Church/Organization Report of Ministerial Change
If a remittance is to be submitted with change, please click here to download printable form. Otherwise, information may be submitted electronically below.
New Minister/Staff:
Name
Position MinisterAssociateD.R.E.CustodianSecretaryMusicianOther
If Other:
Address
Address Cont.
City
State
Zip/Postal Code
Location:
Church
Phone
Email
Date Service Begins
Monthly Compensation:
Cash Salary per month.......................................$
Parsonage Allowances.......................................$
Pension Plan dues must be paid on the cash salary plus parsonage. If parsonage is
provided, add fair rental value (at least 25% of cash salary) plus all utility and housing
allowances. Otherwise, add full amount of any and all parsonage, housing, utility
allowances.
Other Expense Allowances.................................$
Other allowances such as auto, assembly, book, etc., may be included and will increase
Plan benefits accordingly.
Total Monthly Compensation on which
Pension Plan dues will be paid...........................$
Please check how dues will be paid:
Church/Organization pays full 14% dues.
Church/Organization pays 14% dues, with 3% member dues reduced
before taxes from salary.
Church/Organization remits 14% dues, with 3% member dues withheld
after taxes from salary.
Church/Organization pays 11% dues and member remits 3% dues personally.
Other
Member of Churchwide Health Care Program: Yes No
Coverage: Single Family
Full premium will be paid by the church: Yes No
If no, Please indiate the amount of premium to be paid:
By the Church $
By the Member $
Treasurer or Remitting Officer:
Board Chair/Moderator:
Former Minister/Staff:
Date Salary Terminated
Church/Organization Where He/She Now Serves