2014-2015 YEAR END RETURN
SPECIAL NOTICE TO THE WORSHIPFUL MASTER AND SECRETARY
(PLEASE READ THIS ENTIRE RETURN CAREFULLY)
The 168th Annual Communication of the Most Worshipful Prince Hall Grand Lodge will be
held on December 4-6, 2015. Please forward your returns to the Grand Secretary's Office no
later than Friday, November 06, 2015. Failure to do so could prevent your Lodge
Representatives from being seated at the session, and the levy of a fifty ($50.00) dollar late
fee on both the retiring Worshipful Master and retiring Secretary.
__________________________________
In listing your membership, please list the names of all the Master Masons who are
presently members of the Lodge, including those of the elected officers and all living Past
Masters. PLEASE LIST MEMBERS FULL LEGAL NAMES (i.e. middle initial, Jr., III, etc.). List these
names alphabetically. List the names of deceased members and those dropped for nonpayment of dues in the special sections designated for this information. In addition to listing
your membership, PLEASE ENTER THE AGE OF ALL MEMBERS.
You are to pay the following per member for each member that you list in this Year-EndReturn that is not Grand Lodge exempt;
1) $25.00 for the Per Capita Tax Assessment; (Payable to “MWPHGL, Grand Lodge
Account”).
2) $10.00 for the Scholarship Fund Assessment; (Payable to “MWPHGL, Scholarship
Account”).
3) $25.00 for the Semi-Annual Trustee Maintenance Tax Assessment; (Payable to
“MWPHGL, Trustees Account”).
4) $6.00 for the Charity Fund Assessment; (Payable to “MWPHGL, Charity Account”).
5) $5.00 for the THWISEJR Chip Program Fund Assessment: (Payable to “MWPHGL,
Grand Lodge Account”).
6) $9.50 for the Grand Lodge Magazine Fund Assessment; (Payable to “MWPHGL,
Grand Lodge Account”).
7) $750 minimum due for GL Annual communication for WM, SW, JW, Treas and Sec
Use form on pg. 3 (payable to “MWPHGL, Grand Lodge Account”).
8) $100.00 for the Temple Renovation Assessment for each member raised, healed or
demited into your lodge during the Masonic Year. USE FORM TR100 (Payable to
“MWPHGL, Temple Renovation Account”).
SPECIAL NOTE: Please submit payment unless payment(s) were made during the
Masonic Year. Please list those payment(s) in the special sections designated for this
information.
9) $150.00 for the Old Building Fund Assessment for each member reinstated into
your lodge during the Masonic Year, who was raised before 4/30/96. Use Form
TR100. (payable to “MWPHGL, Temple Renovation Account”).
SPECIAL NOTE: Please submit payment unless payment(s) were made during the
Masonic Year. Please list those payment(s) in the special sections designated for this
2014-2015 ANNUAL RETURN - PAGE
i
information.
10)
$70.00 for the Raised/Healed Assessment for each member raise or healed into
your lodge during the Masonic Year. Use Form GL200. (payable to “MWPHGL,
Grand Lodge Account”).
SPECIAL NOTE: Please submit payment unless payment(s) were made during the
Masonic Year. Please list those payment(s) in the special sections designated for this
information.
11)
$60.00 for the Reinstatement Assessment for each member reinstating into
your lodge during the Masonic Year. Use Form on pg 13. (payable to “MWPHGL,
Grand Lodge Account”).
SPECIAL NOTE: Please submit payment unless payment(s) were made during the
Masonic Year. Please list those payment(s) in the special sections designated for this
information.
12)
$30.00 for the Past Master elected to Worshipful Master and/or elected
Wardens for the LOI and/or Past Masters Refresher Course, Use Form on pg 4.
(payable to “MWPHGL, Grand Lodge Account”).
13)
$35.00 for the Memorial Flowers at the Grand Lodge Session. (payable to
“MWPHGL, Grand Lodge Account”).
Please print or type one (1) copy of these forms Legibly and Accurately, accompanied by the
proper payments and attach to the Year-End-Returns.
NOTE: PLEASE SUBMIT SEPARATE CHECK FOR EACH PAYMENT
SPECIAL NOTE: PLEASE SUBMIT ALL REQUIRED PARTS OF THIS RETURN; PUT
N/A WHERE APPLICABLE
Please print or type two (2) copies of these returns Legibly and Accurately and they must
reach the office of the Grand Secretary no later than Friday, November 06, 2015
accompanied by the proper payments. Please be prompt.
The Honorable Lee A. Taylor Jr, Most Worshipful Grand Master
Right Worshipful William Davidson III
Grand Secretary
2014-2015 ANNUAL RETURN - PAGE ii
(Do not submit this page)
2014-2015 ANNUAL RETURN - PAGE iii
2014-2015 YEAR END RETURN OF
____Lodge Name_____ Lodge No. ___________
Mailing Address ____ ___________________________
UNDER THE JURISDICTION OF THE MOST WORSHIPFUL
PRINCE HALL GRAND LODGE F. & A. M.
FOR THE STATE OF MARYLAND
_______ day of ________ A.D. _____ A.L., _________
OFFICERS ELECTED FOR THE ENSUING YEAR
________________, Worshipful Master
________________________________
Address (include City, State, and Zip Code)
Telephone ( )___________
Home
Work
( )__________
_____________, Senior Warden
________________________________
Address (include City, State, and Zip Code)
Telephone ( )_____________
Home
( )_________
Work
________________, Junior Warden
__________________________________
Address (include City, State, and Zip Code)
Telephone ( )___________
Home
Work
( )________
_________________, Treasurer
____________________________
Address (include City, State, and Zip Code)
Telephone (
)_________
Home
Work
(
)___________
______________, Secretary
_________________________
Address (include City, State, and Zip Code)
Telephone ( )_____________
Home
(
Work
)_______________
Stated meetings held at _________________________________________
Place and Address
on the _____ and ______ ______ of each month
Officers elected ________, ________
Day of week
Month, Day, and Year
2014-2015 ANNUAL RETURN - PAGE 1
Most Worshipful Prince Hall Grand Lodge; F. & A. M., Inc.
For Maryland and its Jurisdiction
END-OF-YEAR REPORT WORKSHEET
LODGE No. ______
Number of Brothers (end-of year)................
(1)
Number of Grand Lodge Exempt Brothers..
(2)
Number of Assessment Paying Brothers......
(3) [Subtract (2) from (1)]
Number of Brothers (Amnesty Program)…._________ Paying for on this report
Number of Brothers (Amnesty Program)…._________ Previously paid for
Registration, Grand Lodge Communication (total from registration form)
Make check payable to: MWPHGL, Grand Lodge Account
Semi-annual Maintenance Tax (Number of paying Brothers times $25.00)
Make check payable to: MWPHGL, Trustees Account
Per Capita Tax (Number of paying Brothers times $25.00)
Make check payable to: MWPHGL, Grand Lodge Account
Scholarship Fund (Number of paying Brothers times $10.00)
Make check payable to: MWPHGL, Scholarship Account
Raised/Healed Brothers (submit $70 times the number of Brothers not paid to
the Grand Lodge during the year)
Make check payable to: MWPHGL, Grand Lodge Account
Reinstated Brothers (submit $60 times the number of Brothers not paid to the
Grand Lodge during the year)
Make check payable to: MWPHGL, Grand Lodge Account
Charity Fund (Number of paying Brothers times $6.00)
Make check payable to: MWPHGL, Charity Fund Account
THWISEJR Chip Program (Number of paying Brothers times $5.00)
$750.00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
$ .00
Make check payable to: MWPHGL, Grand Lodge Account
The Grand Lodge Magazine (Number of paying Brothers time $9.50)
$ .00
Make check payable to: MWPHGL, Grand Lodge Account
Temple Renovation Fund (Number of Brothers paying times $100.00)
Make check payable to: MWPHGL, Temple Renovation Fund Account
Old Building Fund (Number of Brothers paying times $150.00)
$ .00
Make check payable to: MWPHGL, Old Building Fund Account
Registration for Wardens for the LOI and Registration for any Past
Master(s) for the Past Masters Refresher Course (submit $30 times the
number of Wardens and any Past Master elected to Worshipful Master, which
requires the Past Masters Refresher Course)
Make check payable to: MWPHGL, Grand Lodge Account
$60.00
Memorial Flowers at the Grand Lodge Session
$30.00
Make check payable to: MWPHGL, Grand Lodge Account
Reclamation-Reinstated Brothers (submit $76 times the number of
Brothers not paid to the Grand Lodge during the year)
$.00
Make check payable to: MWPHGL, Grand Lodge Account
TOTAL DUE WITH THE ANNUAL RETURN
$ .00
NOTE: No end-of-year Annual Return will be accepted without BOTH the total amount due (above)
and the printed return.
Witness our hand and seal this 31 st day of
October 2015
.
WM
Secretary
2014-2015 ANNUAL RETURN - PAGE 2
ANNUAL RETURN WORKSHEET
RECAPITULATION
Additions:
Number admitted (raised or healed)
___________
Number reinstated or Administrative Transfer
___________
Number affiliated by demit or restoration
____________
Number added back on the roll (not off the roll for more than a year)
____________
TOTAL ADDITIONS
___________
Deductions:
Number demitted out this year
___________
Number died this year
___________
Number suspended/expelled this year
___________
Number dropped from the roll or Administrative Transfer
____________
TOTAL DEDUCTIONS
___________
SUMMARIZATION
Number on return last year
Total Additions (From above)
__________
(+) __________
Sub-total
__________
Total Deductions (From above)
(-) __________
CURRENT LODGE MEMBERSHIP
__________
Total of Grand Lodge Exempt Members (-)
__________
CURRENT TAXABLE LODGE MEMBERSHIP
__________
Number of Brothers (Reclamation Form)
__________
2014-2015 ANNUAL RETURN - PAGE 3
FINANCIAL STATEMENT OF THE LODGE
1.
2.
Brought Forward November 01, 2014
(Include all funds: Bank accounts,
bonds, stocks, petty cash, etc.)…...............$
Total amount Received During Current
Masonic Year (Include all interest
received).........................................................$
3.
Total Funds (Add Lines 1 and 2)..................$
4.
Total amount Expended During Current
Masonic Year.................................................$
5.
Balance on Hand October 31, 2015
(Subtract Line 4 from Line 3)........................$
LIST ADDITIONAL REMARKS BELOW IF NECESSARY
………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………..………
………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………..………
2014-2015 ANNUAL RETURN - PAGE 4
CERTIFICATION
We, the undersigned, hereby certify that the information herein contained on page 3 of
“ANNUAL RETURN WORKSHEET” and Page 4 of “FINANCIAL STATEMENT OF THE LODGE “ in
this 2014-2015 Annual Return packet is true statements of the work done in;
_____________________ Lodge No. _____ for the year ending October 31, 2015.
In witness thereof, we hereunder subscribe our names and cause the Secretary to affix the
seal of the Lodge.
This ______31st_____ day of ______October______________, 2015___.
_____________________________, Retiring Worshipful Master
______________________________, Retiring Secretary
_____________________________, Elected Worshipful Master
______________________________, Elected Secretary
AFFIX
LODGE SEAL
MUST BE SIGNED BY THE RETIRING/ELECT WORSHIPFUL MASTER AND
RETIRING/ELECT SECRETARY AND CAUSE THE SECRETARY TO AFFIX THE SEAL
OF THE LODGE
2014-2015 ANNUAL RETURN - PAGE 5
Most Worshipful Prince Hall Grand Lodge, F. & A. M., Inc.
For Maryland and Its Jurisdiction
REGISTRATION FORM FOR DECEMBER 2014
DELEGATES CERTIFICATION
GRAND LODGE COMMUNICATION
This is to certify that __________
Lodge No. ____ has chosen the following named Brothers to serve at
the 168th Annual Communication to be held at the Princess Royale Oceanfront Hotel and Conference Center 9100
Coastal Highway Ocean City, Maryland on Friday, December 4 through Sunday, December 6, 2014.
Elected Lodge Officers; WM, SW, JW are delegates and will have BLUE badges; Treasurer and
Secretary(s) will have WHITE badges unless they are Past Masters. Please put PM before a Past Masters
name. Each Lodge is required to submit $150.00 for each of the elected officers WM, SW, JW, Treasurer
and Secretary:
for WM
$150
for SW
$150
for JW
$150
for Treasurer
$150
for Secretary
$150
TOTAL FOR ELECTED OFFICERS $750.00
All registrations made after Friday, November 13, 2015 will require an additional $25 per officer
late fee.
Anyone that plans to attend the Most Worshipful Prince Hall Grand Lodge Annual
Communication must complete the “Grand Lodge Annual Communication Registration Form”
and submit it through the Office of the Grand Secretary (Without Exception) by the date of
November 13, 2015. This form requires validation of Dues status and must have the Signatures of
the Worshipful Master and Lodge’s Secretary affixed along with the seal of the respective
constituent Lodge. Use this form from the Grand Lodge Web site for Brothers attending the
Communication only.
Witness our hand and seal this
31st
day of
WM
October 2015
.
Secretary
2014-2015 ANNUAL RETURN - PAGE 6
Most Worshipful Prince Hall Grand Lodge, F. & A. M.
LODGES OF INSTRUCTIONS
&
PAST MASTERS REFRESHER COURSE
REGISTRATION FORM
DATE ________
LODGE NAME:_______________________________
NO.:_________
MAILING ADDRESS:_________________________________________________________
CITY:_________________________________, MARYLAND
ZIPCODE:______________
WORSHIPFUL MASTER:
PMRC:
YES ($30.00)
DOES NOT APPLY
NAME:_____________________________________________
ADDRESS:___________________________________________________
CITY:___________________, STATE:______MD_________ ZIPCODE:_________________
HOME PHONE:___( ) ______________ CELL/WORK:___( ) _______________________
PAST MASTER:
YES
NO VALID LOI CERTIFICATE:
SENIOR WARDEN:
YES
LOI:
NO
YES ($30.00)
PMRC:
YES ($30.00)
NAME:_____________________________________
ADDRESS:________________________________________________
CITY:__________________, STATE:__________________ ZIPCODE:__________
HOME PHONE:__ ( ) _____________ CELL/WORK:_( ) ______________
PAST MASTER:
YES
NO VALID LOI CERTIFICATE:
JUNIOR WARDEN:
YES
LOI:
NO
YES ($30.00)
PMRC:
YES
NO
YES ($30.00)
NAME:_____________________________________
ADDRESS:__________________________________________________
CITY:______, STATE:______________ ZIPCODE:________
HOME PHONE:__( ) ____________ CELL/WORK:___( ) ______________
PAST MASTER:
YES
NO
VALID LOI CERTIFICATE:
Lodge Secretary's Signature:_____________________________ Total Submitted $ 60.00
(Make check payable to: MWPHGL, Grand Lodge Account)
For Use of the Grand Secretary's Office (Account Manager) Only
Total Amount Received $
Signature
______
Date Received/Processed _____________________
______
, Asst. Grand Secretary
2014-2015 ANNUAL RETURN - PAGE 7
INCOMPLETE DEGREES CONFERRED
Candidates who have received ONLY the 1st or 1st and 2nd Degrees
NAME
DATE
RECEIVED
EACH
DEGREE
Address
Include City, State, Zip Code and
Telephone No.
REASON DEGREE
NOT COMPLETED
2014-2015 ANNUAL RETURN - PAGE 8
MASTER MASON DEGREE CONFERRED OR HEALED
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
DATE
MASTER MASON’S
DEGREE
CONFERRED
DATE PAID
RAISED/HEAL
FEES
DATE PAID
TEMPLE
RENOVATION
FUND
2014-2015 ANNUAL RETURN - PAGE 9
REINSTATEMENTS
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
DATE
REINSTATED
DATE PAID
REINSATEMENT
FEES
DATE PAID
OLD BLDG.
FUND
(if applicable)***
DATE PAID
TEMPLE
RENOVATION
FUND
***PLEASE NOTE:
1. BROTHERS RAISED BEFORE 4/30/96 SHOULD HAVE PAID $150.00 FOR THE OLD
BUILDING FUND ASSESSMENT & $100.00 FOR TEMPLE RENOVATION FUND.
2. BROTHERS RAISED AFTER 4/30/96 PAY ONLY $100.00 FOR THE TEMPLE
RENOVATION FUND.
2014-2015 ANNUAL RETURN - PAGE 10
RESTORED
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
DATE
RESTORED
DATE PAID
TEMPLE RENOVATION
FUND
RECEIVED BY DEMIT or Administrative Change
(GIVE NAME AND JURISDICTION OF LODGE DEMITTED FROM)
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
LODGE NAME, NUMBER
AND
JURISDICTION
DATE
ACCEPTED
INTO LODGE
(MUST FILL-IN INFORMATION)
DATE PAID
TEMPLE
RENOVATION
FUND
2014-2015 ANNUAL RETURN - PAGE 11
APPROVED MEMBERS EXEMPTED FROM TAXES
GRAND LODGE EXEMPT
(Approved by Grand Lodge Trustee Board)
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
DATE RECEIVED
EXEMPTION
MUST LIST AN EXEMPT MEMBER IN ONE OF THE TWO CATEGORIES ONLY
APPROVED LIFE MEMBERS EXEMPTED FROM TAXES
GRAND LODGE EXEMPT
(50 Years of continuous service or 90 years of age)
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
DATE RECEIVED
LIFE MEMBERSHIP
2014-2015 ANNUAL RETURN - PAGE 12
MEMBERS OF CHARITY FUND WAIVER
(Members name must be included in Master Mason’s List)
NAME
LISTED ALPHABETICALLY
DATE
WAIVER SIGNED
(Form C102)
MEMBERS DEMITTING FROM THIS LODGE
NAME
LISTED ALPHABETICALLY
DATE
DEMITTED
ADDRESS
Include City, State, and Zip Code
2014-2015 ANNUAL RETURN - PAGE 13
DEATHS
NAME
LISTED ALPHABETICALLY
DATE
OF
DEATH
ADDRESS
Include City, State, and Zip Code
REJECTIONS
NAME
LISTED ALPHABETICALLY
DATE
REJECTED
ADDRESS
Include City, State, and Zip Code
Telephone
Number
SUSPENSIONS/EXPULSIONS
NAME
LISTED ALPHABETICALLY
DATE
OF
SUSPENSION /
EXPULSION
ADDRESS
(Include City, State, and Zip Code)
2014-2015 ANNUAL RETURN - PAGE 14
DROPPED FOR NON-PAYMENT OF DUES
(List Names, Dates, Addresses and Telephone Numbers)
NAME
LISTED ALPHABETICALLY
DATE
DROPPED
ADDRESS
(Include City, State, and Zip Code)
2014-2015 ANNUAL RETURN - PAGE 15
2014-2015 Reclamation Form
REINSTATEMENTS
(Members name must be included in Master Mason’s List)
NAMES
LISTED ALPHABETICALLY
DATE
REINSTATED
DATE PAID
REINSATEMENT
FEES
DATE PAID
OLD BLDG.
FUND
(if applicable)***
DATE PAID
TEMPLE
RENOVATION
FUND
***PLEASE NOTE:
1. BROTHERS RAISED BEFORE 4/30/96 SHOULD HAVE PAID $150.00 FOR THE OLD
BUILDING FUND ASSESSMENT & $100.00 FOR TEMPLE RENOVATION FUND.
2. BROTHERS RAISED AFTER 4/30/96 PAY ONLY $100.00 FOR THE TEMPLE
RENOVATION FUND.
2014-2015 ANNUAL RETURN - PAGE 16
PAST MASTERS
List names only - alphabetically

Deceased
2014-2015 ANNUAL RETURN - PAGE 17
GRAND LODGE ROSTER 2014 - 2015
(PLEASE READ THIS SECTION CAREFULLY)
The next section contains information necessary for the Grand Lodge to put together the
2014 - 2015 Roster based on these Returns. Please complete the information as requested.
PLEASE TYPE OR PRINT LEGIBLY.
Remember, the information listed here MUST be consistent with your 2013-2014 Annual
Returns submitted to the Grand Lodge. Please submit two copies of the following section
with your Lodges Returns.
The Honorable Lee A. Taylor Jr, Most Worshipful Grand Master
Right Worshipful William Davidson III
Grand Secretary
(Do not submit this page)
2014-2015 ANNUAL RETURN - PAGE 18
MASTER MASONS
(INCLUDE ALL FINANCIALLY CURRENT MEMBERS)
(ALSO INCLUDE ALL GRAND LODGE EXEMPT MEMBERS)
(ALSO INCLUDE ALL RECLAIMED MEMBERS)
List Names
Alphabetically
Age
Address
(Include City, State and Zip Code)
Telephone No.
(Include Area Code)
PAGE _______ OF _______
2014-2015 ANNUAL RETURN - PAGE 19