INDOCTRINATION AGREEMENT
Originator: CIA
Document date: 04/01/1976
Document type: PAPER - TEXTUAL DOCUMENT

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2023 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992

69102

6T 70H C

MED INDOCTRINATION AGREEMENT

Background Use y

Do Not Reproduce

I have been advised of the procedures to follow in order to determine

the identity of individuals who have been approved for access to MED) 2L

Restrictions, the current Hazardous Activities Restrictions and how to

resolve questions which may arise under this agreement.

I have read and understand the contents of this oath and voluntarily

affix my signature hereto with the full knowledge that this oath was

executed for the mutual benefit of myself and the United States

Government, and that it will be retained in the files of the MCO for

its future

use or for reference by me at any time in the future.

In witness whereof, I have set my hand this Ist day of Apr.1976.

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TRIGRAPHS: (MED) (CLI) (BRI)

LEVEL 3

GRADE/RANK

SERVICE

_ TYPED NAME

SSN

Clave Broke fuce!

Signature

Clare Booth Luce

064-18-3062

ORGANIZATION

WH/PFIAB

Wätnessed by (Mary Louise Odom)

ignature,of Witness

SECRET

(when filled in)

Chi Privacy Act, Public Law 93-579, requires that Federal agencies infom

Iralividuals when they are asked to grovide their Social Security Account

inser (SSN) whether the disclosure is mandatory or voluntary, by what authority

such number is solicited and what uses will be made of the SSY. Disclosure by

you of your SSY is voluncary. The asthority for this solicitation is Excoutive

Order 9397. The SSi is used as an ilentifier in quests for access certification.

Failure to provide your SSY may delay the processing required to obtain a

gecurity access certification.

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