Region District No. Date Report Completed

Transcription

1 ANNUAL REPORT 2014 MOST WORSHIPFUL PRINCE HALL GRAND LODGE OF FREE AND ACCEPTED MASONS OF NORTH CAROLINA AND JURISDICTION, INC. P. O. Box 1507, Durham, NC, ANNUAL REPORT FOR THE MASONIC YEAR ENDING JUNE 30, 2014 SHOULD BE RECEIVED BY GRAND LODGE NO LATER THAN JULY 31, 2014 (Please type or print legible) Lodge Information: Lodge Name: Region District No. Date Report Completed Incoming Worshipful Master Name: Address: City NC Zip: - Home Phone: ( ) Cell Phone: ( ) Send ALL Correspondence and Communications To: Title: Name: Address: City NC Zip: - Home Phone: ( ) Cell Phone: ( ) Physical Street Address, City, State, Zip Code of Masonic Temple: Mailing Address, City, State, Zip Code of Masonic Temple: Day and Time of Meetings: REQUIRED IRS INFORMATION: IRS GEN (Group Exempt No.) Local Lodge s IRS Tax ID: TOTAL RECEIPTS FOR MASONIC YEAR ENDING JUNE 30, 2014 $ LODGE SEAL AND CERTIFICATION OF REPORT: (SEAL) W.M. Bonded ( ) Yes ( ) No Secretary Bonded ( ) Yes ( ) No Treasurer Bonded ( ) Yes ( ) No FOR GRAND LODGE OFFICE USE ONLY DATE AMOUNT INITIALS Annual Report Received By Grand Lodge ********** Payments Received Number of Cards ********** Cards Mailed ( ) or Picked Up ( ) ********** Page 1 of 7

2 Lodge No. Elected and Appointed Returns: Title Name Primary Telephone W.M. S.W. J.W. S.D. J.D. S.S. J.S. Marshal Chaplain Secretary Asst Secy Treasurer Tiler Other Other Roster of Active Past Masters: Names, Dates and Specify Where If Different Lodge Members Not Eligible For Benevolence: Name Date Office Held Name Page 2 of 7

3 Membership Summary: **Note: Reference ALL Supplemental Reports Sent To Grand Lodge From July 1, 2013 through June 30, Number of members on roll June 30, 2013 (This number should be from previous year s report) 2. Number of members RAISED between July 1, 2013 and June 30, Number of members REINSTATED between July 1, 2013 and June 30, Number of members DEMITTED IN between July 1, 2013 and June 30, Number of members HEALED between July 1, 2013 and June 30, Number of members RESTORED between July 1, 2013 and June 30, ADD Line 1 THROUGH Line 6 SUBTOTAL 1 8. Number of members DECEASED between July 1, 2013 and June 30, Number of members DEMITTED OUT between July 1, 2013 and June 30, Number of members DROPPED / SUSPENDED between July 1, 2013 and June 30, ADD Line 8 THROUGH Line 10 SUBTOTAL SUBTRACT Line 11 FROM Line 7 MEMBERSHIP TOTAL on June 30, Number of members NOT ELIGIBLE FOR BENEVOLENCE on June 30, SUBTRACT Line 13 FROM Line 12 ELIGIBLE MEMBERSHIP on June 30, 2014 Page 3 of 7

4 Summary of Payments: Lodge Name Grand Lodge Dues for July 1, 2013 through June 30, Grand Lodge Benevolent Dues ($12.00 x Number Benevolent Members) $ $ 2. Grand Lodge Dues ($18.00 x Total Membership) $ $ 3. TOTAL $ $ 4. Previous Balance ON Local Lodge s Grand Lodge Account $ $ 5. Total Benevolence Due (From Line 1 separate check) $ $ 6. Total Grand Lodge Taxes Dues (From Line 2) $ $ 7. Late Fee Penalty $ if Annual Return is submitted after July 31 $ $ 8. ADD Line 4, Line6 and Line 7 GRAND TOTAL GRAND LODGE TAX $ $ (separate check) 9. Total Amount Submitted $ $ 10. BALANCE DUE: GRAND LODGE CREDIT $ $ This Column For Grand Lodge Use Only INSTRUCTIONS FOR CALCULATING PAYMENT USING THE MEMBERSHIP CALCULATION KEY Summary of Payments: Line 1: In order to calculate the total amount of Grand Lodge Benevolent Dues to send in with this report you will need Appendix 1. Read the charts down then across. For example on this chart you have 4 benevolent members on roll as of June 30, The amount you would enter into Line 1 of Page 4 is $ # Of Members X$12.00 # Of Members X $ $ $ $ $ $ $ $ $ $ $ Line 2: In order to calculate the total amount of Grand Lodge Dues to send in with this report you will need Appendix 2. Read the charts down then across. For example on this chart you have 9 members on roll as of June 30, The amount you would enter into Line 2 of Page 4 is $ # Of Members X$18.00 # Of Members X $ $ $ $ $ $ $ $ $ $ $ Payments for Prorated Dues and Miscellaneous Fees July 1, 2013 through June 30, 2014 **Note: ALL MEMBERS RAISED, REINSTATED, DEMITTED IN AND HEALED MUST BE SUBMITTED ON A SUPPLEMENTAL REPORT. Page 4 of 7

5 Register of Names and Dates of Incoming members: Raised/Healed Last Name First Name Date of Birth **Date Raised/Healed ***Code ** If date raised is left blank you will be charged for the entire year. ***Code = R for Raised; H for Healed Reinstated Last Name First Name **Date Reinstated Date Dropped DOB ** If date reinstated is left blank you will be charged for the entire year. Demit In Last Name First Name **Date Demitted Date Raised DOB ** If date demitted is left blank you will be charged for the entire year. Page 5 of 7

6 Register of Names and Dates of Outgoing members: Deceased Last Name First Name Date Deceased Demit Out Last Name First Name Date Demitted Out Dropped / Suspended Members Last Name First Name Date Dropped **Code **Code = D - Dropped for Non Payment of Dues; S - Other than Non Payment of Dues *** PLEASE SUPPLY COMPLETED COPY OF ANNUAL REPORT TO YOUR DDGM *** Page 6 of 7

7 Instructions: List the name of each current member of your lodge. Put B for Benevolent or N for Non-benevolent Members Names B/ N Page 7 of 7