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, the Deputy Secretary of Defense has-pranted approval for the conduct of DSSP activities. b. (S/NOFORN/WNINTEL) The mission of the DSSP is to collect intelligence information through the use of pscychoenergetic methodology. Development and use of DSSP operational intelligence collection personnel will be accomplished with special training based on mission requirements in accordance with established procedures. 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. e. (S/NOFORN/WNINTEL) I understand that 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. However, I understand further that potential for injury during some training cannot be conclusively ruled out. CLASSIFIED BY: DIA/DT DECLAS: OADR Approved For Release 2003/09/09'9 GVA 'RBPS6'00788R001500160009-1 | _ PING NOTICE: SENSITIVE Ql’ RE | A vELLIGENCE SOURCES ANU
Se eT ee TE MN, NE UE ras ER Ese coreeroo1s00160000-1 Approved For Release 2 . £. (S/NOFORN/WNINTEL) I may temporarily choose not to particpate in the project at specific times, or permanently discontinue participation without prejudicial effect. Termination will be affected by notifying the Commander, Prototype Operational Group (POG), DDAP, or his designated representative. 2. (S/NOFORN/WNINTEL) As a participant in DDAP, 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 DDAP 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 DDAP, with the understanding that these tape recordings and transcripts are property of the United States Government. 3.  (C/NOFORN) I hereby acknowledge receiving formal counseling concerning my assignment to DDAP."° 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 DDAP is voluntary and that at my request I may at any time be reassigned without fear of adverse personnel action. “Signature (Participant) — “Name, Rank/Grade — Name, Rank/Grade “Social Security Number “Social Security Number — Approved For Release 2003/09/09 : CIA-RDP96-00788R0N01500160009-1 SECRET