Assassination Records Review Board
Final Determination Notification
AGENCY :
RECORD NUMBER :
RECORD SERIES :
HSCA
180-10060-10470
STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :
December 8, 1995
Status of Document:
Postponed in Part
Number of releases of previously postponed information: 6
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: 3
Postponements: All the postponements in this document represent Social Security numbers.
Reason for Board Action: The text is redacted because the public 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 public interest.
Substitute Language: SSN
Date of Next Review: 2017
Board Review Completed: 10/24/95
NW 88326
Docld:32239478 Page 1
Released under the John F.
Kennedy Assassination
Records Collection Act of
1992 (44 USC 2107 Note).
Case#:NW 88326 Date:
2025
JFK ASSASSINATION SYSTEM
IDENTIFICATION FORM
AGENCY INFORMATION
Date: 08/20/93
Page: 1
AGENCY : HSCA
RECORD NUMBER :
180-10060-10470
RECORDS SERIES :
STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :
ORIGINATOR : HSCA
FROM:
ΤΟ :
TITLE :
DOCUMENT INFORMATION
DATE : 10/11/77
PAGES : 7
SUBJECTS :
HSCA, ADMINISTRATION
LICHTENFELS, BETH ANNE
DOCUMENT TYPE : PRINTED FORM
CLASSIFICATION : U
RESTRICTIONS : 3
CURRENT STATUS: P
DATE OF LAST REVIEW : 06/04/93
OPENING CRITERIA :
COMMENTS :
Box 2.
[R]
ITEM IS RESTRICTED
NW 88326
Docld:32239478 Page 2
PAYROLL AUTHORIZATION FORM
(Please Use Typewriter
or Ballpoint Pen)
U.S. HOUSE OF REPRESENTATIVES
Washington, D.C. 20515.
To the Clerk of the House of Representatives:
I hereby authorize the following payroll action:
Employee Name (First-Middle-Last)
(Any erasures, corrections, or changes
on this form must be initialed by the
authorizing official.)
Effective Date
Type of Action
Beth Anne Lichtenfels
March 1,
1978
Employee Social Security Number:
042-52-4602
☐ Appointment
Employing Office or Committee/Subcommittee
☐ Title Change
Assassinations
Salary Adjustment
☐ 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
Document Control Clerk
Gross Annual Salary*
$14,000
* 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 the salary received from the employing office.
(If Committee Employee, complete appropriate item below.)
1. ☐ Standing Committee: Staff -☐ Clerical or ☐ Professional.
2. ☐ Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res. 956 of 951 Congress.
3. ☐ 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 U.S.C. 3110(b), prohibiting the employment of
relatives.
Date March 14,
19. 79
(Signature of Authorizing Official)
1001S STOKES
(If appropriate, signature of Subcommittee Chairman or Ranking Minority Member).
(Type or print name of Authorizing Official)
Chairman
(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.
Office of Finance use only:
APPROVED:
Chairman, Committee on House Administration
ID
Office Code
Benefits
Monthly Annuity $_.
.00
as of
Payroll
(Revised: August 1, 1977)
Copy for Initiating Office or Committee
NW 88326
Docld:32239478 Page 3
MEMORANDUM
TO:
ALL STAFF
RE:
Payroll Certification
The Regulations and Accounting Procedures for Allowances and
Expenses of Committees, Members and Employees of the U.S. House of
Representatives require that, among other things, the Committee's
monthly payroll certification include the relationship, if any, of
each employee to any current Member of Congress. This certification
is signed monthly by our Chairman.
The following are the relationships to be included in the
certification:
father
mother
nephew
niece
brother-in-law
sister-in-law
son
daughter
brother
sister
uncle
aunt
first cousin
husband
stepfather
wife
stepmother
father-in-law
stepbrother
mother-in-law
stepsister
half-brother
half-sister
son-in-law
daughter-in-law
Please complete the appropriate portion below, sign and date.
this form, which will then become a part of your permanent personnel
file. If this status changes, you must notify the Committee's Budget
Office immediately of the change.
✓ I am not related to any current (95th Congress) Member of Congress.
I am related to a current (95th Congress) Member of Congress.
(Please specify.)
NW 88326
Docld:32239478 Page 4
Oct. 11, 1977
Signature of Employee
Date
C
TO:
FROM:
DATE:
RE:
MEMORANDUM
Tom Howarth, Budget Officer
Charlie Mathews, Special Counsel
October 5, 1977
Ms. Beth AnneLichtenfels
d.e.m
Ms. Beth AnneLichtenfels has accepted the position
of Document Control Clerk with the John F. Kennedy Task
11
Force. Her effective starting date will be October X, 1977,
and her starting salary will be $12,000.00.
Your full co-operation will be appreciated in familiarizing
Ms. Lichtenfels with staff procedures and welcoming her
aboard.
ICM: jl
NW 88326
Docid:32239478 Page 5
eb
PAYROLL AUTHORIZATION FORM
(Please Use Typewriter
or Ballpoint Pen)
U.S. HOUSE OF REPRESENTATIVES
Washington, D.C. 20515
To the Clerk of the House of Representatives: .
I hereby authorize the following payroll action:
Employee Name (First-Middle-Last)
Beth Anne Lichtenfels
(Any erasures, corrections, or changes.
on this form must be initialed by the
authorizing official.)
Effective Date
October 11, 1977
Employee Social Security Number
☐ Appointment
Salary Adjustment
042-52-4602
Employing Office or Committee
Assassinations
Type of Action
Termination (At close of business on effective date)
(If type of action is an Appointment or Salary Adjustment; complete the following information.).
Position Title
Document Control Clerk
(If Committee Employee, complete appropriate item below.)
1. ☐ Standing Committee: Staff -☐ Clerical or ☐ Professional.
2. ☑ Special or Select Committee: Authority-H. Res. 465
Gross Annual Salary
$12,000.00
of 95th Congress. ·
3. ☐ 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 U.S.. .3110(b), prohibiting the employment of ...
relatives.
Date
October 11
1977
(Signature of Authorizing Official)
Louis Stokes
(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 Administration:
Office of Finance use only:
Office Code
Monthly Annuity $.
.00
NW 88326
Docid:32239478 Page 6
APPROVED:
Chairman, Committee on House Administration
Copy for Initiating Office or Committee
21. Department or Agency
OFFICIAL SUPERIOR'S REPORT OF TRAUMATIC INJURY
22. Bureau or Office
HOUSE OF REPRESENTATIVES
SELECT COMMITTEE ON ASSASSINATIONS
23. Name and Address of Reporting Office (No., street, city, state, Zip Code)
HOUSE ANNEX #2 3rd AND D STREET,
WASHINGTON, D.C.
24. Regular Work Day.
Begins
☑ AM
☐ PM
Ends
☐ AM
☑ PM
25. Number of Hours:
Worked Per Day
26. Circle Days Paid Per Week
8.
S
M 1 W
S
27. Date and Hour of Injury
(mo., day, year)
28. Date Reporting Office
Received Notice of Injury
29. Date and Hour Stopped
30. If Pay Has Been Terminated,
☐ AM.
Year)
Work
TINA
(mo, day, year)-
Give Date
(mo., day, year)
7/19/78
☑PM
31. 45 Day Period Begins
(mo., day, year)
cout
$
per
to
33: Do Work
(mo., day, year)
7/19/78.
32. Pay Rate When Employee 33: Date and Hour Employee Returned 34. Name of Supervisor At Time of
Stopped Work
AM
PM
Injury
120WARTH
35. Was Employee In Performance of Duty At The Time of Injury? ☑ Yes, No. If No, Furnish A Detailed Explanation Or A Copy
of Employing Agency's Investigation Report.
dos Alberto un joxicatiese w
36. Was Injury Caused By Willful Misconduct, Intoxication or Intent To Injure Self or Another?
☐ Yes
☑ No. If Yes, Furnish Detailed Report.
37. Was Injury Caused By Third Party?..
Yes ☑ No. If Yes, Furnish Name and Address of Party Responsible...
38. Date Employee First Obtained
Medical Care for The Injury
(mo., day, year)DAS
7/19/78
fox copsgrid chee' four signing
39. Name and Address of Physician First Providing Medical Care
40. Do Medical Reports Show
Employee is Disabled For
། འ ོ་ ་
་་་་
☐ Yes
☑
No
SUBURBAN HOSPITAL EMERGENCY ROOM Work?
BETHESDA, MARYLAND
41. Does Your Knowledge of The Facts About This Injury Agree With The Statements of The Employee. And/Or Witness?
Yes ☐ No. If No, Furnish A Detailed Explanation.
BETEGL
☐ Yes
42. Does The Employing Agency Controvert Continuation of Pay?
☑ No. If Yes, Give Full Explanation For Basis of
Controversion (See Item 6 of Instruction Sheet). Attach Additional Sheets If More Space Is Needed.
☐☐
43. Signature of Supervisor
1.
44. Title and Office Phone Number.
Thomas Howarth Bulyst offices
Budget officer 225-298.
45. Date (mo., day, year)..
7-77-78
NW 88326
Docid:32239478 Page 7
M
U.S. DEPARTMENT OF LABOR
EMPLOYMENT STANDARDS ADMINISTRATION
OFFICE OF WORKERS' COMPENSATION PROGRAMS
1. Name of Injured Employee (Last, first, middle)
LICHTENFELS, BETH ANNE
FEDERAL EMPLOYEE'S NOTICE OF TRAUMATIC INJURY
AND CLAIM FOR CONTINUATION OF PAY/COMPENSATION
2. Date of Birth
1/5/55
3.
Male
4. Social Security Number
5. Employee's Home Mailing Address (No., street, city, state, zip code)
4401 EAST WEST HGWY, BETHESDA, MD. APT 300
7. Name and Address of Employing Agency
☑ Female
042-52-4602
6. Home Telephone
Area Code: 301
Number: 654-7184
8. Place Where Injury Occurred (e.g., 2nd floor, Main Post Office
House SELECT COMM. ON ASSASSINATIONS Bldg., 12th & Pine)
3rd AND D STREET, S.W.
WASHINGTON, D.C.
2nd AND C STREET
WASHINGTON,
D.C.
9. Date and Hour of Injury..
(mo., day, year)
AM
☑ PM
10. Date of This Notice.
(mo., day, year)
7/27/78
11. Dependents
Wife/Husband
13. Cause of Injury (Describe how and why the injury occurred)
Fall was caused by faulty shoe
strap which broke and tripped
injured employee
Children Under 18 Years Old
12. Employee's..
Occupation
Doc. Clerk
14. Nature of Injury (Identify the part of the body injured, e.g.,
fractured left leg, etc.)
Partially separated right shoulder
torn rotating cuff, torn and bruised
tendons, ligaments and muscles. Skin
burn to right shoulder
15. If This Notice and Claim Was Not Filed With The Employing Agency Within 2 Working Days After The Injury, Explain The Reason
For The Delay.
16. I certify that the injury described above was sustained in performance of duty as an employee of the United States Government and that
it was not caused by my willful misconduct, intent to injure myself or another person, nor by my intoxication. I hereby claim medical
treatment, if needed, and the following, as checked below, while disabled for work:
32 ☐ a. Sick and/or annual leave
z que pasou
☐ b. Continuation of regular pay not to exceed 45 days and compensation for wage loss if disability for work continues beyond 45
days (If my claim is denied, I understand that the continuation of my regular pay shall be charged to sick or annual leave, or
be deemed an overpayment within the meaning of 5 USC 5584).
B.
Весь
Signature of Employee or Person Acting on His/Her Behalf
17. Statement of Witness (Describe what you saw, heard or know about this injury)
HONER VITA -5
HOOD OF BEEREALFITADE
18. Witness' Signature
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ФСБУКЕТ митентистой
TBCI COMMON
19. Witness' Address
OELICHAGEBOB EGOBOIBYANVI UMAG
20. Date Signed__
(mo., day, year)
Form CA-1
Rev. Nov. 1974
LOUIS STOKES, OHIO, CHAIRMAN
RICHARDSON PREYER, N.C.
WALTER E. FAUNTROY, D.C.
YVONNE BRATHWAITE, BURKE, CALIF.
CHRISTOPHER J. DODD, CONN.
HAROLD E. FORD, TENN.
FLOYD J. FITHIAN, IND.
SAMUEL L. DEVINE, OHIO
STEWART B. MCKINNEY, CONN.
CHARLES THONE, NEBR.
HAROLD S. SAWYER, MICH.
ROBERT W. EDGAR, PA.
(202) 225-4624
Select Committee on Assassinations
U.S. House of Representatives
3331 HOUSE OFFICE BUILDING, ANNEX 2
WASHINGTON, D.C. 20515
September 25, 1978
Office of Workers' Compensation Programs
Special Claims Unit
711
-
14th Street, N. W.
Washington, D. C. 20211
Dear Sirs:
We are forwarding herewith Form CA-1 for Beth C.
Lichtenfels an employee of this Committee. We apologize
for the late filing but we mis-read the instructions.
While Miss Lichtenfels did not require sick or annual
leave and the Committee did not controvert continuation
of pay, she did require medical treatment.
In the meantime, we filed her Form CA-1 in her per-
sonnel file.
TH: ht
NW 88326
Docld:32239478 Page 9
Sincerely yours,
Thomas Howarh
THOMAS HOWARTH
Budget Officer