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LETTER OF TRANSFER
This is to certify that the person(s) whose name(s) appear below is (are) registered or enrolled in:
___________________________________________________________________________________________ Church,
____________________________________________________________________,
in the Diocese of ____________________________________________________, as
Adult Members (16 or Older)
Date of Birth
Date of Baptism
Active Member
Communicant in
Good Standing
Date of
Confirmation/Reception
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Younger Members
Date of Birth
Date of Baptism
Active Member
Communicant in
Good Standing
(if applicable)
Date of
Confirmation/Reception
(if applicable)
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
Yes / No
I, the undersigned, do hereby transfer the above-named Member(s) to the spiritual charge of the Rector (or
Minister) of the Parish or Congregation of _______________________________________________________________
__________________________________________________________________________________________________
in the Diocese of ______________________________________________________________________, pursuant to the
provisions of the Canon “Of Regulations Respecting the Laity.”
Please acknowledge the acceptance of this Letter of Transfer. Upon receipt of acknowledgement, the name(s)
of the Member(s) will be removed from the Register of the Parish.
Given under my hand (and seal), this ________________________________________________________ day of
_________________________________, A.D., 20_________.
(Signed) ________________________________________________________________
(Rector) (Minister) (Warden)
New Address (if known): ______________________________________________________________________________


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