Assassination Records Review Board
Final Determination Notification
AGENCY
RECORD NUMBER
: HSCA
:
RECORD SERIES :
AGENCY FILE NUMBER :
180-10068-10362
STAFF PAYROLL RECORDS
December 8, 1995
Status of Document:
Postponed in Part
Number of releases of previously postponed information: 4
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: 2
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:32243328 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:
180-10068-10362
RECORDS SERIES :
STAFF PAYROLL RECORDS
AGENCY FILE NUMBER :
ORIGINATOR: HSCA
FROM:
TO :
TITLE :
DOCUMENT INFORMATION
DATE: 05/12/78
PAGES: 4
SUBJECTS :
HSCA, ADMINISTRATION
GREEN, CHARLOTTE
DOCUMENT TYPE :
CLASSIFICATION
RESTRICTIONS
PRINTED FORM
: U
: 3
CURRENT STATUS: P
DATE OF LAST REVIEW: 07/07/93
OPENING CRITERIA :
COMMENTS :
Box #:1.
'NW 88326
Docld:32243328 Page 2
[R]
-
ITEM IS RESTRICTED
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:
7/31/78
Type of Action
☐ Salary Adjustment
Charlotte Green
Employee Social Security Number
148-52-9861
☐ Appointment
Employing Office or Committee/Subcommittee
☐ Title Change
Assassinations
☐ Termination (Af 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.
2. ☑Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res. 956 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.C.: 31-10(b), prohibiting the employment of
relatives
.
Date August 10.
19_78
(Signature of Authorizing Official)
(Type or print name of Authorizing Official)
LOUIS STOKES, CHAIRMAN
(If appropriate, signature of Subcommittee Chairman or Ranking Minority Member)
(Type or print name and title of above official)
(Title If Member, District and State)
All appointments and salary adjustments for employee's 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
Copy for Initiating Office or Committee
(Revised: August 1977)
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Docid:32243328 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)
Charlotte Green
(Any erasures, corrections, or changes
on this form must be initialed by the
authorizing official.)
5/12/78
Effective Date
Employee Social Security Number
Type of Action
148-52-9861
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
Summer Intern
Gross Annual Salary*
$6240.00
* 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. 956 of 95t 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 May 22
1978
(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)
CHAIRMAN
(Type or print name of Authorizing Official)
(Title If Member, District and State)
All appointments and salary adjustments for employee's 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 $_
NW 88326
Docid:32243328 Page 4
.00
as of
APPROVED:..
Chairman, Committee on House Administration.
Copy for Initiating Office or Committee
ID
Benefits
Payroll
(Revised: August 1, 1977)
Certificate of Relationship/Nonrelationship to
Any Current Member of Congress
Date
• "May 12, 1978
To: House Select Committee on Assasinations
(Employing Authority)
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Docid:32243328 Page 5
I certify that I do not have any of the following relationships to any
current Member of Congress.
father
mother
nephew
niece
son
husband
daughter
wife
brother
sister
uncle
aunt
first cousin
I certify that I am the
Honorable
father-in-law
mother-in-law
son-in-law
daughter-in-law
brother-in-law
(Relationship)
sister-in-law
stepfather
stepmother
stepson
stepdaughter
stepbrother
stepsister
half-brother
half-sister
of the
(Name of Member to whom related)
Charlott A. Green
(Employee)
GPO
16-78695-3
MEMORANDUM
TO:
FROM:
DATE:
RE:
Thomas Howarth, Budget Officer
Elizabeth Berning, Chief Clerk
2tem
I. Charles Mathews, Special Counsel
May 22, 1978
Charlotte Green
Please be advised that effective Friday, May 12,
1978, Ms. Charlotte Green joined the Committee staff as
a summer intern. Her effective starting salary will be
$6240.00 per annum.
If you have any questions concerning this matter,
please contact me at your convenience.
ICM: j
NW 88326
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