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Assassination Records Review Board

Final Determination Notification

AGENCY :

HSCA

RECORD

NUMBER

: 180-10060-10470

RECORD

SERIES

: STAFF PAYROLL RECORDS

AGENCY FILE

NUMBER

December 8, 1995

Status of Document:

Postponed in Part

Number of releases of previously postponed information: 6

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

Released under the John F

Kennedy assassination

Records Collection Act of

Case#:NW 88326 Date:

NW 88326

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•=

Date: 08/20/93

Page: 1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA

RECORD NUMBER

: 180-10060-10470

RECORDS SERIES :

STAFF PAYROLL RECORDS

AGENCY FILE NUMBER :

DOCUMENT INFORMATION

ORIGINATOR : HSCA

FROM

TO :

TITLE:

DATE: 10/11/77

PAGES : 7

SUBJECTS :

HSCA, ADMINISTRATION

LICHTENFELS, BETH ANNE

DOCUMENT TYPE : PRINTED FORM

CLASSIFICATION : U

RESTRICTIONS : 3

CURRENT STATUS : P

DATE OF LAST REVIEW : 06/04/93

OPENING CRITERIA :

COMMENTS :

BOX

[R] - ITEM IS RESTRICTED

NW 88326

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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

Beth Anne Lichten els

Employee Social Security. Number

March

1978

Type of Action

942-52-4602

Employing Office or Committee/Subcommittee

Assassinazions

• 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*

Docisn' Control Clerk

524, 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. • Standing Committee: Staff—• Clerical or • Professional.

2. : Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res. 2542 of 25$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

not. in violation of..5 U.S.C: 3110/b), prohibiting the employment of:

relatives.

Date Maren 122-

-, 19

29

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

(Signature of Authorizing Officiall

222S

S2083S_

(Type or print name of Authorizing Official)

Chasmas

(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

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## 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

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.

X/

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

1 am related to a current (95th Congress) Member of Congress.

(Please specify.)

Bed Arme

Distendela

Signature of Employee

Oc 1,902

Date

NW 88326

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TO:

Tom Howarth, Budget Officer

FROM:

DATE:

October 5, 1977

RE: Ms. Beth AnneLichtenfels

Ms. Beth Annelichtenfels has accepted the position

of Document Control Clerk with the John F. Kennedy Task

Force:

Her effective starting date will be October X, 1977,

and her starting salary will be $12,000.00.

Your full co-operation will be appreciated in familiarizing

Ms. Lichtenfels with staff procedures and welcoming her

aboard.

ICM: j1

NW 88326

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## Page 6

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

Beth Anne Lichtenfels

Employee Social Security Number

042-52-4602

Octeber 11, 1977

Type of Action

Employing Office or Committee

EJ 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

Document Control Clerk

$12,000.00

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

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

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

465

..of_25th. Congress.

3. I 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.E: 3110(b), prohibiting the employment of..

relatives.

Date_.

October 11

., 1977

eb

(Signature of Authorizing Official)

Loufs 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

NW 88326

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## Page 7

HER LAUN

JONg

20nd Eu

OFFICIAL SUPERIOR'S REPORT OF TRAUMATIC INJURY

1407 dole Nea

21. Department or Agency

HOUSE OF REPRESENTATIVES

22. Bureau or Office

SELECT COMMITTEE ON ASSASSINATIONS

29922S0A

coperas

23. Name and Address of Reporting Office (No., street, city, state, Zip Code)

HOUSE ANNEX #2

3ra AND D. STREET, WASHINGTON, D.C

24. Regular Work Day

Begins

SAM

PM

AM

Ends

PM

28. Date Reporting Office

Received Notice of Injury

25. Number of Hours

Worked Per Day

8

26. Circle Days Paid Per Week

27. Date and Hour of Injury.

(mo., day, year)

7/19/78

29. Date and Hour Stopped

Work

04. 5366997

(mon, day, year.

30. If Pay Has Been Terminated,

Give Date

(mo. day, year)

JAM.

LX PM

31. 45 Day Period Begins

(mo., day, year)

20 0.

32. Pay Rate When Employee

05h

Stopped Work

2:091

33: Date and Hour Employee.Returned

to Work:

34. Name of Supervisor At Time of

GFV33

600 42 57

$

- per

35. Was Employee In Performance of Duty At The Time of Injury?

of Employing Agency's Investigation Report.

Yes,

-01(5t

DAM

go: 11990

D3 PM

No. If No, Furnish A Detailed Explanation Or A Copy

MANS Q09P90 491 P06

R0UR804.40y2GG09A08 104014

CLA COCCADOR B20AG MG: 3026097 6/66:

36. Was Injury Caused By Willful Misconduct, Intoxication or Intent To Injure Self or Another?

Yes

No. If Yes, Furnish Detailed Report.

37. Was Injury Caused By Third Party?..

Yes

X, No. If Yes, Furnish Name and Address of Party Responsible.

20X1

copterid chige

38. Date Employee First Obtained

39. Name and Address of Physician First Providing Medical Care

Medical Care for The Injury

chan 9:9128' 6004

(mo., day, year) /06pm

SUBURBAN HOSPITAL EMERGENCY ROOM

7/19/78

BETHESDA, MARYLAND

SugarCe 0/26 16 4606 019

MAD:H0:0014

41. Does Your Knowledge of The Facts About This Injury Agree With The Statements of The Employee And/Or Witness?

Yes:

No. If No, Furnish A Detailed Explanation.

fG3E

40. Do Medical Reports Show

Employee is Disabled For

.. Work? on waki

Yes

XI No

SETE

964"

WAS BA.CH

42. Does The Employing Agency Controvert Continuation of Pay?

Yes

R$ No.

If Yes, Give Full Explanation For Basis of

Controversion (See Item 6 of Instruction Sheet). Attach Additional Sheets If More Space Is Needed. *

1 2.07

cape to trad

of Superviso

44. Title and Office Phone Number....

Budgot Officer 245-298.

45. Date (mo., day, year)..

7-87-78

NW 88326

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U.S. DEPARTMENT OF LABOR

EMPLOYMENT STANDARDS ADMINISTRATION

OFFICE OF WORKERS' COMPENSATION PROGRAMS

1. Name of Injured Employee (Last, first, middle)

LICHTENFELS, BETH ANNE

FEDERAL EMPLOYEE'S NOTICE OF TRAUMATIC INJURY

AND CLAIM FOR CONTINUATION OF PAY/COMPENSATION

2. Date of Birth

3.

1/5/55

Male

4. Social Security Number

042-52-4602

5. Employee's Home Mailing Address (No., street, city, state, zip code)

4401 EAST WEST HGWY, BETHESDA, MD. APT 300

Female

6. Home Telephone

Area Code:

301

Number: 654-7184

7. Name and Address of Employing Agency

8. Place Where Injury Occurred (e.g., 2nd floor, Main Post Office

House SELECT COMM. ON ASSASSINATIONS Bldg., 12th & Pine)

3rd AND D STREET, S.W.

2nd AND C STREET

WASHINGTON, D.C

212154-6

WASHINGTON, D.C.

9. Date and Hour of Injury.

10. Date of This Notice

(mo., day, year)

DAM

(mo., day, year)

7/17/78

ДЕРМ

7/27/78

13. Cause of Injury (Describe how and why the injury occurred

Fall was caused by faulty shoes

strap which broke-and tripped

injured employee

11. Dependents.

12. Employee's

Wife/Husband

Occupation

Children Under 18 Years Old

oc. Clerk

14. Nature of Injury (Identify the part of the body injured, e.g..

fractured left leg, etc.)

B1 4it

40: 960.

-Partially separated right shoulder

torn rotating cuff, torn and bruised

tendons, ligaments

and muscles. Skin

burn to right shoulder

15. If This Notice and Claim Was Not Filed With The Employing Agency Within 2 Working Days After The Injury, Explain The Reason

For The Delay,

140 14 A99 ECue De9099 49201

16. I certify that the injury described above was sustained in performance of duty as an employee of the United States Government and that

it was not caused by my willful misconduct, intent to injure myself or another person, nor by my intoxication. I hereby claim medical

treatment, if needed, and the following, as checked below, while disabled for work:

a. Sick and/or annual leave: D

9.10:9044

: $7.

b. Continuation of regular pay not to exceed 45 days and compensation for wage loss if disability for work continues beyond 45

days (If my claim is denied, I understand that the continuation of my regular pay shall be charged to sick or annual leave, or

02:09714166 65209

196404

King on His/Her Behalf

17. Statement of Witness (Dascribe what you saw, heard or know about this injury)

149:159 60. 032.

Hones. 2113X

220170-D 206ESH

мантиетой!

NO*C

49029

18: Witness' Signature

NESSE SORBAGE INLADE

19. Witnass' Address.

antor concaten on veerance

Au0408

20. Date Signed

(mo., day, year)

Form CA-1

Rev. Nov. 1974

NW 88326

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LOUTS STOKES, OHIO, CHAIRMAN

RICHARDSON PREYER, N.C.

SAMUEL L. DEVINE, OHIO

STEWART B, MC KINNEY, CONA.

GHRISTOPHER J. D00D CONN

HAROLD E. FORD, TENN.

FLOYD J. FITHIAN, IND.

ROBERT W. EDGAR, PA.

HAROLD S. SAWYER,

MiCK.

(202) 225-4524

Select Committee on Assassinations

H.. House of Representatines

3331 HOUSE OFFICE BUILDING, ANNEX 2

WASKINGTON, D.C. 20515

September 25, 1978

Office of Workers' Compensation Programs

Special Claims Unit

711 - 14th Street, N.

Washington, D. C.

W.

20211

Dear Sirs:

We are

forwarding herewith Form CA-l for Beth C.

Lichtenfels an employee of this Committee. We apologize

for the late filing but we mis-read the instructions.

While Miss Lichtenfels did not require sick or annual.

leave and the Committee did not controvert continuation

of pay, she did require medical treatment.

In the meantime, we filed her Form CA-1 in her per

sonnel file.

Sincerely yougs,

Thomas Howast

THOMAS HOWARTH

Budget Officer

TH: ht

NW 88326

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