## Page 1

Assassination Records Review Board

Final Determination Notification

AGENCY : HSCA

RECORD NUMBER: 180-10068-10357

RECORD SERIES : STAFF PAYROLL RECORDS

AGENCY FILE NUMBER

December 8, 1995

Status of Document: Postponed in Part

Number of releases of previously postponed information: 9

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: 8

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

Heleased under the John F. Kennedy Assassination Records Collection Act of 199

44 USC. 2107 Motel. Case#: N 09926 Date: 2025

NW 88326

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## Page 2

Date: 08/20/93

Page: 1

JFK ASSASSINATION SYSTEM

IDENTIFICATION FORM

AGENCY INFORMATION

AGENCY : HSCA

RECORD NUMBER: 180-10068-10357

RECORDS SERIES :

STAFF PAYROLL RECORDS

AGENCY FILE NUMBER :

DOCUMENT INFORMATION

ORIGINATOR : HSCA

FROM:

TO :

TITLE :

DATE: 12/30/76

PAGES:

SUBJECTS :

SCA, ADMINISTRATION

GOFREY, JANE E.

DOCUMENT TYPE : PRINTED FORM

CLASSIFICATION : U

RESTRICTIONS : 3

PRINTED FORM

CURRENT STATUS : P

DATE OF LAST REVIEW : 07/07/93

OPENING CRITERIA :

COMMENTS :

Box. #:1.

[R] - ITEM IS RESTRICTED

NW 88326

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## Page 3

PAYROLL AUTHORIZATION FOR

(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

Jane to Godfrey

Employee. Social Security Number

December 1g 1978

Type of Action

119•35-4041

Employing Office or Committee/Subcommittee

Assassinations

• Appointment

El 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

Specify Date

Gross Annual Salary*

$23,400.00

,* 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. 0 Standing Committee: Staff—D Clerical or • Professional.

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

-_of 5th Congress.

3. 0

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.

decenter 11

Date

78

19

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

(Type or print name and title of above official)

(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:.

Office of Finance use only:

Office Code..

Monthly Annuity $

Chairman, Commitiee on House Administration

ID --

Benefits

Payroll -

•00 as of

Copy for Initiating Office or Committee

(Revised: August !

NW 88326

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## Page 4

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-Middie-Last)

Jane E. Godfrey

Employee Social Security Number

119-36-4041

Employing Onice or Committee/Subcommittee

Assassinations

Effective Date

12/31/78

Type of Action

• Appointment

• Salary Adjustment

• Title Change

SE 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. Standing Committee: Staff— Clerical or • Professional.

2. & Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res256

0, 95 t' 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.C. 3110(b), prohibiting the employment.of

relatives.

Date.-

Jacuary 2

79

19

Ilf appropriate, signature of Subcommittee Chairman or Ranking Minority Member)

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

(Signature of Authorizing Official)

LOUIS STOKES

CHAT RARE or print nome of Authorizing Ofticial)

(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.

ID

Benefits.

Monthly. Annuity S_

00 as of _

Payroll -

(Revised: August 1, 1977)

Copy: for Initiating Office or Committee

NW 88326

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## Page 5

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:

† hereby authorize. the following.payroll action:

•Employee Name (First-Middle-Last):

4325.

Effective Date

Jane E. Godfrey

Employee Social Security Number

119-36-4041

December 1, 1977

Type of Action

Employing Office or Committee

Assassinations

• Appointment

@ Salary Adjustment:

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

w. (If type of action.is an Appointment:or Salary Adjustment, complete the following.information.)saa/octadetsi

Position Title

Gross Annual Salary

Office Manager

$17,100

(If Committee Employee, complete appropriate item below.)

466r%w2

EJ Standing Committee: Staff -Ll Clerical or E3 Professional.

2. 0 Special or Select Committee: Authority-H. Res.

465

of tl2 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_

Decenber 1

19

77

(Signature of Authorizing Official)

Louts Stokes

(Type or print name of Authorizing Officiall

Chairman

eb

(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

Copy for Initiating Office or Committee:

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)

Jane E. Godfrey

Employee Social Security Number

119-36-4041

3/1/77

Effective Date

Type of Action

Employing Office or Committee

Assassinations

• Appointment

E. 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

Secretary

Gross Annual Salary

16,000

(If Committee Employee, complete appropriate item below.)

1.

Standing Committee: Staff-E Clerical or L Professional.

465.

Special or Select Committee: Authority -H. Res:

_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: 3110(b); prohibiting the employment of.

relatives.

Date -

August &

777

..19

(Signature of Authorizing Official)

- LOUIS STOKES

CHAIRMAN 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-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:32243323 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)

Jane E. Godfrey

Employee Social Security Number

119 36 4041

Effective Date

5/1/77

Type of Action

Employing Office or Committee

Assassinatioes

• Appointment

2. 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

$14,000

(If Committee Employee, complete appropriate item below.)

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

2. 14 Special or Select Committee: Authority-H. Res...

465

_of.

95th

- 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

May

10

-19.

(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 Glassification Act.and for.Committee.em-.

ployees, except those,.of: the Committee on Appropriations; the Committee.on the.Budget,-and-the.Joint.Committees,mustr

be approved by the Committee on House Administration.

APPROVED:

Chairman, Committee on House Administration

Office of Finance use only:

Office Code

Monthly Annuity $.

≤111

.00

Copy for Initiating Office or Committee

NW 88326

Docld:32243323 Page 7

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## 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

Jane t. Godirey

Employee Social Security Number:

4/1/77

Type of Action

119 36 4041

Assassinations

Employing Office or Committee:

[ 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

$26,000

(If Committee Employee, complete appropriate item below.)

1. 0 Standing Committee: Staff-• Clerical or D Professional.

2. 0 Special or Select Committee: Authority-H. Res. 465

_of_ 95thCongress.

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_

April 29, 19-77 €

• (Signature of Authorizing Official)

Louis Stokes

(Type or print name of Authorizing Official)

Chairman

(Title

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

Docld:32243323 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)

Jane Elizabeth Godfrey

Employee Social Security Number

Effective Date

1/3/77

Type of Action

119 35 4041

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

1510,000.

(If Committee Employee, complete appropriate item below.)

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

2. E Special or Select Committée: Authority-H. Res...

_ 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_

1917

(Signature of Authorizing Official)

Henry E.

Gonzalez

(Type or print name of Authorizing Official)

Chaleman

- 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

Docld:32243323 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:

Employee Name (First-Middle-Last)

Effective Date

Jane Elizabeth Godfrey

Employee Social Security Number

119 36 4341

December

30 g

1976

Type of Action

Employing Office or Committee

* Appointment

• Salary Adjustment

• Termination (At close of business on effective date)

Select Committee on Assassinations

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

Position Title

Gross Annual Salary

$14,000.00

Secretary

(If Committee Employee, complete appropriate item below.)

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

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

1540. of 94 th

-_Congress.:

3. L 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_

December 23

÷ 1976

(Signature of Authorizing Official).

Thonas N. Downing, Chairman

(Type or print name of Authorizing Official). i

Select Committee on Assassinations

•(Title-lf Member, Distr

*All appointments and salary adjustments. for employees-under the House Classification Act and for Committee em-t

ployees; except-those of thé 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:32243323 Page 10

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## Page 11

MEMORANDUM

TO:

All Staff Employees

FROM: Budget Officer

DATE:

January 3, 1977

RE:

Payroll Certification

Starting with the January, 1977 payroll, the certification

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

аж.

Signature of

ployee

frey

Ofanuary 1927

NW 88326

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