Transcript of 180-10068-10321.pdf
==================================================
Page 1
==================================================
Assassination Records Review Board
Final Determination Notification
AGENCY HSCA
RECORD NUMBER 180-10068-10321
RECORD SERIES STAFF PAYROLL RECORDS
AGENCY FILE NUMBER
December 8, 1995
Status of Document: Postponed in Part
Number of releases of previously postponed information: 5
Reason for Board Action:
The Review Board's decision was premised on several factors
including: (a) the significant historical interest in the document in question; (b) the_
absence of evidence that the release of the information would cause harm to the United
States or to any individual
Number of Postponements: 4
Postponements:
All the postponements in this document represent Social Security numbers.
Reason for Board Action: The text is redacted because the disclosure of the redaction could
reasonably be expected to constitute an unwarranted invasion of personal privacy, and that invasion of
privacy would be so substantial that it outweighs the interest:
Substitute Language: SSN
Date of Next Review: 2017
Board Review Completed: 10/24/95
Released under the John
Kennedy Assassination
Records Collection Act of
992 (44USC 2107 Note)
aset:Nw 88326Date:
PQ26
NW 88326
Qocld:32243287 Page 1
public
public
==================================================
Page 2
==================================================
Date:08 /20/93
Page: 1
JFK ASSASSINATION SYSTEM
IDENTIFICATION FORM
AGENCY INFORMATION
AGENCY HSCA
RECORD NUMBER 180-10068-10321
RECORDS SERIES
STAFF PAYROLL RECORD
AGENCY FILE NUMBER
DOCUMENT INFORMATION
ORIGINATOR HSCA
FROM
TO
TITLE
DATE 08 / 18/77
PAGES 5
SUBJECTS
HSCA _ ADMINISTRATION
DOCUMENT TYPE PRINTED FORM
CLASSIFICATION U
RESTRICTIONS
CURRENT STATUS P
DATE OF LAST REVIEW 07 /07/93
OPENING CRITERIA
COMMENTS
Box #:1.
[R] ITEM IS RESTRICTED
'NW 88326
Docld:32243287 Page 2
==================================================
Page 3
==================================================
PAYROLL Authorization FORM
(Please Use Typewriter U.S. house 0F `REPRESENTATIVES
(Any erasures, corrections, or. changes.
or Ballpoint Pen) Washington, D.C. 20515 00 this form must be initialed by fhe
authorizing Official.)
To the Clerk of the House of Representatives:
hereby authorize the following payroll action:
Employee Name (First-Middle-Last) Effective Date
0iver 4 & Chzzplon 8/31/78
Employee Social Security Number Type of Action
Appointment
086-46-9505
Salary Adjustment
Employing Ofice or_Committee/Subcommittee
Title Change
Termination (At close of business.on effective date)
Leave without pay (Beginning with effective date above and ending
48E0 3203640n8 close of business_
Specify Date
(If. type of action is an Appointment, Salary-Adjustment, or Title Change, complete appropriate-information below:)
Position Title Gross Annual Salary
If employee is.a civil service gnnuitant (includes U.S.-House_of Representatives), 'the gross annual salary shown should include the annuity received by the employee
plus ihe salary received from the employing office.
(If Committee Employee, complete appropriate item below:)
I_ Standing Committee: Staff_C Clerical or Professional.
2 Ck Special (Investigative staff of Standing Committee) or Select Committee: Authority-_H. Res:_956of_ 95thCongress
3. D Joint Committee.
(If Employee of an Officer of the House, complete item below:)
Position Number_ If applicable, Level_
certify tthat this authorization is not: in violation of 5 US.C 31106); prohibiting the. employment of
relatives
Date_ September_14_ 19_78_
(Signature of Authorizing Official)
LCUIS_STOUTFE
3_
C24TPMAH
(If appropriate, signature of Subcommittee Chairman or Ranking Minority Member) (Type or name of Authorizing Officiol)
(Type or name and title of above official) (Title If Member, District and Stote)
All appointments and: salary adjustments for employees under the House Classification Act and for:Committee 'em-
ployees, except those of the Committee on. Appropriations, the.Committee-on the Budget; and the Joint Committees; must
be approved by the Committee on House Administration
APPROVED:_
Chairman, Committee on House Administration
Office of Finance use only:
Office Code_
Benefits
Monthly Annuity $_ .00 as of Payroll _
(Revised: August 1, 1977)
for Initiating Office Or Committee
NW 88326
pocld:32243287 Page 3
Step__
Prinf
print
Copy
==================================================
Page 4
==================================================
PAYROLL AUTHORIZATION FORM
(Please Use Typewriter U.S. HOUSE 0F 'REPRESENTATIVES (Any erasures; corrections; or changes
or Ballpoint Pen) Washington, D.C. 20515
on this form must be initialed by the
authorizing Official.)
To the Clerk of the House of Representatives:
hereby authorize the following payroll action:
Employee Name (First-Middle-Last)_ Effective Date"
Ollver 7
0
Chatpion Nerek 10 1978
Employee Social Security Number Type of Action
086-46-9505 Appointment
ZTSalary Adjustment
Employing Otiice or Committee/Subcommittee Title Change
Termination (Af close of business on effective date)
42 Ons Leave without pay (Beginning with effective date above and ending
close of business_
Specify Date
(If type of action is an Appointment; Salary Adjustment;'or Title:Change, complete appropriate information below:)
Position Title Gross Annual Salary
Clerical Assistant 812 000
*If employee is,a civil service annuitant (includes U.S. House: of Representatives), the gross annual salary shown should inclde the annuity received by the employee
plus the salary received from the employing office.
(If Committee Employee, complete appropriate item below:)
1 Standing Committee: Staff Clerical or Professional:
2 DrSpecial (Investigative staff of Standing Committee) or Select Committee: Authority_H. Res.956_of 9S. Congress.
3. Joint Committee.
(If Employee of an Officer of the House, complete item below:)
Position Number If applicable, Level_
certify that this' authorization is not in violation of 5 U.S.C. 3110b), prohibiting the employment of
relatives.
Date_ Harck 10
# 9
(Signature of Authorizing Official)
(If appropriate, signature of Subcommittee Chairman Or
Ranking Minority Member) ype or print name of Authorizing Official)
Chaz[7zr_
Type or print name and title of above 'official) (Title If Member, District and State)
All appointments: and salary adjustments for employees under the House Classification Act for Committee em-
ployees, except those of the Committee on Appropriations, the Committee on the Budget; and the Joint Committees, must
be approved by the Committee on House Administration:
APPROVED:_
Chairman, Committee on House Administration
Office of Finance use only:
ID
Office Code_
Benefits
Monthly Annuity $__- 00 as of Payroll _
(Revised: August 19771
for Initiating Office or. Committee
NW 88326
pocld:32243287 Page 4
20.
Step_
~and
Copy
==================================================
Page 5
==================================================
PAYROLL Authorization FORM
(Please Use Typewriter U.S. HOUSE 0F REPRESENTATIVES (Any erasures, corrections or changes
Or Ballpoint Pen) Washington, D.C. 20515 00 this form must be initialed by fhe
authorizing Official.)
To the Clerk of the House of Representatives:
hereby authorize the following payroll action:
Employee_Name (First-Middle-Last) Effective Date
'Q1#ver J_
0
Ch:zd {ow Decenber 1, 1977
Empioyee Social Security Number Type of Action
086+46-9505 Appointment
Salary Adjustment
Employing_Office_or_Committee/Subcommittee Title Change
Termination (At close of business on effective date)
Ass *,693* 02S Leave without pay (Beginning with effective date above and ending
close of business_
Specify Date
(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below:)
Position Title Gross Anqual Salary
Clerlcal #ssdse1n€ 811,000
If employee is.a civil service annuitant (includes U.S. House of Representatives), the gross annual salary shown should include the annuity received by the employee
plus ihe salary received 'from the employing office.
(If Committee Employee, complete appropriate item below:)
Standing Committee: Staff_C Clerical or Professional:
2.
Special (Investigative staff of Standing Committee) or-Select Committee: Authority _H. Res.265_of
3 Joint Committee.
(If Employee of an Officer of the House, complete item below:)
Position Number_ If applicable, Level Step_
certify_ that this authorization is not in violation of 5 U.S.C 3110b), prohibiting the ~employment of
relatives:
Date_ Centev
9
'7
(Signature of Authorizing Official)
Louig_Stokes_
UIf appropriate, signature of Subcommittee Chairman or. Ranking Minority Member)
ype Or print name of Author Officiol)
Q41rzn
= (Type or print name and title of above official) (Title If Member, District and State)
All appointments and salary adjustments for employees. under the House Classification Act and for Committee em-
ployees, except those of the Committee on. Appropriations, the Committee on the Budget, and the Joint Committees, must
be approved by the Committee on House Administration
APPROVED:_
Chairman, Committee on House Administration
Office of Finance use only:
ID
Office Code_
Benefits
Monthly Annuity $_ 00 as of Payroll _
(Revised: August 1, 1977)
for Initiating Office or Committee
NW 88326
Qocld:32243287 Page 5
95# Congress:
rizing
Copy
==================================================
Page 6
==================================================
PAYROLL -AUTHORIZATION FORM
(Please Use Typewriter U.S: HOUSE OF 'REPRESENTATIVES (Aiy erasures; corrections, or changes:
or Ballpoint Pen) Washington, 'D.C. 20515
on this form:must be initialed by.the
authorizing official:)
To the Clerkof the House of Representatives:
hereby authorize the following payroll action:
Employee Name (First-Middle:Last) Effective Date:
O} iver J. Champion 8/18/77
Employee Social Security Number Type of Action
086-46-9506
Appointment
Employing Office or Committee Salary Adjustment
Assassinations Termination (At close of business on effective date)
(If type of.action is an Appointment or Salary Adjustment, complete the following information:)}
Position Title Gross Annual Salary
Clerica] Assistant $9,500
(If Committee Employee, complete appropriate item below:)
1 Standing Committee: Staff-[] Clerical or Professional;
2: Special or Select Committee: Authority H.Resz_465
Cj
of
95th_
4
Congress:
3 Joint Committee:
(If Employee of an Officer of the House, complete item below:)
Position Number_ If applicable, Level_ Step_
1 certify; that this authorization':is not- in' violation: of 5 U.S.C. 3110b), prohibiting the employment of:
relatives:
Date_
August_22 19_77
(Signature of Authorizing Official)
ype or prinf name of Authorizing Official)
LOuIS__STORES
9
CHAIRMAN
(Title ~ If Member, District and State)
All: appointments and salary adjustments for employees under the: House Classification and: for: Committee em-
ployees, except those: of the Committee on Appropriations; the Committee on: the Budget, and 'the Joint: Committees, must
be approved by the Committee on House Administration
APPROVED:_
Chairman, Committee on House Administration
Office of Finance use only:
Office Code_
Monthly Annuity $__ 00
for Initiating Office or:Committee:
NW 88326
Qocld:32243287 Page 6
Act
Copy
==================================================
Page 7
==================================================
M E M 0 R A N D U M
To: ALL STAFF
RE: Payro]1 Certificatjon
The Regulations_ and_Accounting_Procedures for_Allowances and
Expenses 0f Committees
3
Members_ and Employees of the U.S. House of
Representatives requ re that;
9
among other things the Committee' s
monthTy payro]T certification include the relationship, jf any 0f
each employee to any current Memher of Congress_ This certification
is signed monthly by our Cha irman
The fo]owing are the relationships to be included in the
certifica tion:
father nephew brother-in-Iaw
mo ther niece sister-in-Iaw
son husband stepfather
daughter wife stepmother
brother father-in-Tal stepbrother
sister mother-in-Taw S
teps ister
unc]e son-in-]aw hal f-brother
aunt daugh ter-in-]aw half-sister
first cousin
PTease complete the appropriate portion below, date
this form; Which 1i]] then beconie
a part 0f your permanent personnel
file_ If this status_changes
9
ou nust notify the Committee S Budget
Office immnediately of the_chenge-
I am not related to any current (95th Congress) Member of Congress .
T am related to a
current (95th Congress ) Member 0f Congress.
(PTease specify. )
N)at 0
18 1622
Signatyre Of Emp]eyee Date
NWV 88326
Qocld:32243287 Page 7
sign and
Chp puA'