Official Submission

Report Blank

The official UCCI church reporting form — membership counts, financial contributions, credential fees, and love offerings. All Report Blanks must be turned in at the Executive Council Meeting.

Section I

Church Information

Report DateChurch / Ministry Name *Pastor / Executive DirectorChurch Admin / SecretaryMailing Address

CityStateZip

Admin Contact NumberSubmitter Email

Section II

Membership Numbers

Active MembersEldersVolunteersMinistersDeaconsYoung PeopleMissionariesJuniors

Section III

Financial Report

Membership Registration

$20 (19+), $10 (13-18), $5 (6-12), free under 5

Ministers @ $50

Deacons @ $50

Missionaries @ $25

Sunday School

Foreign Mission Donation

Credential Report

Vice Bishop $250 · Apostle $200 · Bishop $150 · Pastor $125 · District Elder $100 · Elder $75

Love Offering — Presiding Prelate

Love Offering — General Mother

Donations

Total This Report

$0.00

Balance Due (if any)

Section IV

Payment & Notes

Payment Method

Additional Comments

"New Vision, New Direction" — Isaiah 43:19 & Habakkuk 2:2