SCI_ATTESTATION.pdf

(U) UNCLASSIFIED//FOR OFFICIAL USE ONLY

PRIVACY ACT STATEMENT: The information contained herein will be used to precisely identify individuals in connection with requirements for Sensitive Compartmented Information access. Failure to provide requested information may result in delaying the processing of your certification.

(U) UNCLASSIFIED//FOR OFFICIAL USE ONLY

MEMORANDUM FOR SSO USSTRATCOM

FROM: USCYBERCOM/J-1 SECURITY

SUBJECT: SCI ATTESTATION

1. All personnel granted access to Sensitive Compartmented Information (SCI) are legally bound to protect and safeguard the information under the guidelines set forth by the

Nondisclosure Agreement (NDA). (Reference: DoD 5105.21-M-1, “SCI Security Manual, Administrative Security.”)

2. SCI Attestation:

“INTENDING TO BE LEGALLY BOUND, I HEREBY ACCEPT THE OBLIGA-

TIONS CONTAINED IN THE SENSITIVE COMPARTMENTED INFORMATION

NONDISCLOSURE STATEMENT IN CONSIDERATION OF MY BEING GRANTED

ACCESS TO INFORMATION OR MATERIAL PROTECTED WITHIN SPECIAL ACCESS

PROGRAMS, HEREIN AFTER REFERRED TO IN THE AGREEMENT AS SENSITIVE

COMPARTMENTED INFORMATION (SCI). I HAVE BEEN ADVISED THAT SCI

INVOLVES OR DERIVES FROM INTELLIGENCE SOURCES OR METHODS AND IS

CLASSIFIED OR IN THE PROCESS OF A CLASSIFICATION DETERMINATION UNDER

THE STANDARDS OF EXECUTIVE ORDER 12356 OR OTHER EXECUTIVE ORDER OR

STATUTE. I UNDERSTAND AND ACCEPT THAT BY BEING GRANTED ACCESS TO

SCI, SPECIAL CONFIDENCE AND TRUST SHALL BE PLACED IN ME BY THE UNITED

STATES GOVERNMENT.”

Last Name, First, Middle Grade/Rank Social Security Number

Signature: ____________________________________ Date: ___________

Presiding Official Signature Date

DEPARTMENT OF DEFENSE

UNITED STATES STRATEGIC COMMAND

UNITED STATES CYBER COMMAND

9800 SAVAGE RD, SUITE 6477

FORT GEORGE G. MEADE, MARYLAND 20755-6477