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....

AGENCY

RECORD NUMBER

RECORD

SERIES

AGENCY FILE

NUMBER

Assassination Records Review Board

Final Determination Notification

: HSCA

: 180-10068-10321

: STAFF PAYROLL RECORDS

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: 4

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

Kennedy Assassination

Records Collection Act of

1992 (44 USC 2107 Note).

Case#:NW 88326 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: 180-10068-10321

RECORDS SERIES :

STAFF PAYROLL RECORD

AGENCY FILE NUMBER :

DOCUMENT INFORMATION

ORIGINATOR : HSCA

FROM:

TO:

TITLE :

DATE: 08/18/77

PAGES : 5

SUBJECTS:

HSCA, ADMINISTRATION

DOCUMENT TYPE : PRINTED FORM

CLASSIFICATION

RESTRICTIONS

: 3

CURRENT STATUS

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 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)

Oliver jo

Champlon

Employee Social Security Number

086-46-9505

Employing Office or Committee/Subcommittee

Ascongrations

Effective Date

8/31/78

Type of Action

• Appointment

• Salary Adjustment

DJ. 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*

* 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: 956 of 95 thCongress.

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. September 14

., 19_28.

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

(Signature of Authorizing Official)

LOUIS

STORES,

CHAIRWAR

(Type or print name of Authorizing Official)

(Type or print name and title of above official)

(Title - If Member, District and Stote)

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

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

Oliver I. Champion

Employee Social Security Number

March 1, 1973

Type of Action

086-46-9505

Employing Office or Committee/Subcommittee

A090826

recions

• Appointment

I 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*

Clerical Assiscant

$22:000

* If employee is a civil service annuitant (includes U.S. House of Representatives), the gross annual salary shown should inclüde 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. *Special (Investigative staff of Standing Committee) or Select Committee: Authority-H. Res. 956-of 95*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_

Masch 14,

78

19_

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

(Signature of Authorizing Official)

LO0t8-800558-----

(Type or print name of Authorizing Official)

(Type or print name and title of above official)

Chairmen-

(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 ! 1977)

NW 88326

Docld:32243287 Page 4

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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:

I hereby authorize the following payroll action:

Employee Name (First-Middle-Last)

Effective Date

oliver da Champion

Employee Social Security Number

Decenber T, 1977

Type of Action

036-46-9505

Employing Office or Committee/Subcommittee

Assassinacions

• Appointment

E 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*

Clerical Assistant

$88,000

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

465

-of a 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_

Decenter 1

1977

(Signature of Authorizing Official)

Louis Stokes

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

(Type or print name of Authorizing Official)

nathan

(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 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)

Oliver J. Champion

Employee Social Security Number

086-46-9506

Effective Date

8/18/77

$ 40

Type of Action

Employing Office or Committee

Assassinations

I Appointment

• Salary Adjustment

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

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

Position Title

Gross Annual Salary

Clerical Assistant

$9,500

(If Committee Employee, complete appropriate item below.)

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

2. [ 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._

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

relatives.

Date_.

August 22

- 19

77

(Signature of Authorizing Official)

(Type or print name of Awhorizing Official

LOUIS STOMAS, 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

Docld:32243287 Page 6

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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 Conmittee'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.

I 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.)

Whih 1

Champion

Ang.

18

1927

Date

NW 88326

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