[1]| NW 88326
[5]2 :
[7]Assassination Records Review Board
[8]Final Determination Notification
[10]AGENCY : HSCA
[11]RECORD NUMBER : 180-10068-10344
[12]RECORD SERIES : STAFF PAYROLL RECORDS
[13]AGENCY FILE NUMBER :
[15]December 8, 1995
[16]Status of Document: Postponed in Part
[18]Number of releases of previously postponed information: 10
[20]Reason for Board Action: The Review Board's decision was premised on several factors
[21]including: (a) the significant historical interest in the document in question; (b) the
[22]absence of evidence that the release of the information would cause harm to the United
[23]States or to any individual. |
[25]Number of Postponements: 8
[27]Postponements: All the postponements in this document represent Social Security numbers.
[29]Reason for Board Action: The text is redacted because the public disclosure of the redaction could
[30]reasonably be expected to constitute an unwarranted invasion of personal privacy, and that invasion of
[31]privacy would be so substantial that it outweighs the public interest.
[33]Substitute Language: SSN
[35]Date of Next Review: 2017
[37]Board Review Completed: 10/24/95
[39]Doechd:32243310 Page 1
[41]Date:08/20/93
[42]Page:1
[43]JFK ASSASSINATION SYSTEM
[45]IDENTIFICATION FORM
[47]AGENCY INFORMATION
[49]HSCA
[50]180-10068-10344 |
[52]| AGENCY
[53]RECORD NUMBER
[55]RECORDS SERIES :
[56]STAFF PAYROLL RECORDS
[58]AGENCY FILE NUMBER : .
[60]' ; . DOCUMENT INFORMATION
[61]ORIGINATOR : HSCA
[62]| FROM :
[63]TO :.
[65]_ TITLE :
[67]DATE
[69]12/30/76
[70], Oo PAGES .
[72]10
[74]a _ SUBJECTS :
[75]HSCA, ADMINISTRATION
[76]| FACTER, JEFFREY
[78]DOCUMENT TYPE : PRINTED FORM
[80]CLASSIFICATION : U
[81]RESTRICTIONS : 3
[82]CURRENT STATUS : P
[84]DATE OF LAST REVIEW : 07/07/93
[86]OPENING CRITERIA
[88]COMMENTS
[90]Box #:1.
[92]| [R] - ITEM IS RESTRICTED
[93]NW 88326 |
[94]Dochd:37274310 Page 2
[97]FACTER, Jeffrey. ne OFFICE OF THE CLERK EE SE Se
[98]a Ramet Employee ’ US, HOUSE OF REPRESENTATIVES ae 0 DALANCE BrousHT
[99]Coe Bs So ; me mo, _ es FORWARD FROM 9°
[100]on —<—— nn oe PERSONAL LEAVE RECORD ~ ce BRECEBING YEA
[102], j Audrass ; : a : = Se bea f. oo, - YEAR
[104]ANNUAL LEAVE
[105]CATEGORY | a - a oe be
[107]ACCRUED avaitasle «| usep | ALANGE
[108]THIS MONTH | THIS MONTH | THIS MONTH » OF SORE
[110]DATE OF APPOINTMENT
[112]Phone WN umber
[114]“Position Title — - 4
[115]; —_ PRIOR FEDERAL SERVICE .
[118]Position Number : bevel Step Este : onthe po 2.0 O
[120]” Anqual Sick Annual Sick Annual Sick
[121]Lesve Leave | Leave -} Leave Leave . Leave
[123]7 13)
[125]DAY OF MONTH
[127]rt 15 i Wire
[129]EMPLOYEE
[130]TNITHALS.
[134]0.6 day annual eave ERT IBIED CORRECT
[136]= 1.0 day annual leave . oo oe Jo . : ne i
[138]= 0.5 day sick leave . . . . a ; . .
[140]= 1.0 day sick leave Po a _ . ; "Employee's Signatura po ; Date a Chiei's Signature Date
[141]es "(If employee refuses to slgn, slate reason Eclows OO st Ce ee
[143]5 day administrative teave
[145]a 1,0 day edministrative leave a ee Approved: ee
[146]a be ; re ; Clerk of the Housa | ; : .  “Oota
[147]= 0.5 doy unauthorized absence © oo,
[148]7 “This record. will be forwarded to the c ork of the House at the end of cach calendar year, or in case of termination along
[149]= 1.0 day unauthorized absence ” with the request for termination. » Upan, approval the record will be tiled in the employee's official personnel: folder,
[151]= 0.5 day Ieava without pay |
[153]1.0 doy leave without pay
[155]; my ‘ soe oe .
[156]Te AL TGS BVOC CET CA SCT ore NOU BY er pes conse EXHIB ED Toons omen ovingntsoseninsr creep, mete STE
[159]Sm ; _ I
[161]MEMORANDUM
[163]em: ALL Staff “Employees
[164]- SFROM: © Budget Officer eee
[165]“DATE: January 3, (1977,
[167]ORE: Payroll Certification Bee
[169]“starting with the January, 1977 payroll, “the: certification -
[170]to. the House Finance Office requires, among other things, ‘the
[171]_- srxelationship, if any, of each staff employee to any current -
[172]» SMember, of Congress (those taking office January 3, 1977).
[174]‘The following are the relationships | ‘to be included in eS
[175]the certification: oe er rs
[176]Po father © nephew rae! ~ prother-inlew Tse |
[177]mother = niece gi ster-in-law - ~ od
[178]sm usband > stepfather |
[179]daughter Wife os 2 stepmother. 77 | TEE ST \
[180]‘brother ss) father-inlaw  *  s stepbrother 2 Po
[182]i
[184]sister = mother-in-law: Stepsister
[185]~uncle _— _ son-in-law ~ half-brother 9 =)
[186]aunt os daughter-in-law half-sister
[187]: first cousin — Sa a . a Pe
[189]ea
[191]“RIL staff ‘employees are ‘requested to complete this:
[192]“form and. return it to the Budget < officer. —
[194],  SNpproved SO
[195]_ Richard A. Sprague
[197]I-am not related
[199]oTvam related by the following relationship
[201]NW 88326 . a ee
[202]ocld:32243310 Page 4 : or -
[205]| PAYROLL AUTHORIZATION FORM | | _ 7
[206]. {Please-Use. Typewriter: Joey $. HOUSE OF REPRESENTATIVES. . (Any erasures,:corrections, or changes ©
[208]|
[210].
[211]| 7 ~~~ or Ballpoint Pen) «> Washington, D.C..20515 - on this form must, a ‘initialed by. the.
[212]| ~°To the Clerk of the House of Representatives: - , °
[214]| hereby authorize the following payroll action:
[216]Employee Name (First-Middle-Last) _ ~ oy : a Effective Date
[218]Employee Social Security Number 7 a . : oo ; “Type ¢ of Action _
[219], O Appointment
[220]34) @h4—-8951 _ __| Gi Salary Adjustment
[221]Employing Office or Committee/Subcommittee:~“- -°.-* ‘| O Title Change °
[224]| : i ; ts . ; 3 Termination (At close of business on effective date)
[225]|
[227]C1 Leave without pay (Beginning with effective date above and ending | a
[229]AsSS@ss 4 natéons , _ close of business
[231]Specify Date
[233]“Ae type of action is an. Appointment, Salary: Adjustment; or Title Change, complete appropriate information ‘below.).~ = : on “a
[235]_ Position Title . fo Gross Annual — a . : oS
[237]ve .*.lf-emoloyee is a civil service annuitant.(includes-U.S. House'of Representatives), ‘the gross annual salary shown should include the annuity received by the employee ;
[238]plus the salary received from the employing office.
[240](If Committee Employee; complete appropriate item below.)
[242]3 v
[243]1. 1 Standing Committee: Staff—O Clerical’or 0) Professional. os a oe : \
[244]2. [1 Special (Investigative staff-of Standing: Committee) or Select Committee: Authority—H. Res. 956. of AB tle ongress, © 3 \
[245]3. 0 Joint Committee. 4
[246](If Employee of an ‘Officer of the House, complete item below.) > - co a 3 nN
[248]Position Number __.._.If applicable, Level_
[250]slate
[251]SLATAB NA Uo ty
[253]| certify: that. this authorization is not: in violation of 5°~°U.S:C. 31F0(b), prohibiting ‘the employment. of
[254]ger
[256]ot Ube a!
[258]relatives. . a
[259]Date Apel Uo a 9 8 | 2
[260]i Loe P SHS ctore ol Authorizing Official
[261]asa Louts STOKES
[262]tifa Ppropriate, ignature of Subcommittee Chairman or Ranking Minority Member) > ype'ei priavnome of Auihorning Oleh TTT TTT
[263]4 £ HATREAN
[264]nn ( Type or print name and ttle ‘of above official) = SSStC<“<~<S SSCS tc =I Member, Dis ond Ste) TT
[266]All appointments and salary adjustments. foremployees under the House Classification ‘Act -and'-for Committee em: -. - *<2
[269]_. ployees, except those of the Committee on Appropriations,-the Committee on the Budget, ‘andthe Joint: Committees; must”. mar \
[270]be approved by the Committee on House Administration. ’
[272]APPROVED:.
[274]Office of Finance use only:
[276]Office Code
[278]‘Copy. for- Initiating. Office or Committee .-'::
[281]PAYROLL AUTHORIZATION FORM . .
[283]~ (Please Use Typewriter «. > U. S. HOUSE. OF. REPRESENTATIVES > - ¢ <(Any: erasures; corrections, or:changes =
[284]sor Ballpoint Pen) = Washington, D.C. 20515 oon, his form ust be initiated by the
[286]To the Clerk of the House of Representatives:
[288]| hereby authorize the following payroll action:
[290]sa ee eee ee cate = Effective Date .
[292]December 7, 1977 |
[293]. Type of Action
[295]© Appointment
[296]. dE Salary Adjustment
[297]Employing Office or Commuttee/ Subcommittee - . . 1-0} Title Change
[298]; —_ O Termination (At close of business : on effective date}
[299], . ‘Pasass dnati ons ; Co Leave without pay (Beginning with effective date above and ending
[301]close of business
[302]Specify Date
[304]-(If type of action. is an Appointment, Salary Adjustment, .or Title Change, complete appropriate: information below.) - - -
[306]Position Title Oo . Gross Annual Salary*
[308]“ Sta€€. Counsel , _ ote $27 B00
[310]tl employee i is.a civil service. annuitant includes U.S. House. of. Representatives), the gross annual salary shown should include the annuity received-by the employee os
[312]plus the salary received. ‘from the employing office.
[314](If Committee Employee, complete appropriate item below.)
[316]q. oO 7 Stoning Committee: Staff—Cl. Clerical-or 1 Professional:
[318]3. Oo. Joint Committee.
[320](If Employee of. an Officer of the House, complete item below.)
[322]Position Number If applicable, Level_
[324]relotives.
[326]All ‘appointments and salary adjustments for employees under the House Classification Act and-for Committee em- =
[327]._ployees, except those of the Committee on-Appropriations, the Committee on the Budget, and the. Joint Committees, must «
[328]be approved -by the Committee on. House Administration.
[330]APPROVED:
[332]Chairman, Committee on House Administration
[336]Office of Finance use only:
[338]Office Code.
[340]Fw 8826 | eae ae
[341]1d:32243310 Page 6 i Pa! ;
[346]pee Lf oe Te “ws a
[347]SRDS aE EE PROSE POR LON SLR EARLE CUR S VU CLS BT eT TO
[349]Etat
[351]Jt. “certify. that this authorization is not: in violation .of 5 USE. 3110) ~ Prohibiting the employment of a
[353]ath Malte pei phbuaecd
[358]er
[359]4 \
[360]-
[361]ad
[363]a ee
[364]ed
[366]3
[367]4
[368]B
[369]8
[370]4
[371]“4
[373]Bold wo rate he ta ae tt ot A ain oa,
[374].
[377]pote. August 2 0 Te
[379]88326 | : [Oe
[381]Wi:37243310 Page f
[383]PAYROLL AUTHORIZATION . FORM -
[385]~(Please: Use Typewriter ae vu. Ss. HOUSE OF REPRESENTATIVES. - “(Any erasures, corrections;-or-changes.
[387]-on-this form must. be initialed by.the. . 7
[389]or Ballpoint-Pen) a ~ Washington, D.C: 20515. authorizing official.)
[391]To the Clerk of the House of Representatives:  -
[393]| hereby authorize the following payroll action:
[395]_Employee Name ‘(First- Middle- -Last) Se esrp ee ; y = oS Te Effective Date 7 |
[396]Jeffrey Factgr | oe 8/1/77
[398]Employee Social Security Number - 7 “a ~ oe ~ _ | ; 7 ~ - “Type of ‘Action : ee
[402]CJ Appointment
[404]_ Employing Office or Committee See ySelory Adjustment .
[406]om Termination (At close of business on effective date)
[408]| ‘Assass {nations
[410]~ (IF type of. action’is-an Appointment-or Salary Adjustment, complete the following information.)
[412]Position Title. _ 7 a 7 _ _ _ Gross Annual Salary
[414]Staff Counse}
[416](If Committee Employee, complete appropriate item-below.): ~
[418]1. C). Standing Committee: Staff ~L Clerical or[] Professional. oe
[420]2. B [4] Special or Select Committee: ‘Authority He: Res. AGS sof asth ‘Congress. ”
[421]3. Ol Joint Committee. -
[422](if Employee of an’ Officer of the:House, completé item below.) °° =
[424]Position Number oe If applicable, Level _-
[426]wt Mop ceteces ° eB -
[428]relatives.
[430]fF : “Type or print.name.of Authorizing Official) =
[432]x hes
[433]ue CHATRHAL i
[435]nae + -_—" <7 es - = em a ee ere re a ae ee ee er
[437]Allk.appointments:and salary. adjustments: for employee's’ under. the. House’ Classification: Actzand “for Committee: ém-
[438]~: ployees, .except-those: ofthe. Committee on Appropriations, the- Committee: on: nthe Budget; ‘and thé ‘Joint: ‘Committees, must
[439]--be approved: by: the Committee.on House Administration: PA Re a Te Meg te .
[441]_ APPROVED:
[443]Chairman’ Committee on n House Administration een bs
[445]Office of Finance-use only: >.’
[447]as _ Office Code.
[449]wichita Labelled lac ah oil blak Sel
[451]me Me i ee
[452]A tia Lal diated ycnthngtaon con
[454]|
[455]4
[456]“4
[458]tr eee ne a 7 “eegr  y
[459]My Gt te Bl ea Sula ih a daaindadls tin MeL Eg ult
[461]3.
[462]na
[466]Ld
[468]ate Soe ve
[469]att ta cats ais,
[471]on
[473]arb ov
[476]ee EE EE EE EE EEE EE EEE_EEeeeeeeEeeeeee
[478]PAYROLL AUTHORIZATION FORM Ma ie oD Fp
[480]7 _: (Please Use. Typewriter“ a U. S:- HOUSE: OF REPRESENTATIVES - -. ‘e(Any- erasures; corrections, or changes
[482]er - _— oe... On this form must be initialed by. the
[483]or Ballpoint Pen) _ Washington, D.C. 20515 a authorizing official.) |
[485]To the Clerk.of the House of Representatives: —
[487]4 hereby authorize the following payroll action: = = |
[489]_Employee Name (First- Middle- -Last) 7 a ve esp ae Effective Date we
[490]5/8777
[492]Jetfiey | Facter
[494]“Employee Social Security Number
[496]wat 34 §35)
[498]. Type of Action -
[499][] Appointment ‘
[501]i) Salary Adjustment
[503]Employing Office or Committee
[505]L] Termination (At close of business on effective date)
[507]| Assassinations
[509]- (If type.of.action is an Appointment or Salary Adjustment, complete the following information.) foe
[511]: ployees,, except..those.of: the-Gommitteeton ‘Appropritionsis the: Committee .on- the:Budget;and ‘theJoint. Gommittees;. must
[512]be: approved by the.Committee on.House Administration. MED tl ole ‘ wae
[514]lr
[516]Position Title Oo Gross Annual Salary |
[518]$25, G00
[520]_ (If Committee Employee, complete appropriate item below.) .: -
[522]1 Standing Committee: Staff—[-] Clerical or {.] Professional. .
[523]2. [2%] Special or Select Committee: Authority H.. Res. 865 of S5¢R_ Congress:
[525]3. [_} Joint Committee.
[527](If Employee of .an:Officer-of:the House, complete item below,).-- fie
[529]“Position Number_2 2-2. lt applicable, Level_
[531]Step
[533]eth ty Elan maa epee ict foe boven ites he tg ka a ek Sadthy hous veoh a tp et
[534]sPiapteab intents te te Sia bto Mom che OE ea Se ci Ee ed
[536]Se Ee
[537]ee Ea tac ad bal a ated
[539]a habs,
[541]|
[542]J
[544]Ree RATE ne TENS!
[548]_L-_certify.. that this authorization’. ds ~notein.. violation: of. = U.S.C, -3110(b), prohibiting ‘the. employment -of. ::.2 9»
[550]relatives. een EE,
[551]Date. a ay 10. a9. —_— :
[552]“ a va _ (Signature of Authorizing Official).
[553]| _#_bowis Stokes
[554]~ oo e : (Type or print name of Authorizing Official)...
[555] Shatrman
[556]ca , : : (Title —If Member, District and State) +;
[558]oo All -appointments: and: aalary: adjustments: for: employees under--the: House: ClassificationzAct:and -for. ECommittee.eme. wi 2
[560]__._ APPROVED.
[562]. Office: of Finance use onlys.<2s) ec
[564]Office Code
[566]88326 a ee ae
[568]By
[570]EE RM peace Lb Bante ER haha darle al! Has hh ate cl is hilt tee BL aly inne a nals tne i acl Sate hepsi ede Aa Baga dt lk
[572]xi
[574]oe te west ee ae kg ae yt ete Tet agth
[575]edu! Sadish tet Cb bauaitnaceied Sar oo ey a hy
[577]1d:327243310 Page 8 : Cyt ;
[579]PAYROLL AUTHORIZATION -
[581].- (Please Use Typewriter: =
[583]or Ballpoint Pen):
[585]FORM
[587]U.S. HOUSE - OF REPRESENTATIVES
[588]: Washington, D.C. 20515 -
[590]© (Any. erasures; corrections: or.changes: — ~
[592]on this form must be initialed by the:
[593]authorizing official.) .
[595]To the Clerk of the House of Representatives: :
[596]| hereby authorize the following payroll action: - So
[598]‘Employee Name (First- -Middle-Last) a Effective Date. -~
[600]_settrey. Facter
[602]4/1/77
[604]“Employee Social. Security Number | Type of Action” ;
[606]Sa aa 6951 | | |
[608]C
[610](_] Appointment
[611]CiSclary Adjustment: ; ,
[613]Termination (At close of business on effective date) —
[617]~ Gross Annual Salary
[620]- Position Title ~~
[622](If Committee Employee, complete appropriate item below, -
[624]Lo Stonding Committee: Staff-[_] Clerical or [] Professional. |
[625]2. GI Special or Select Committee: Authority—H. Res. 489. of _ SStB Congress.
[627]~ 3. EJ Joint Committee.
[629](if Employee of an Officer of the House, complete item below.)
[631]Position Number__.7 If applicable, Level_ oe
[633]. ch “certify. that: this -authorization: is not: in. violation: of 5 US.G, #3110(b),
[634]relatives.
[636]pee
[638]ad
[640]ceaayet ger aw
[642]a e a on ie: et,
[643]a es peeled “5 cal Se ntenctisetroneeane tt:
[644]Date. __._.-_-_____..___ ApPH] 2819 77 COL pssagag
[645]— Led eal fo (Signature of Authorizing Official)
[647]"7 ~ a “(ype or print name of Authorizing Official) |
[648]a Chairman
[649]a . (Title— If Member, District ond iStote)
[651]All.appointments. and salary adjustments for ‘employees “under. the. House Classification: ‘Act: and: for-Committée em:
[652] ployees,. except.those ofthe -Committee on ‘Appropriations, the Committee ‘on the: Budget, and the Joint: ‘Committees, must. °
[653]be approved by the Committee on House Administration. Ss ; ee so SE Ts
[655]_ APPROVED:
[657]Office of Finance use only: :. °
[659]. Office Code
[661]Prohibiting the employment of.
[663]| NW 88326 ; np
[664]ocld:32243310 Page 9 : gel! ;
[666]PAYROLL J AUTHORIZATION: FORM
[668]. (Please'Use Typewriters U. S: “HOUSE: OF REPRESENTATIVES: -=(Any erasures, corrections, or-changes’ es
[670]. on this form must be. initialed by the
[671]or Ballpoint Pen) . 5 Washington, D.C. 20515: authorizing official.)
[673]-To the Clerk of the-House of Representatives: ..
[675]| hereby-authorize the following payroll action: 278 +
[677]_ Employee Name (First-Middle-Last) Pras ne woe ea Effective Date 7
[679]Jef Frey Facter a
[680]. . “Employee Social Security Number. ce dtefeee Type of Action”
[682]34]- 44-595] ; C] Appointment
[683]Employing Office or Committee | Ue Solory Adjustment a
[685]Select Committee on Assassinations | C Termination (At close of business on effective date)
[687](If type.of action is an Appointment-or-Salary Adjustment, complete the following information:) .
[689]Position Title : ; ~ 7 oe T | 7 ~ Gross Annual Salary
[691]$15.3 375.
[693](If Committee Employee, complete appropriate item below.)
[695]Lo Standing Committee: Staff—[_] Clerical of [_] Professional. - »
[697]87
[698]2. (“t Special. or Select Committee: Authority—H. Res... i. of 29 Congress. =
[700]3. [_} Joint Committee.
[702]- (If Employee of an Officer of the House,: complete: item below:) °°." .’ -
[704]Position Number___.2.__:_-_.Fapplicable, Level
[706]“Stepso e
[708]Accertify that: this .authorization..is’-not: in violation: of. 5. US.C. 3110(b), prohibiting. the’ employment: of
[709]relatives.
[711](Signature of ‘Authorizing Official) ~
[713]_ Henry B. Gonzalez —
[715](Type or print name of) Authorizing Official) =
[716]‘Chairman
[718]_ SF Title= if ember, Distr ond Ste) ae _
[719]- All-appointments. and. salary adjustments: for-employee’s.under ‘the House.:Classification Act-and. for: Corhmittee-am=
[720]-ployees, except those -of the: Committeeon. Appropriations; the: ‘Committee on’ the Budget, cand the: Joitit: Committees, must:
[722]“be approved by. the.Committee:on House Administrations 1x70 0 stb er :
[725]- Chairman, Committee on House: Administration Sas
[727]Office of Finance use-only: :.-
[729]Office Code:_.
[731]i ee, /  . . - Copy for Initiating Office or. Committee...
[733]NW 88326 | : Fe ne ee
[737]w
[740]_ PAYROLL AUTHORIZATION FORM. . o~ . “¢ . OO
[741]~ Sn |(PleaseUse Typewriter- 2 U S. ‘HOUSE OF REPRESENTATIVES \_ ) (Any erasures, corrections, or changes .. -
[742]© or Ballpoint Pen)" Washington, D.C, 20515. on this form must be initialed by bythe
[743]To the Clerk of the House. of Representatives: i
[744]| hereby authorize the following payroll action: - - : ~ ot 3 : ~~
[745]Employee Name (First-Middle-Last)\. _ _— . - i Effective Date |
[746]ns Jaffrey Facter oy og VRAT7 - os
[747]i} Employee Social Security Number - 7 [Type of Action |
[748]3A] 42 $957 oe sO | Ci Appointment - | |
[749]: Employing Office or Committee _ ~ & Salary Adjustment .
[751](lf Committee.Employee, complete appropriate-item below.)
[753](If type of action is an Appointment‘or Salary Adjustment, complete the following information.).. : SN
[755]Select Comnittes on Assassinations Oo Termination (At close of business on effective date)
[757]Position Title ; 7 Gross Annual Salary
[759]416250,
[761]1 L] Standing Committee: Staff-(] Clerical or [| Professional.
[763]2 Special or Select Committee: Authority —H. Res. ue of 78% “Bcongress
[765]3, LJ Joint Committee. 7 a oe - oo, ee a
[766](If. Employee of an Officer of the House, complete item below.) ° wet
[767]‘ Position Number if opplicable, Level__ = Step» ae '
[768]~ _— . 5 , va “ ’ ~ Ss : ; ! a
[769]I certify _that . this: authorization’. is not.-in. violation. of 5. U.S.C. 3110(b), prohibiting the employment of
[770]‘relatives. . Ye
[771]- “ey
[772]Date, = a a ba
[773]- ° f, ° . (Signature, of Authorizing Official) : : ii
[774]. a Co os Henry S, Gonzalez : :
[775]Ste oer 7 Wipe ar pint sane of haing Oia
[776]ny - Pare ,
[777]Ce a 4 rien, .
[778]—--a-e we SSDI SAO _
[779]. _ L Title I. Member, District and State) .
[780]All appointments. and salary: adjustments for: employees, ‘under the House Classification Act and for Committee em-. <. “e °
[781]a
[782]ployees, except those ‘of the'Committee -on Appropriations, ther Committee on the Budget, and the Joint ‘Committees, must." | 7
[783]be approved by the Committee on House Administration. . ; ~ . : . \
[784]op ; : a . » be
[785]a 7 OS oe > APPROVED: a
[786]; i _ : ; . Chairman, Committee on House Administration ;
[787]- ; em |
[788]. ' 7 7
[789]4 | . .
[790]i
[791]. a :
[792]. 4
[793]~~ Copy for. Initiating Office or Committee .- - ”
[794]_ 7 = y ; - :
[795]88326 pn wp ee penne ne ee
[797]Wi:37243310 Page 11
[799]r
[801]7
[803]an _, (Please Use Typewriter Co U. S. HOUSE: OF. REPRESENTATIVES *
[805]- PAYROLL AUTHORIZATION FORM
[807]; (Any erasures,. corrections, or changes .~\
[808]a on. this form must be initialed. by the
[809]sea authorizing official.) ;
[811]ae or Ballpoint Pen) .. ges Washington, D.C. 20515",
[815]: To the Clerk of the House of: Representatives:
[817]| hereby authorize the following Payroll ‘action: _
[819]“ger frey. Facter co |
[820]Vf Employee Social Security Number ” 7 We of ‘etion
[821]. i) [1_Appointment
[823]Oo Salary Adjustthent , 5
[825]o Termination (At close of business on effective date)
[827]|
[828]|
[829]Employee e Name (Ft Middle- -Last) ; - 1 ~ os ” ffecti - Date : | | | |
[830]|
[831]|
[832]|
[833]|
[834]|
[835]|
[836]|
[837]j
[839]Te ee “Position Title |
[840]| Starf Counsel - eaat un mit.
[841]» (If Committee Employee, complete oppropriate item below.) . co ce
[842]“d, L] Standing. Committee: Staff— FJ Clerical: of Professional. . = °° - 7 S | n~
[843]2 - Special, or Select. Committee: AuthorityH. Res 1540 _of SAN congress. ‘ \
[844]1S | . oe 7 | | \
[845]30 Joint Committee. - _ ’ Le _ —_
[846](If Employee of an Officer of the House, complete item below.).. - - De | ae
[847]Position Number -. __ If applicable, Level_ oo. Step. cm. 7
[848]| certify that | this authorization is_not in. Violation of .5 U.S:C,. 31108), prohibiting the employment of _
[849]relatives, . ; . a i,
[850]Date Becember 15 1976 Sg Te e.i yf
[851]ens re rs |. Gignature of Authorizing Official SSO
[852]. Ss . Thomas N. Downimt. Chairman
[853]oe c a oe _ ar wees print nome of Authorizing Official) 7 TO
[854]: | - Select Committee on Assassinations _
[855]iP ow y fe : : oo . . . ey say (Title -—H-Member,; District and State)
[858].
[859]All appointments and salary adjustments for employees under :the ‘House Classification Act and for Cominittee em- —
[860]‘ployees; except those-of the Committee on: Appropriations;:the Committee-on the Budget, ‘and the ‘Joint Committees, must
[862]be approved by the Committee on House Administration. Lo _ oo ‘
[863]~ a . . \
[865]Oe APPROVED: -
[867]Office of Finance use only:
[869]- Office Code
[871]i
[873]tet ns eee nese nennenme mies mene ne ane aap apne renee ne rene
[875]88326 | | FO ae a po
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