Originator: HSCA
Document date: 1977-08-29 00:00:00
Document type: PRINTED FORM

# DOCID-32243324

## Page 1

Date: 08/20/93

Page: 1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA

RECORD NUMBER: 180-10068-10358

RECORDS SERIES :

STAFF PAYROLL RECORDS

AGENCY FILE NUMBER

DOCUMENT INFORMATION

ORIGINATOR : HSCA

FROM :

TO :

TITLE:

DATE : 08/29/77

PAGES: 6

SUBJECTS:

HSCA, ADMINISTRATION

GOLDSMITH, MICHAEL

DOCUMENT TYPE : PRINTED FORM

CLASSIFICATION : U

RESTRICTIONS : 3

CURRENT STATUS: P

DATE OF LAST REVIEW : 07/07/93

OPENING CRITERIA :

Released under the John F

Sennedy assassination

Pecords Collection Act of

1992 (44 USC 2107 Note].

Case#:NW 66000 Date:

11-04-2021

COMMENTS :

Box #:1.

[R] - ITEM IS RESTRICTED

NW 66000

Docld:32243324 Page 1

---

## Page 2

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 Representatives:

I hereby authorize the following payroll action:

• Employee Name (First-Middle-Last)

Effective Date

Michae!

Goldsmith

Employee Social Security Number

058

6772

March 1, 1978

Type of Action

• Appointment

SE Salary Adjustment

Employing Office or Committee/Subcommittee

• Title Change

• Termination (At close of business on effective date).

Assassinations

• 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*

Staff Counsel

$32,000

* 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. 0

Standing Committee: Staff— Clerical or J. Professional.

2. 0

Special (Investigative staff.of: Standing Committee) or Select Committee: Authority-H. Res. 256

ELor ?Et'èongress.

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 24r

, 19_

78

(if appropriate, signature of Subcommittee Chairman or Ranking Minority Member)

(Signature of Authorizing Official)

LOUIS STORES

(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.

APPROVED:

Office of Finance use only:

Office Code...

Monthly Annuity $

Chairman, Committee on House Administration

ID

Benefits --

Payroll __

00

as of

Copy for Initiating Office or Committee

(Revised: August 1, 1977)

NW 66000

Docld:32243324 Page 2

---

## Page 3

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 Representatives:

I hereby authorize the following payroll action:

Employee Name (First-Middle-Last)

Michael Goldsmith

Effective Date

8/29/77

Employee Social Security Number

058 44 6772

Employing Office or Committee

Type of Action

I 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

Gross Annual Salary.

Staff Counsel

$30,000

(If Committee Employee, complete appropriate item below.)

I Standing. Committee: Staff-E] Clerical or [ Professional.

2. I Special or Select Committee: Authority-H. Res.

465

_Congress.

3.

Joint Committee.

- (If Employee of an Officer of the House, complete item below.)

Position Number_

If applicable, Level.

Step_

certify. that this authorization is not in violation of 5 U.S.C: 3110(b), prohibiting the employment of

rélatives.

Date.

August 31

_., 19.

77

(Signature of Authorizing Official)

Louts 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.

APPROVED:

Chairman, Committee on House Administration.

Office of Finance use only:

Office Code.

Monthly Annuity S_

.00

70,

8/31

Copy for Initiating Office or Committee

NW 66000

Docld:32243324 Page 3

---

## Page 4

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

son

daughter

brother

sister

uncle

aunt

first cousin

nephew

niece

husband

wife

father-in-law

mother-in-law

son-in-law

daughter-in-law

brother-in-law

sister-in-law.

stepfather

stepmother

stepbrother

stepsister

half-brother

half-sister

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.

am not related to any current (95th Congress) Member of Congress.

L/ I am related to

a current (95th Congress) Member of Congress.

(Please specify.)

Michel Grate

Signature of Employee

8/30/77

Date

NW 66000

Docld:32243324 Page 4

---

## Page 5

MEMORANDUM

TO: Tom Howarth

FROM: Bob Blakey

DATE: July 8, 1977

RE: Employment of Michael Goldsmith

Michael (Mickey) Goldsmith has been

hired as a Counsel on the Kennedy Task Force at a

salary of $30,000. He will notify us of his

beginning date--it may be as late as September.

NW 66000

Docld:32243324 Page 5

---

## Page 6

MEMORANDUM

TO:

Tom Howarth

FROM: Bob Blakey

DATE: July 8, 1977

RE: Employment of Michael Goldsmith

Michael (Mickey) Goldsmith has been

hired as a Counsel on the Kennedy Task Force at a

salary of $30, 000. He will notify us of his

beginning date-it may be as late as September.

NW 66000

Docld:32243324

Page 6

---

## Page 7

July 7, 1977

Mr. Michael Goldsmith

Blakely Road

R.F. D.

#4

Winooski, Vermont 05404

Dear Mickey:

The enclosed pamphlets are for your

information.

Please send me your current resume and

the completed security torms which are enclosed.

It will be necessary for you also to fill out various

employment forms upon your arrival, and if you could

give me the date you expect to report for work, it

would be helpful.

Sincerely,

G. Robert Blakey

Chief Counsel and Director

GRB: elb

Enclosures

P.S.: Regarding the purchase of the material I

requested you to read, please keep the receipts and

present them to our Chief Clerk for reimbursement

from petty cash.

NW 66000

Docld:32243324 Page 7

---