MYRA GRAND CHAPTER – OES PHA
ANNUAL RETURNS
______Chapter No.: ______
Charter Date: ______
Meeting Location: ______
City, State and Zip Code: ______
Day and Time of Meeting: ______
For the year beginning November 1, 2014 and closing October 31, 2015
Officers elected ______, 20______, and installed ______, 20______
Worthy Matron / PhoneAddress
Worthy Patron / Phone:
Address
Associate Matron / Phone:
Address
Associate Patron / Phone:
Address
Conductress / Phone
Address
Associate Conductress / Phone:
Address
Financial Secretary / Phone:
Address
Recording Secretary / Phone:
Address
Treasurer / Phone:
Address
Chairman of Trustees / Phone:
Address
Trustee 2 Year / Phone:
Address
Trustee 3 Year / Phone:
Address
MGC Annual Returns Form #1 Page 1
______Chapter No.:______
APPOINTED OFFICERS
Marshal / Phone:Address
Musician / Phone:
Address
Christian Flag Bearer / Phone:
Address
US Flag Bearer / Phone:
Address
OES Flag Bearer / Phone:
Address
Chaplain / Phone:
Address
Warder / Phone:
Address
Sentinel / Phone:
Address
Adah / Phone:
Address
Ruth / Phone:
Address
Esther / Phone:
Address
Martha / Phone:
Address
Electa / Phone:
Address
Ways & Means Chairman / Phone:
Address
Ways & Means Co-Chairman / Phone:
Address
MGC Annual Returns Form #2 Page 2
______Chapter No.:______
LIST OF MEMBERS
List Alphabetically All Living Members and Present Officers
Sisters First – Brothers Last
Name / Phone:Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
Name / Phone:
Address
MGC Annual Returns Form #3 (May be duplicated for additional names) Page 3
______Chapter No.:______
PAST MATRONS and PAST PATRONS
List Names Alphabetically – Past Matrons First, then Past Patrons
Names (Last Name First) Names (Last Name First)
MGC Annual Returns Form #4 Page 4
______Chapter No.:______
PAST GRAND OFFICERS
Print alphabetically names with titles and year served
Names (Last Name First) Title Year Served
MGC Annual Returns Form #5 Page 5
______Chapter No.______
DEGREES CONFERRED
Name (Last, First Middle Initial) / Eastern Star Degree / Queen of the South Degree / Amaranth Degree / HealedMGC Annual Returns Form #6 Page 6
______Chapter No. ______
OTHER ACTIONS
Name / Affiliated / DemittedIn/Out / Rejected / Withdrawal / Dropped / Suspended / Expelled / Death
MGC Annual Return Form #7 Page 7
______Chapter No.______
MEMBERS EXEMPTED FROM CONSTITUTENT CHAPTER
List Names, Addresses and Dates Exempted (90 years of age or 50 years of consecutive service)
Name / Date ExemptedAddress
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
Name / Date Exempted
Address
MGC Form 8 Page 8
______Chapter No. ______
RECAPITULATION
Additions Deductions
Number Initiated: ______Number Deceased: ______
Number Reinstated: ______Number Suspended: ______
Number Affiliated: ______Number Expelled: ______
Number Restored: ______Number Dropped: ______
Number Demitted In: ______Number Demitted Out: ______
Total Additions: ______Total Deductions: ______
______
SUMMARIZATION
Number of members returned last year: ______
Plus total additions (above): ______
Sub-total:______
Less Total Deductions (above): ______
Present Membership:
(Should agree with number of members reported on form #3 __
No. of female members______
No. of male members______
FINANCIAL STATEMENT OF THE CHAPTER
Balance Brought Forward November 1, 20______$______
Total Receipts Received during fiscal year 20______$______
Dues $______
Activities $______
Donations, etc. $______
Total Expenditures during fiscal year $______
Grand Lodge Maintenance Tax $______
Status as of October 31, 20______$______
Savings $______
Checking $______
Paraphernalia $______
Monetary Worth of Chapter $______
MGC Annual Returns Form #9 Page 9
______Chapter No.______
Present Membership (Taxable): ______
4th Quarter Tax @ $2.00 per member on roll $______
Representative Fees 4 @ $2.00 $______
Total submitted to Myra Grand Chapter $______
Exempt Members:
· Age 90 or 50+ years of consecutive Service ______
· Past Grand Matrons ______
· Past Grand Patrons ______
We hereby certify that the forgoing is a true statement to the work done in
______Chapter No.______
For the year beginning ______, 20______, and ending ______, 20_____.
In witness thereof, we, herewith, ascribe our names and affix the seal of the Chapter
______, 20______
______, Retiring Worthy Matron
Seal
______, Retiring Financial Secretary
Countersign:
______
Worthy Matron (elect) Financial Secretary (elect)
FOR GRAND CHAPTER SECRETARY OFFICE ONLYDate Returns Received: ______
Amount Due Myra Grand Chapter: $______
Amount Received: $______Check Number: ______
______
Grand Secretary Grand Financial Secretary
MGC Annual Returns Form #10 Page 10