APA

Request for Letter of Transfer


To the Rector or Vicar of:

Church_______________________________________________________

Street________________________________________________________

City_____________________ State_______________ Zip______________

Please Send an official Letter of Transfer for me / us to:

Church_______________________________________________________

Street________________________________________________________

City_____________________ State_______________ Zip______________

Signed _______________________________________________________

Print Name____________________________________________________

Effective date of transfer from church now leaving___________________

Name and Confirmation dates of members being transferred:

Name________________________________________________________

Confirmation Date______________________________________________

Name________________________________________________________

Confirmation Date______________________________________________

Name________________________________________________________

Confirmation Date______________________________________________

Name________________________________________________________

Confirmation Date______________________________________________

Name________________________________________________________

Confirmation Date______________________________________________

DEUS-FM004