Assassination Records Review Board
Final Determination Notification
AGENCY :
HSCA
RECORD NUMBER :
180-10068-10357
RECORD SERIES : STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :
December 8, 1995
Status of Document:
Postponed in Part
Number of releases of previously postponed information: 9
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
individual.
States or to any
Number of Postponements: 8
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:32243323 Page 1
Released under the John F. Kennedy Assassination Records Collection Act of 1992
44 USC 2107 Note). Case#:NW 88326 Date: 2025
20
JFK ASSASSINATION SYSTEM
IDENTIFICATION FORM
AGENCY INFORMATION
Date: 08/20/93
Page: 1
AGENCY : HSCA
RECORD NUMBER :
180-10068-10357
RECORDS SERIES :
STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :
ORIGINATOR : HSCA
FROM:
ΤΟ :
TITLE :
DATE : 12/30/76
PAGES : 9
SUBJECTS :
HSCA, ADMINISTRATION
GOFREY, JANE E.
DOCUMENT INFORMATION
DOCUMENT TYPE :
CLASSIFICATION
PRINTED FORM
: U
RESTRICTIONS : 3
CURRENT STATUS : P
DATE OF LAST REVIEW : 07/07/93
OPENING CRITERIA:
COMMENTS :
Box #:1.
[R]
ITEM IS RESTRICTED
NW 88326
Docld:32243323 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
December 1, 1978
Type of Action
Jane E. Godfrey
Employee Social Security Number:
☐ Appointment
119-36-4041
Employing Office or Committee/Subcommittee
Assassinations
☐ Title Change
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
Gross Annual Salary**
$23,400.00
** 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. 56 of 5th 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.
December 11
Date_
78
19
(If appropriate, signature of Subcommittee Chairman or Ranking Minority Member)
(Type or print name and title of above official)
(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:
NW 88326
APPROVED:
Chairman, Committee on House Administration
ID
Office Code
Benefits
Monthly Annuity $.
.00
as of
Payroll.
Copy for Initiating Office or Committee
(Revised: August ! 1977)
Docid:32243323 Page 3
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)
Jane E. Godfrey
(Any erasures, corrections, or changes
on this form must be initialed by the
authorizing official.)
Effective Date
12/31/78
Employee Social Security Number
Type of Action
119-36-4041
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 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..
956
95th
of
Congress.
2. ☑ Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res. _
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.
January 2
Date_
79
19.
(Signature of Authorizing Official)
LOUIS STORES
(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:
NW 88326
Office Code...
Monthly Annuity $_.
Docld:32243323 Page 4
.00
as of
APPROVED:
Chairman, Committee on House Administration
Copy for Initiating Office or Committee
ID
Benefits
Payroll ___
(Revised: August 1, 1977)
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)
(Any erasures, corrections, or changes
on this form must be initialed by the
authorizing official.)
Effective Date
Jane E. Godfrey
Employee Social Security Number
December 1, 1977
Type of Action
119-36-4041
Employing Office or Committee:
Assassinations.
Appointment
Salary Adjustment
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
$17,100
Office Manager
(If Committee Employee, complete appropriate item below.)
1. Standing Committee: Staff ☐ Clerical or ☐ Professional and dupindo
2.
Special or Select Committee: Authority H. Res. 465 of 95th Congress:
3. ☐ Joint Committee.
(If Employee of an Officer of the House, complete item below.) an
✓ Position Number.
If applicable, Level ___ Step _
I certify that this authorization is not in violation of 5 U.S.C. 31.10(b), prohibiting the employment of
relatives.
December 1
Date
19
77.
(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 an
Office of Finance use only:
Office Code _
Monthly Annuity $.
.00
NW 88326
Docld:32243323 Page 5
APPROVED:
Chairman, Committee on House Administration.
Copy for Initiating Office or Committee
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).
Jane E. Godfrey
Employee Social Security Number
119-36-4041
Employing Office or Committee
Assassinations
Appointment
(Any erasures, corrections, or changes
on this form must be initialed by the
authorizing official.)
Effective Date.
8/1/77
Type of Action
☐ Salary Adjustment
Termination (At close of business on effective date).-
(If type of action is an Appointment or Salary Adjustment, complete the following information.)
Position Title
Secretary
(If Committee Employee, complete appropriate item below.)
1. ☐ Standing Committee: Staff -☐ Clerical or ☐ Professional.
2. ☐ Special or Select Committee: Authority H. Res.__
7
Gross Annual Salary
16,000
465
95th
_of_
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
August 2
77
19
(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-s
_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, veter
Office of Finance use only:>>
Office Code
Monthly Annuity $
.00.
NW 88326
Docid:32243323 Page 6
APPROVED:
Chairman, Committee on House Administration
Copy for Initiating Office or Committee:
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
Jane E. Godfrey
5/1/77
Employee Social Security Number
Type of Action
Employing Office or Committee
Assassinations
Appointment
Salary Adjustment
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
$14,000
(If Committee Employee, complete appropriate item below.)
1. ☐ Standing Committee: Staff -☐ Clerical or ☐ Professional.
2. ☑Special or Select Committee: Authority-H. Res.___ 465
3. ☐ Joint Committee.
(If Employee of an Officer of the House, complete item below.).
Position Number_
If applicable; Level__
95th
_of_
Congress. stage
Step
relatives.
certify that this authorization is not in violation of 5 U.S.C. 3110(b), prohibiting the employment of
Date
May 10
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 eme
ployees, except those of the Committee on Appropriations, the Committee on the Budget, and the Joint Committees, musty
be approved by the Committee on House Administration.
Office of Finance use only:
Office Code
Monthly Annuity $.
.00
NW 88326
Docld:32243323 Page 7
APPROVED:
Chairman, Committee on House Administration.
Copy for Initiating Office or Committee
F0 5/11
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)
Jane E. Godfrey
(Any erasures, corrections, or changes
on this form must be initialed by the
authorizing official.)
Effective Date
4/7/77
Type of Action
Employee Social Security Number
119 36 4041
Employing Office or Committee
Appointment
☑ Salary Adjustment
Termination (At close of business on effective date)
Assassinations
(If type of action is an Appointment or Salary Adjustment, complete the following information.).
Position Title
(If Committee Employee, complete appropriate item below.)
1. ☐ Standing Committee: Staff -☐ Clerical or ☐ Professional.
2. ☑ Special or Select Committee: Authority-H. Res. 465 of 95th Congress.
3. ☐ Joint Committee.
(If Employee of an Officer of the House, complete item below.)
Position Number_
If applicable, Level
Step__
Gross Annual Salary
$26,000
I certify that this authorization is not in violation of 5 U.S.C. 3110(b), prohibiting the employment of
relatives.
Date_
April 29, 19_11
(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:
NW 88326
Office Code….
Monthly Annuity $__
.00
Docid:32243323 Page 8
APPROVED:
Chairman, Committee on House Administration
Copy for Initiating Office or Committee
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
Jane Elizabeth Godfrey.
1/3/77
Employee Social Security Number
119 36 4041
Employing Office or Committee
Select Committee on Assassinations
Appointment
Salary Adjustment
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
(If Committee Employee, complete appropriate item below.)
1:
Standing Committee: Staff -☐ Clerical or ☐ Professional.
Gross Annual Salary
$10,000.
2. Special or Select Committée: Authority-H. Res... 11 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 violation of 5 U.S.C. 3110(b), prohibiting the employment of
relatives...
Date_
1977
(Signature of Authorizing Official)
Henry B. Gonzalez
(Type or print name of Authorizing Official)
Chaieman
(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:32243323 Page 9
APPROVED:
Chairman, Committee on House Administration
• Copy for Initiating Office or Committee'
١٢٠
PAYROLL AUTHORIZATION. FORM
(Please Use Typewriter ☐ U.S. HOUSE OF REPRESENTATIVES.
.or Ballpoint Pen).
Washington, D.C. 20515
To the Clerk of the House of Representatives:
I hereby authorize the following payroll action:
Employee Name (First-Middle-Last)
Jane Elizabeth Godfrey
Employee Social Security Number
(Any erasures, corrections, or changes
on this form; must be initialed by the
authorizing official.)
Effective Date
December 30, 1976
Type of Action
119 36 4941
Appointment
Employing Office or Committee
Select Committes on Assassinations
Salary Adjustment.
Termination (At close of business on effective date)
(If type of action is an Appointment or Salary Adjustment, complete the following information.).
Position Title
Secretary
(If Committee Employee, complete appropriate item below.)
Standing Committee: Staff -☐ Clerical or ☐ Professional.
L
2. ☐ Special or Select Committee: Authority-H. Res. 1540 of 94th
3. Joint Committee..
(If Employee of an Officer of the House, complete item below.)
Position Number_.
If applicable, Level_
Step
Gross Annual Salary
$14,000.00
Congress.
relatives.
Date
certify that this authorization is not in violation of 5 U.S.G. 3110(b), prohibiting the employment of
December 23
1975
(Signature of Authorizing Official).
Thomas N. Downing, Chairman
(Type or print name of Authorizing Official).?
Select Committee on Assassinations
(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.
APPROVED:
Chairman, Committee on House Administration
Monthly Annuity $
.00
✓ Copy for Initiating Office or Committee
NW 88326
Docid:32243323 Page 10

MEMORANDUM
TO:
All Staff Employees
FROM:
Budget Officer
DATE:
January 3, 1977
RE:
Payroll Certification
Starting with the January, 1977 payroll, the certification
to the House Finance Office requires, among other things, the
relationship, if any, of each staff employee to any current
Member of Congress (those taking office January 3, 1977).
The following are the relationships to be included in
the certification:
father
mother
son
daughter
brother
nephew
niece
husband
wife
father-in-law
mother-in-law
brother-in-law
sister-in-law
stepfather
stepmother
stepbrother
stepsister
sister
uncle
aunt
first cousin
son-in-law
daughter-in-law
half-brother
half-sister
All staff employees are requested to complete this
form and return it to the Budget officer.
Approved
Richard A. Sprague
I am not related
✓
I am related by the following relationship
Jane E addrey
Signature of Employee
NW 88326
Docid:32243323 Page 11
10 January 1977