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# PAYROLL AUTHORIZATION FORM(Please Use Typewriter or Ballpoint Pen) U S HOUSE OF REPRESENTATIVES Washington, D C 20515 (Any erasures, corrections, or changes on this form must be initialed by the authorizing official )To the Clerk of the House of RepresentativesI hereby authorize the following payroll action| Employee Name (First-Middle-Last)          | Effective Date || ------------------------------------------ | -------------- || Gerald P. Hamilton                         | 12/31/73       || Employee Social Security Number            | Type of Action || 251-88-1541                                |                || Employing Office or Committee/Subcommittee |                || Assassinations                             |                |*   Appointment*   Salary Adjustment*   Title Change*   Termination (At close of business on effective date)*   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* || -------------- | -------------------- |* If employee is a cıvıl service annuitant (includes U S House of Representatives), the gross annual salary shown should include 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 Professional2 Special (Investigative staff of Standing Committee) or Select Committee Authority-H Res 956_of5th_Congress3 Joint Committee(If Employee of an Officer of the House, complete item below)Position Number__________ If applicable, Level________ Step________I certify that this authorization is not in violation of 5 USC 3110(b), prohibiting the employment of relativesDate January 2 1979_________________________________________________________________________________________________________________(If appropriate, signature of Subcommittee Chairman or Ranking Minority Member) LOUIS STOKES (Signature of Authorizing Official)_________________________________________________________________________________________________________________(Type or print name and title of above official) (Type or print name of Authorizing Official)_________________________________________________________________________________________________________________CHAIRMAN (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 AdministrationAPPROVED_________________________________________________________________________________________________________________Chairman Committee on House Administration| Office of Finance use only                  |          || ------------------------------------------- | -------- || Office Code                                 | ID       || Monthly Annuity $__________00 as of________ | Benefits ||                                             | Payroll  |Copy for Initiating Office or Committee (Revised August 1 1977)NW 88326 Docld:32239444 Page 3