Originator: HSCA
Document date: 9/9/77
Document type: PAPER-TEXTUAL DOCUMENT

## Page 1

Assassination Records Review Board

Final Determination Notification

AGENCY

: HSCA

RECORD

NUMBER

: 180-10068-10330

RECORD

SERIES

: STAFF PAYROLL RECORDS

AGENCY FILE NUMBER

December 8, 1995

Status of Document:

Postponed in Part

Number of releases of previously postponed information: 5

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

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## Page 2

Date: 08/20/93

Page: 1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA

RECORD NUMBER: 180-10068-10330

RECORDS SERIES :

STAFF PAYROLL RECORDS

AGENCY FILE NUMBER :

DOCUMENT INFORMATION

ORIGINATOR : HSCA

FROM :

TO :

TITLE :

DATE: 09/09/77

PAGES :

5

SUBJECTS :

HSCA, ADMINISTRATION

CULLINGS, JEROME A.

DOCUMENT TYPE : PRINTED FORM

CLASSIFICATION

RESTRICTIONS

CURRENT STATUS

DATE OF LAST REVIEW : 07/07/93

OPENING CRITERIA :

COMMENTS :

Box #:1.

[R] - ITEM

IS RESTRICTED

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## 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)

Jerome A.

Cul

Lings

Employee Social Security Number

220-36-0563

Employing Office or Committee/Subcommittee

Assassinations

12/31/78

Effective Date

Type of Action

• 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.

2. • Special (Investigative staff of Standing Committee) or Select Committee: Authority—H. Res.

-of _ch

-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_.

19

LOUIS

(Signature of Authorizing Official)

STO

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

(Type or print name of Authorizing Official)

CHAIR

(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

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)

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## Page 4

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.)

Jerome

Employee Social Security Number

Effective Date

October 1, 1978

Type of Action

220-36-056

Employing Office or Committee/Subcommittee

SSR8

• 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*

$25,700.00

* If emoloyee 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..

3. • Joint Committee.

-____Congress.

(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. -

19.

(Signature of Authorizing Official)

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

(Type or print name of Authorizing Official)

(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)

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## Page 5

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)

Jerome A.

220 36 0563

Employee Social Security Number

Employing Office or Committee

(Any erasures, corrections, or changes

on this form must be initialed by the

authorizing official.)

Effective Date

Type of Action

9/9/77

[ 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 c

(If Committee Employee, complete appropriate item below.)

1. Standing Committee: Staff -• Clerical or [ Professional.

2. • Special or Select Committee: Authority-H. Res._-

465

of_5 th

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_.

., 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.

APPROVED:

Chairman, Committee on House Administration

Office of Finance use only:

Office Code

Monthly Annuity $

00

Copy for Initiating Office or Committee

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## Page 6

MEMORANDUM

TO:

FROM:

Mr. Blakey

Edward M. Evans/

DATE:

SUBJECT:

September 6, 1977

Jerome Cullings

Mr. Cullings has agreed to take a position with us as

Staff Investigator assigned to the Martin Luther King, Jr.

Task Force.

He will start September 9, 1977 at $24,000.

EME: ek

Q.K.

CRB

5-7.87

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## Page 7

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

motner

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:

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

[7 I am related to a current (95th Congress) Member of Congress.

(Please specify.)

Jerome dr Clings

ignature of employee

18 Octaher 1977

Date

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