## Page 1

Assassination Records Review Board

Final Determination Notification

AGENCY : HSCA

RECORD NUMBER: 180-10068-10363

RECORD SERIES : STAFF PAYROLL RECORDS

AGENCY FILE NUMBER

December 8, 1995

Status of Document: Postponed in Part

Number of releases of previously postponed information: 11

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: 9

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

Feleased under the John F. Kennedy Assassination Records Collection Act of 1992144 050

2107 Notel. Case#iN 89326 Date: 2025

NW 88326

Docld:32243329 Page 1

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## Page 2

Date: 08/20/93

Page: 1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA

RECORD NUMBER: 180-10068-10363

RECORDS SERIES :

STAFF PAYROLL RECORDS

AGENCY FILE NUMBER :

DOCUMENT INFORMATION

ORIGINATOR : HSCA

FROM :

TO :

TITLE:

DATE : 01/01/77

PAGES : 11

SUBJECTS :

HSCA, ADMINSTRATION

GRIMES, MARY SUSAN

DOCUMENT TYPE : PRINTED FORM

CLASSIFICATION : 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:32243329 Page 2

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## Page 3

PAYROLL AUTHORIZATION FORM

(Please Use Typewriter

or Ballpoint Pen)

U.S.

HOUSE CF REFRESENTATIVES

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

Mary Susan Grines

Employee Social Security Number

212-56-6718

12/31/78

Type of Action

Employing Office or Committee/Subcommittee

Assassinations

• Appointment

• Salary Adjustment

• Title Change

2M: Termination (At close of business on effective date)

• Leave without pay (Beginning with effective date above and ending

close of business_

(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below.)

Position Title

Specify Date

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. 0 Standing Committee: Staff— Clerical or Professional.

2. El Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Rest 56

-_0#5Ch_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__..

January

2

1979

(Signature of Authorizing Official)

LOUIS 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.

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 88326

Docld:32243329 Page 3

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## Page 4

PAYROLL AUTHORIZATION

(Please Use Typewriter

or Ballpoint Pen)

FC

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:

HaEy

Susan

• Employee Name (First-Middle-Last)

Grines

• Effective Date

Hovenbes 1, 1978

Employee Social Security Number

Type of Action

212-566718

Employing Office or Committee/Subcommittee

Asse0sinat1o28

= 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_

(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below.)

Position Title

Researcher

Specify Date

Gross Annual Salary*

$4, 200.00

* 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.)

1.0

Standing Committee: Staff— Clerical or • Professional.

2. I. Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res?56_

-_of Set 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 s. U.S.C. 3110(b), prohibiting the employment of

relatives.

Date_

Noverbar &

1978

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

•(Type or print name and title of above official)

(Signature of Authorizing Official)

LOUIS STOKES

(Type or print name öf Authorizing Official)

Chairan

(Title - It 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 S

Chairman, Committee on House Administration

ID ---

Benefits -

Payroll _

00 as of

Copy for Initiating Office or Committee

(Revised: August !

NW 88326

Docld:32243329 Page 4

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## Page 5

Certificate of Relationship/Nonrelationship to

Any Current Member of Congress

Date.

Mox z

no: Set Committu on Assassinations

(Employing Authority)

& I certify that I do not have any of the following relationships to any

current Member of Congress.

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

stepson

stepdaughter

stepbrother

stepsister

half-brother

half-sister

I certify that I am the

of the

(Relationship)

Honorable

(Name of Member to whom related)

Man Susa Gimm

(Employee)

GPO

16-78695-3

NW 88326

Docld:32243329 Page 5

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## Page 6

DUCB IS

F50. 9178

DISTRICT UNEMPLOYMENT COMPENSATION BOARD

LOW EARNINGS REPORI-To be completed by the employer and delivered

to the claimant at his sequest.

Employee's

212-56-6718

Social Security No. -

Name ---

Mary Susan Grimes

1. During the CALENDAR WEEK beginning SUNDAY -

October 22

and ending

SATURDAY

October 28

_(NOT your payroll week, if different),

this employee worked 1 FULL TIME XO PART TIME

2. His gross earnings paycule before deductions, which include tips, cash value of meals, lodgings, and all other remunera-

tion for that week were S_: 63.64

3. Original employment date

Oct 18

Last day worked

_October 25

and

Reason for separation -

employee works one day a week untie and of December

Select Committee on Assassinations

1. Employer's Name

and

Address -

U,S House of Representatives.

toler 15.

1978 Tom Howarth 2252980

Sigassure of authorized orüriul)

1-55701

(DArE)

(Person who nuay be cootaciod)

(Phone No.)

XXXXXXXX

XXXXXXXXXXXXXXXX

OFFICE USE ONLY

XXXXXXXXXXXXXXXXXXXXXXXX

XXXXXXXXXXX

O LER accepted as an Additional Claim (Larnings oxceed eligibility amount.) .

Date of Claim

Office

Representative

DOCB 119

Ter. 9/78

DISTRICT UNEMPLOYMENT COMPENSATION BOARD

LOW EARNINGS REPORT-To be completed by the employer and delivered

to the ciaimant at his request.

Encloyee's

212-56-6718

Social Security No. -

Name Mary Susan Grimes.

October 15

During the CALENDAR WEEK beginning SUNDAY -

- and ending

SATURDAY

October 21

__(NOT your payroll week, it different),

this employee worked D FULL TIME

& PART TIME

2. His gross earnings payable before deductions, which include tips, cash value of meals, lodgings, and all other remunera-

tion for that week were $-:

63.64

Oct 18

3. Original employment date

Oct

18

Last day worked

arid

Reason for separation

employee works one day a week until end of DECEMBER:

1. Employer's Name

Select Committee on Assassinations

and.

Address ..

U.S. House of Representatives

1104d0

1-55703

tober 18.1978

Tom I

Howarth.-

225-2980

(Person #ho may be contackod)

(Phone No.y

zansure of aushorized atruly

(DAre)

XXXXXXXX

XXXXXXXXXXXXXXXXXXXXXXXXX.

OFFICE USE ONLY

XXXX

[I LER accepted as an Additional Claim (Earnings oxceed eligibility amount.).. N

Date of Claim

Office Representative

NW 88326

Docld:32243329 Page 6

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## Page 7

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

Mary

Susan

Grises

Employee Social Security Number

9/15/78

Type of Action

212-56-6718

Employing Office or Committee/Subcommittee

Assassinations

• Appointment

• Salary. Adjustment.

7 Title Change

Z Termination (At close of business on effective date)

• Leave without pay (Beginning with effective date above and ending

close of business_.

(If type of action is an Appointment, Salary Adjustment, or Title Change, complete appropriate information below.)

Position Title

Specify Date

Gross Annual Salary*

* If employee is a civil service annuitant (includes U:S: House of Representatives), the gross annual saläry 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—D Clerical or • Professional. :

2.8

Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res: 956_of_25k*Congress:

3. • Joint Committee.

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

Position Number_

If applicable, Level

Step_

I certity that this authorization is not in violation of 5. U.S.C. 3110(b); prohibiting the employment of

relatives.

Date_

September

14

1928

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

(Signature of Authorizing Official)

LOUIS STOKES, CHAIRMAN

(Type or print rome 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

NW 88326

Docld:32243329 Page 7

---

## Page 8

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

Mary

Susan Grimes

Employee Social Security Number

212 56 6718

5/1/77

Type of Action

Employing Office or Committee

Assassinations

• Appointment.

i Sclary Adjustment:

• Termination (At close of büsiness on effective date):

(If type of action is an Appointment.or Salary Adjustment, complete the following information.)

Position Title

Gross Annual Salary

$21,000

(If Committee Employee, complete appropriate item below.)

1. • Standing Committee: Staff-D Clerical or E Professional:

2. 1 Special or Select Committee: Authority-H. Res.

465

-of 25 th

L 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. U.S.C. prohibiting the emplöyment of:

relatives.*

Date-

Nay 10

- 19_77

(Signature of Authorizing Officiall

Aouis Stokes

(Type or print name of Authorizing Official)

Chai man

Member, District and State)

Allappointments 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, Committée on House Administration

Office of Finance use only:

Office Code.

Monthly Annuity S

5111

.00

Copy for Initiating Office or Committee:

NW 88326

Docld:32243329 Page 8

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## Page 9

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

Mary Susan Grimes

Employee Social Security Number

272 56 6718

4/1/77

Type of Action

• Employing Office or Committee

I Appointment

( Salary Adjustment

Assassinations

•. 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

$44, 600

(If Committee Employee, complete appropriate item below.)

1. L Standing Committee: Staff- Clerical or l Professional.:

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

465

-of 35th Congress::

3. I Joint Committee.

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

Pôsition 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_ i

April 29

.,19_77

(Signature of Authorizing Official)

Louis Stokes

(Type or print name of Authorizing Official)

Chairman

Member, District and State)

All appointments and salary adjustments for employees under the House Classification Act and for Committeé em-

ployees, except.those of the Committee.on Appropriations; the Committee on the Budget, and. the Joint Committees, musts.

•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

NW 88326

Docld:32243329 Page 9

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## Page 10

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:

Mary Susan Grimes

Employee Name (First-Middle-Last)

Employee Social Security Number

Effective Date

2-7-77

Type of Action

212-56-6718

Employing Office or Committee:

Select Committee on 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

$12,915.

(If Committee Employee, complete appropriate item below.) :

1. L Standing Committee: Staff -L Clerical or L Professional.

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

11

-__of_.

95

__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

relatives.

Date_

228-77

., 19

(Signature of Authorizing Official)

Henry B. Gonzalez

Chairman

(Type or print name of Authorizing Official)

(Title- If Member, District and State)

*4. 4".

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.

APPROVED:

Chairman, Committee on House Administration

Office of Finance use only:

Office Code.

Monthly. Annuity S_

00

Copy for Initiating Office or Committee:

NW 88326

Docld:32243329 Page 10

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## Page 11

PAYROLL AUTHORIZATION FORM

(Please Use Typewriter

or Ballpoint Pen)

To the Clerk of the House of Representatives:

U.S. HOUSE OF REPRESENTATIVES

Washington, D.C. 20515

(Any erasures, corrections, or changes

on this form must be initialed by the

authorizing official.)

I hereby authorize the following payroll action:

Employee Name (First-Middle-Last),

Nary Susan Grimes

Employee Social Security Number

Effective Date

173/77

Type of Action

27E 56 6718

_Employing Office or Committee

Select Conmittee on 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

$13,650.

(If Committee Employee, complete appropriate item below.)

1. L Standing Committee: Staff - Clerical or Professiónal:

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

of25ch

Congress.

-3.

Joint Committee.

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

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)

Henrg 3.

Gonzalez

(Type or print name of Authorizing Official)

Chairman

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_

Copy for Initiating Office.or Committee ;

NW 88326

Docld:32243329 Page 11

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## Page 12

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

Mary Susan Crimes

Employee Social Security Number

1/1/77

Type of Action

212-56 6710

Employing Office or Committee

Satect Committee on Assassinations

I 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

$21,000

Researcher ‹

(If Committee Employee, complete appropriate item below.) *

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

• IX Special or Select Committee: Authority-H. Res. L542

of24 th

_Congress.

3.

_ Joint Committee.

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

Position Number_

If applicablé, Level

Step_

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

relatives.

Date_

December 30

. 1976

(Signature of Authorizing Official)

Thomas il. downing, Chairman

(Type or print name of Authorizing Official)

Seléct Committee on Assassinations

(Title - If Member, District and State)

"in-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:

Office Code.

Monthly Annuity S

.00

. Copy for Initiating Office or Committee

NW 88326

Docld:32243329 Page 12

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## Page 13

MEMORANDUM

TO:

All Staff Employees

FROM: Budget Officer

DATE: January 3, 1977

RE:

Payroll Certification

Starting with the

January, 1977 payroll, the certificatior

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

sister

uncle

aunt

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

first cousin

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

sisaL

Grimis

Signature of Employee

110)7I

NW 88326

Docld:32243329 Page 13

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