ARCHIVED – Annex 3-E: Non-disclosure certificate form

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An officer or director of a subsidiary organization uses this form to certify that the subsidiary will not disclose protected or classified information to the parent organization.

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Non-disclosure certificate form

I, the undersigned, am an officer and/or director of

a corporation which, by official action of its board of directors, is excluded from access to protected/classified information. I am also an officer and/or director of

and I am required to be granted a government personnel security clearance as a condition of clearing

for access to protected/classified information. I understand that

is not cleared for access to protected/classified information and I certify that I shall not disclose protected/classified information to the

or any of its agents regardless of my official business or personal association therewith. I further understand that any breach of security with respect to the disclosure of protected/classified information or assets to

may result in the denial of access to such information to

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