BEN
BillL
2004-08-12T10:27:32Z
2004-08-12T09:44:36Z
2004-08-15T23:39:44Z
RETIRED
11.5703
9120
12120
315
60
False
False
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NARFE |
Florida Federation of Chapters |
| CHAPTER SEMIANNUAL REPORT |
| AS PER MEMBERSHIP M-114 RECEIVED IN MAR - OCT & NOV - APL |
| DUE DATES - 1st Report May 15th - 2nd Report Nov 15th |
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PLEASE RETURN TO DVP BY DUE DATE |
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CH NO. |
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CH NAME |
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| PERIOD ENDING |
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DATE PREPARED |
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REQUIRED INFORMATION |
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| A |
CHAPTER MEMBERS AT END OF LAST REPORT |
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| B |
NUMBER OF CHAPTER MEMBERS GAINED THIS PERIOD |
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| 1 |
NEW MEMBERS |
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| 2 |
REINSTATEMENTS |
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| 3 |
TRANSFERS INTO CHAPTER |
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| 4 |
ASSUMPTIONS |
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| TOTAL MEMBERS GAINED THIS PERIOD (B1 + B2 + B3 + B4) |
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0 |
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| C |
NUMBER OF CHAPTER MEMBERS LOST DURING PERIOD |
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| 1 |
DEATH |
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| 2 |
NON-RENEWAL OF MEMBER |
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| 3 |
RESIGNED |
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| 4 |
TRANSFERRED OUT OF CHAPTER |
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| TOTAL MEMBERS LOST THIS PERIOD (C1 + C2 + C3 + C4) |
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0 |
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| D |
TOTAL CHAPTER MEMBERSHIP AT END OF PERIOD (A + B - C) |
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0 |
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| E |
NUMBER OF CHAPTER HONORARY MEMBERS |
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| E1 |
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| F |
NUMBER OF CHAPTER MEMBERS SUBJECT TO PER CAPITA TAX (D - E- E1) |
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0 |
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OPTIONAL INFORMATION |
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| G |
NUMBER OF CHAPTER MEMBERS ON DUES WITHHOLDING |
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| PREPARED BY (NAME) |
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TITLE |
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| ADDRESS |
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| CITY/STATE/ZIP |
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| PHONE NO, |
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FL FED FORM QR-A 08/04 ® |
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INSTRUCTIONS FOR COMPLETING THE |
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CHAPTER SEMIANNUAL MEMBERSHIP REPORT |
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PLEASE PRINT CLEARLY |
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| 1 |
DISTRICT NUMBER |
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Enter your district number. |
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| 2 |
CHAPTER NUMBER |
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Enter chapter number. |
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| 3 |
CHAPTER NAME |
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Enter chapter name. |
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| 4 |
PERIOD ENDING |
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Enter the date for which the report is being submitted. See due date on front of this form. |
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| 5 |
DATE PREPARED |
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Enter the date you completed this form. |
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| 6 |
A. |
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CHAPTER MEMBERS AT END OF LAST REPORT, Enter number of |
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chapter members brought forward from last report. This number must match |
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total chapter membership as reported on last report. (Sect. D) |
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| 7 |
B, 1. |
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NEW MEMBERS, Enter the number of new members who have joined your |
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chapter this reporting period. Note; REINSTATEMENTS, incoming TRANSFERS and |
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ASSUMPTIONS are reported separately and should not be included in this column. |
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| 8 |
B, 2. |
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REINSTATEMENTS, Enter the number of reinstatements this period. |
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| 9 |
B, 3. |
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TRANSFERS TO CHAPTER, Enter the number of members that have transferred into your |
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chapter this period. |
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B, 4. |
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ASSUMPTIONS, Enter the number of members (spouse replacing member) gained this period |
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by assumption of membership due to death of a member. |
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| 11 |
Total members gained this period. ( B1 + B2 + B3 + B4 ) |
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| 12 |
C, 1. |
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DEATH, Enter the number of chapter members who have died during this period. (Code K) |
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| 13 |
C, 2. |
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NON-RENEWAL OF MEMBERSHIP, Enter the number of chapter members |
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who did not renew their membership during this period. ( Code I ) |
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| 14 |
C, 3. |
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RESIGNED FROM CHAPTER, Enter the number of chapter members who resigned during this period. |
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(Code J) |
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| 15 |
C, 4. |
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TRANSFERRED OUT OF CHAPTER, Enter the number of chapter |
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members that transferred to another chapter this period. |
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| 16 |
Total members lost this quarter. ( C1 + C2 + C3 + C4 ) |
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| 17 |
D. |
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TOTAL CHAPTER MEMBERS AT END OF PERIOD (A + B - C ) |
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| 18 |
E. |
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NUMBER OF CHAPTER HONORARY MEMBERS, Enter the number of chapter honorary members. |
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(Code F) |
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E-1 |
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| 19 |
F. |
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NUMBER OF CHAPTER MEMBERS SUBJECT TO PER CAPITA TAX. (D - E - E1 - E2 - E3) |
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| 20 |
G. |
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NUMBER OF CHAPTER MEMBERS ON DUES WITHHOLDING (Code B) |
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-4
-4
False
False
False
False
False
False