State and District Forms

Both online and print forms are listed below in order of due date. For help, please view our Help Section.

To access these forms, you need Adobe Acrobat Reader (version 7.0 or higher). This is a free download.

Tips when using online forms:

  • Please print out a copy of the form before submission.
  • To email a copy to yourself, include your email address at the bottom of the form.

Due Date
Form Name
Form #
Online Print
1/31 State Council Annual Survey of Fraternal Activity 1728
(state council)
State Council Annual Survey of Fraternal Activity - Print version
1/31 State Council Special Olympics Report Form 4584
(state council)
Annual Survey of Special Olympic Activity State Council - Print version
6/3 Council Awards Distribution AAD Council Awards Distribution - Print Version
6/3 District Deputy Organizational Meeting JDDPACKS District Deputy Organizational Meeting - Print Version
6/3 State Per Capita Tax Form PC State Per Capita Tax Form - Print Version
6/3 State Deputy Address Form SDA State Deputy Address Form - Print Version
6/3 Executive Secretary’s/Administrative Assistants EXAA Executive Secretary’s/Administrative Assistants - Print Version
6/30 District Deputy Semiannual Report 944B District Deputy Semiannual Report - Print Version
12/31 District Deputy Semiannual Report 944A District Deputy Semiannual Report - Print Version
As needed District Deputy Appoinment Form 189 District Deputy Appointment Form - Print Version
As needed State Service Program Personnel S365 State Service ProgramDirectors and Chairmen - Print Version
As needed Notice of Election of State Council Officers 111 Notice of Election of State Council Officers - Online Version  Notice of Election of State Council Officers - Print Version
As needed Notice of Intent to Establish a Council 133 Notice of Intent to Establish a Council - Print Version
As needed Notice of Institution of a Council 136 Notice of Institution of a Council - Print Version
As needed Application for Council Charter 137 Application for Council Charter - Print Version
As needed State Council Youth Leader 4369 State Council Youth Leader - Print Version
As needed Notice of Certification of First Degree Team (District Deputy) 543 Notice of Certification of First Degree Team (District Deputy) - Print Version
As needed District Deputy's Degree Exemplification Report 450 District Deputy's Degree Exemplification Report - Online Version  District Deputy's Degree Exemplification Report - Print Version

Any questions concerning the online report forms site or the forms themselves should be directed to: Supreme Council Department of Fraternal Services, 1 Columbus Plaza, New Haven, CT 06510-3326 or (203) 752-4270.

 

Expense Forms

Due to the change in mileage rates, for travel starting in 2013, the form listed in the "2012" column should be used for all travel that took place in 2012 and the form listed in the "2013" column should be used for all travel that took place in 2013. You can not report 2012 and 2013 travel on the same expense form.

Due Date
Form Name
Form #
2012 2013
As needed State Deputy Expense Form (Miles) 267SDME
As needed State Deputy Expense Form (Kilometers) 267SDKE
As needed District Deputy Expense Form (Miles) 267DDME
As needed District Deputy Expense Form (Kilometers) 267DDKE

Any questions concerning Expense forms should be directed to: General Office Department, 1 Columbus Plaza, New Haven, CT 06510-3326 or (203) 752-4034.