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104-10120-10646 JFK Assassination Records Archives 1 (3/23/1976)

handle is hein.jfk/jfkarch10938 and id is 1 raw text is: 104-10120-10646 U n2oao' 1iE~Hh 1. I acknowledge that by virtue of my duties I have been exposed to or the recipient of classified information, which, in itself, or by the implications drawn from it, is highly sen- sitive and its unauthorized disclosure or negligent handling could adversely affect the interests of the United States. I am aware that the unauthorized disclosure of classified information is prohibited by the Espionage Laws (18 U.S.C., Sections 793, 794 and 798) and that a vi- olation of these laws may subject me to prosecution by the U. S. Government. 2. I hereby reaffirm my pledge that I will never publish or reveal by any means such information. I agree further that I do not now, nor will I ever, possess any right, interest, title or claim whatsoever to such information. I recognize the full and vested property right of the United States in such matters. 3. 1 certify that I have surrendered and no longer have in my possession or custody any classified information or material acquired as a result of this association. 4. I further acknowledge and agree that I have a continuing individual responsibility to the United States Government for the protection of such information and that the termina- tion from this relationship with my employer and/or the United States Government does not relieve me of my obligations under this oath or any other previously executed Secrecy Agree- ments. I understand that I will not be relieved of these obligations except when specifically advised in writing by the sponsoring activity of the U. S. Government. 5. I understand that this oath may be retained by the U. S. Government for its future use in any manner within the scope of this oath. 6. I take this obligation freely, without any mental reservation or purpose of evasion and in the absence of duress. . NAME OF WITNESS (Type or Print) NAME (Type or Print) Theodore M. Anderson Clare Booth Luce SIGNATURE OF WITNESS SIGNATURE AdImin Debrief REMARKS NAME & ADDRESS OF AFFILIATION WH/PFIAB SOCIAL SECURITY NUMBER: 064-18-3062 DATE 23 March 76 OR' 2442 (12) The Privacy Act, Public Law 93-579, requires that Federal agencies inform individuals when they are asked to provide their Social Security Account Num- her (SSN) whether the disclosure is mandatory or *. ~voluntary, by what authority such number is solic- ited and what uses will be made of the SSN. Dis- \a ) N~t~L meclosure by you of you SN is voluntary. The au- thority for this solicitatio is Executive Order 9397. The SSN is used as an id ntifier in removing your atharized accesto te esignated Special Proj. TERMINATION SECRECY AGREEMENT 'ct(s). Fai t 'ivif v. 5Nmay delay t processing required/n access authority removal.

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