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Instructions to Camp Clerks 


This Pass report book and the forms contained herein have been 
devised to assist Camp Clerks in the preservation of copies of all Pass 
and Semi-annual reports mailed, from time to time, to the Head Clerk. 
Blank forms of Pass and Semi-annual reports are invariably mailed 
from the office of the Head Clerk in time to reach the Camp Clerk by 
the first day of the month in which remittance, under call accompanying 
such report, is required to be made. 

LEVY OF ASSESSMENTS 

The Clerks should formulate reports on the blank forms supplied, 
in accordance with the printed directions thereon, and then carefully 
copy such completed report into this Pass report book. This is neces¬ 
sary for the permanent preservation of Camp records, and Clerks will 
also find it a valuable aid in formulating subsequent reports. 

Section 51 of the 1911 By-laws provides that an assessment shall 
be levied for each and every calendar month hereafter, one of which 
said assessments shall be paid on or before the last day of the month 
for which it is levied, to the Clerk of the Camp in which membership 
is held, without further notice than that contained in the By-laws. If 
a member defaults in his payment on or before the last day of the 
month of levy, he stands suspended under the law. 

THE CALL 

The Call for an assessment is issued by the Head Clerk on the first 
day of the month following the date of the levy thereof, the Call always 
being addressed to local Camp Clerks. The Clerk is required to accept 
this Call as a legal demand to remit forthwith, to the Head Clerk, the 
full amount collected under the assessment levied by the Board of 
Directors, and payable to him by the members of his Camp, in the 
month preceding that in which the Call is dated. The Clerks are, of 
course, required to remit arrearages for members who, previously sus¬ 
pended, may have reinstated. Every dollar due under a Call is in the 
hands of the Clerk and Banker of the Camp on the day Call is dated; 
hence, no valid reason can be advanced for delay in responding thereto. 

PASS REPORT BLANKS 

Blank forms on which to make reports to accompany remittances 
under Call are mailed to all Clerks of Camp with Copy of Official Call. 
By means of these reports, the Head Clerk is informed as to the exact 
standing of or any incident affecting all members of the local Camp. 
Such reports must be correctly formulated, as error may impair a mem¬ 
ber’s standing. Remittances must invariably accompany reports and be 
mailed to the Head Clerk. Remittances forwarded to the Head Clerk 
without report, on blank form furnished by the Head Clerk, will be re¬ 
turned to the Camp Clerk. Remittances cannot be received without 
report, because the Head Clerk has no way of knowing who the individ¬ 
ual members are, who may be entitled to credit for the amount remitted. 

FORM OF REMITTANCE 

All remittances are required, under the By-laws, to be made by 
bank draft, postal money order, or express money order, drawn payable 
to “Head Banker, M. W. of A., Rock Island, Illinois,’’ and mailed 
to the Head Clerk. To maintain the good standing of a Camp, report, 
with remittance in form stated, much reach the Head Clerk on or before 
the 18th day of the month of Call. (See Secs. 252 and 295, 1911 By¬ 
laws.) 

FIRST LIABILITY OF NEW MEMBERS 

Section 35 and 36 of the 1911 By-laws establishes the first liabil¬ 
ity of new members. An applicant adopted into an old Camp or a 
charter member of a new Camp is liable for the assessment current at 
the date of his adoption; and this assessment is payable at the time of 
adoption, as the Head Consul has ruled that a Benefit certificate, if . 
in the hands of the Camp Clerk, must be delivered to an applicant when 
the latter receives his Beneficial degree. In other words, the delivery 
of the certificate must not be delayed in order to affect the new mem¬ 
ber’s liability. Therefore, Camp Clerks are required to collect from 
newly adopted Beneficial members one assessment on the date of adop¬ 
tion and remit same to the Head Clerk with the Pass report next due. 
The name of the new member, the date certificate is delivered, and his 
assessment rate, should be reported on page 2 of the Pass report. 

ADOPTION WHILE IN GOOD HEALTH 

Adoption of an applicant for membership must take place while the 
applicant is in good health and within sixty days from the date of cer¬ 
tificate issued by the Head Clerk. If, for any cause, the applicant is 
not adopted within sixty days, the Benefit certificate becomes null and 
void and must be returned to the Head Clerk with notation thereon 
“Not adopted.” The applicant is then required to make a new appli¬ 
cation and a new Benefit certificate will be issued, but he is not required 
to pay a second membership fee. 

PER CAPITA 

Per Capita is a charge against the Camp. Social as well as Bene¬ 
ficial members are liable for Per Capita, this being the annual amount 
due to the Head Camp from every member of the Society; It is pay¬ 
able semi-annually in advance from the General fund of the Camp, upon 
Call from the Head Clerk, during the months of January and July of 
each year. When a Camp is organized,. General fund dues should be 
fixed in an amount sufficient to meet the incidental expenses of the 
Camp, including the Clerk’s compensation. (See Sec. 289 of 1911 
By-laws), and also including Per Capita tax of $1.20 per member per 
year. To maintain their good standing at all times, the Neighbors,. 
Beneficial and Social, must be prompt in the payment of their local Camp 
dues,, which cover their Camp’s liability to the Head Camp of $1.20 
annually. 

Call for Per Capita is addressed by the Head Clerk to the local 
Camp Clerks on the first days of January and July of each year. 


Remittance, in response to this Call, is required to be made so as to 
reach the Head Clerk on or before the 18th day of the month Call is 
dated. Failure to make remittance within the limit of time provided 
by law will cause the suspension of the Camp and all its members. 

All members, both Beneficial and Social, adopted during the semi¬ 
annual term, are liable for Per Capita pro rata to the end of the current 
semi-annual term, beginning with the month following date of adoption, 
and are required to pay to the Camp Clerk General Fund Camp dues 
for the unexpi'red portion of the current quarterly term. 

PROHIBITED OCCUPATIONS 

On the subject of prohibited occupations see Sections 10, 11, 12, 
13, 14, and 290. No person, while engaged in the manufacture or sale 
of liquor to be used as a beverage, is eligible to membership in the 
Society. A member engaging in the manufacture or sale of liquor to 
be used as a beverage, unless within the exceptions contained in the 
proviso of Section 2 of the 1911 By-laws, renders his Benefit certificate 
absolutely null and void the moment he engages in this prohibited 
occupation. (See Chap. III., 1911 By-laws.) A Camp Clerk must 
promptly refuse dues and assessments from a member engaging in the 
liquor traffic (See Sec. 290), and if he violates Section 290 may be re¬ 
moved from office and expelled from the Society. (See Sec. 296, 1911 
By-laws.) When a member engages in the liquor business, his name 
should be entered on page 6 of the next following Pass report forwarded 
to the Head Clerk. If the member makes objection to the action of the 
Clerk in refusing his dues and assessments, the Camp Clerk should 
report his objection by mail to the Head Clerk, with request for 
instructions. 

HAZARDOUS OCCUPATIONS 

No person while engaged in the occupations mentioned in Section 
15 of the 1911 By-laws can legally obtain Beneficial membership in the 
Society. 

When a member engages in a hazardous occupation—meaning 
thereby any occupation mentioned in Chapter IV. of the 1911 revision 
of the By-laws—the Camp Clerk should report to the Head Clerk the 
Neighbor’s name, with full particulars concerning the occupation in 
which the Neighbor has engaged, so that the Head Clerk may give such 
instructions as may be deemed necessary. 

REINSTATEMENT 

A member in good health and not engaged in any of the prohibited 
occupations enumerated in Section 12, revised By-laws, 1911, may 
reinstate by paying to his Camp Clerk arrearages of every kind, pro¬ 
vided he has not been in suspension for a period exceeding sixty days. 
Written certificate of good health is not required. 

If a member has been suspended for more than sixty days and less 
than six months, he will be required to furnish a Certificate of Good 
Health from the Camp Physician (Form 53), which certificate must be 
submitted to and receive the approval of the State or Provincial Medical 
Director. Aside from arrearages, such member is required to pay a 
reinstatement fee of $1.00 and be re-rated according to his attained age. 
All' reinstating members must pay the current assessment and dues 
(if any) before the provisions of Section 56 and 57 are fulfilled. 

If a member is suspended for more than six months he loses, all 
rights as a member of the Society and must come in as a new member, 
if at all. (See Sec. 58.) 

A person over 45 years of age and in suspension for more than six 
months cannot again become a Beneficial member of the Society. 

DISCIPLINE 

The latest revised By-laws (Secs. 133 and 134) impose upon the 
Head Clerk the duty of removing from office incompetent, negligent or 
habitually dilatory Camp Clerks, and appointing their successors. 

The provisions of these sections will be impartially enforced, but 
the Head Clerk entertains the hope that instances calling for the 
exercise of the authority conferred upon him will be rare. 

SUGGESTIONS TO CLERKS 

The Camp Clerk is urged to familarize himself with the provisions 
of the Society’s By-laws, especially those defining the duties of his 
office. The instructions given in circular No. 44, dated February 1, 
1909, issued by the Head Clerk, mailed to all Camp Clerks, are based 
upon the provisions of the By-laws, which should be consulted by 
Clerks as a guide in the performance of their official duties. 

The Summary of members paying, by rates, is provided for the 
purpose of proving the accuracy of all Pass reports formulated by the 
Clerk. Formulate by entering opposite each rate the total number of 
members actually paying such rate. Then, on the right, enter the 
total amount paid by the members, excluding all arrearages. After 
thus listing the membership and extending the amounts, if the work be 
correct, the footings thereof will agree with item 15 of the Combined 
Membership and Financial Statement." 

In addressing the Head Offiee, Clerks should invariably give their 
Camp number and location. This is absolutely necessary. 

Clerks are earnestly requested, in the interest of the Camp as well 
as of the members of the Society generally, to correctly formulate all 
reports. There is no statement called for by the Head Clerk in any 
report that is not essential to the interests of the Society, and absolutely 
necessary in maintaining an accurate system of. accounting with the 
Camp at the Head Office. Fraternally yours, 


Head Clerk, M. W. of A. 



REPORT SOCIAL MEMBERSHIP ON PAGE 8 

PASS REPORT 

Assessment 

Levied for.j19 L 3 

Due Head Office on or before 19 f4- 

Camp No.-.2^.£--Q- 

Province 


Give Exact Date of Delivery of Benefit Certificate Enter date when neighbor paid arrearages 

J Adoptions in.first liable Asst. No- 1 Neirrhhnr« i?.:,...... . ' 


Neighbors Reinstated 

iixty (60) days from date of susp< 


f susp ension—Sec. 66 
Bate) No. of B. C. I hi 


_ M 'AJjJjJ ’ll Jo 

Y— - ip /iz 

-?A IWJZJ. 


Pleasy Fill in Camp Location and State 

MEMBERS AMOUNT 

Total Membership this Report _ 4.3.. . --3-2- 

Arrears for. _ 3 _ Neighbors reinstated .— 2 *.. C J.J. 

Benefit short last report _.____ 


| Total benefit due _ MM2 


Memoranda for Head Clerk 

Camp Clerks will leave blank space below for Head Office 

Draft or Money Order, $. _ Credit Slip, $ _ 


Benefit. . . ._... Returntd 

Per Capita ___ Credit Slip ) „ 

Supplies . . ._ji r _...... 

Certificate Fees 1 .. Cash _ $. 

( Benefit, $ _ 


l Per Capita, ______ 

Audited by __ ; _ Date _ 

Daily Report Number and Date Received 


Neighbors Reinstated 1 

e than sixty .(60) days, but less than six (6) 
months.—Sec. 67 


Date Returned . 
Date Received .. 





=ame > tit v pydper credit 
















































































































































































































































































































































































































































































































-postoffice'i: 















































































































































































































































































































































































































































































































































REPORT SOCIAL MEMBERSHIP ON PAGE 8 

PASS REPORT 

Assessment No.-X^..:..... 

Levied for. (yl&XL .., 19 !.% 

Due Head Office ol or before^!\w^—18, 

Camp No. A^'L--1- 

_ Province } - 


Give Exact Date of Delivery of Benefit Certificate 


ENTER DATE WHEN NEIGHBOR I 


"Di«e of Adoption and^ 
>te Carefully Sec 35 


s adopted on date of o 
I No. oi B. C. I Rate I 


Li' .. 




4..-.. 

. 



9..... 





‘M. 

M 

5.... 








Total Membership this Report. ...L -"—• 

6 . 




11 - - - - - . . 




• Arrears for _ f _ Neighbors reinstated 

...L. 

£>Jt 

8-...-...... 








Benefit short last report... _— 

.<£? 

13___.... .... 







9.... 




14_ 











15___............ 







*9 _ _ _ 




i6... 



...... 

Total benefit due _:- 

It 

5'0 

13_-.... 




17 . ... _ __ 

DRAW ALL REMITTANCES PAYABLE TO "HI 
M. W. OF A., ROCK ISLAND, ILL." (Sc 

EAD BANKER, 
c. 286.) 

14...... .—:., 

15..... 




18____ 

19..i... 




Memoranda for Head Clerk 

Camp Clerks will ieave blank space below (or 

Head Off 

c S 





20..... 





21_—...... 





I Draft or Money Order, $ _ Credit Slip, 


Benefit . , . __i_. .;_ 

Per Capita . .. Credi 

No.. 

Supplies . . _...... 

Certificate Fees __ Cash 

( Benefit, $. _ 


Returned 
Credit Slip ) . 


Audited by _ Date _ 

Daily Report Number and Date Received 


Date Returned . 
Date Received . 


Neighbors Reinstated 

e than sixty (60) days, but le: 
months.—Sec. 67 



Report only those Neighbors who are Suspended for the Non-payment of Assessment N0.J4 

NAME Ra(e Not 0 [ B , Cf LAST KNOWN P. 0. ADDRESS | STREET AND NUMBER 

— Lo. ---- 

SJ- L2l:*$ct J.<^uCUy.^JL. __ 

-S.o ifU'm 


Neighbors Whose Assessment and Dues Refused Under Provisions Chapter III. and Secs. 290-292 
2 NAME I Rate I No. of B. C. I E°'i^ed | Wisy Suspended I I If so, When? I 


{ \ 

Ir | f>S]i g 


4X 33 3*1 §* 




33M3I31M! 


nth the By-laws of the 


































































































































































































































REPORT SOCIAL MEMBERSHIP ON PAGE 8 Give Exact Date ot 

-!-- I Adoptions in.. 

PASS REPORT t Adoptions in 

"D&te of Adoption and 

- T C\ ^ Note Carefully Sec 35 

Assessment No.._.*-.S~£. 

first day of the month in whu 

Levied for _. 19)3. . Z a“on. n fu b C c*™g^ubfc-s«l 

Due Head Office or, or before8, 19.LH name 

Camp ® _ i .. 

(&erlt^SM Pf ovmce} - 


Give Exact Date of Deliver y of Benefit Certificate 

I Adoptions in..first liable Asst. No.- 


ENTER DATE WHEN NEIGHBOR PAID ARREARAGES 


2 _ SZrfNCKi. . . X. 


= u -‘- v - /3J i 

l.. 6.P. fAZS>ZL± 

k.o fu.az. %o ! 
JjJLw i-D /A3^.y4 %!_ j 


Total Membership this Report. y 

• Arrears for __ Neighbors r, 

Benefit short last report __ 


| AMOUNT j 


QJl 







in. 

3.5: 


I Total benefit due ..: 


Memoranda for Head Clerk 

Camp Clerks will leave blank space below tor Head Offic? 

Draft or Money Order, $ _ Credit Slip, $ _ 


nc. Returned 

Benefit .*. 20 

Per Capita .,. <****> ^ 

Supplies . . _ 22.. 

Certificate Fees __ Cash .... .$ _.. 23 ~ 

{ Benefit, $ . 24 " 

Shortage J 25.. 

a ° r “ J \7,7c^' u ',T.~. “Z“~~ 


Neighbors Reinstated 

more than sixty (60) days, but less than six (6) 


Audited by _ Date _ 

Daily Report Number and Date Received 


Application for 
Item 2 


Date Returned . 
Date Received . 



Neighbors Deceased—Secs. 60-65 

Last Paying Assessment No. . 

NAME , ■ . I Rate I £ as ' I £ 


■j NAME 

How 

Rejected 

Date 




■S B 






iWiiiliiMBHiH 




Report only those Neighbors who are 

Suspended for the Non-payment of Assessment No._£r_^jf_iT__Sec. 53 

NAME 

Item 1 (write plainly) 

Bate 

No. of B. C. 

LAST KNOWN P. 0. ADDRESS 

STREET AND NUMBER 

(if free delivery) 

, 





, 










A 










a 





7 









4 






an 





11 















11 





1 = . 




















1« 





on 





?1 


















































31_—------ 





32- -1-1- 

Neighbors Whose Assessment and Dugs Refused 1 

Under Provisions Chapter III. and Secs. 290-292 

Item? NAME Bate 

Nil. of B 

r No. Asst. 

U | Refused 

Way Suspended sessmenf 

Tendered? 










3 . _ - - ... 




0 

Monthly Report of Social^ Membership 

Combined Membership 

and Financial Statement 


Rate Summary 

of members (net) In good 
ne, then amount paid by ea< 


Amt. This 
Assess meat 

No. 

Hbrs. 

ire 



. 1 





















4- 
/. 

10 

U' 


2.60. 

2.55 


1-0 



$ 

o 



- 4 - 

ft 

.0. 

U 


2.70. 

? 

m 



4 



2.85 


i 



3 

n> 





•- 



M 


3.10 

-4~- 



3.20 




330 




335 

-L. 

40 


340 




345 

„v„ 

i-0 


3.50 




3.65 

0-1 



3.60 

3.65 




3.70 

5- 



3.75 




385 




390 




395 

0_ 



4.00 

B- 

o_ 

■— 


4.05 

4.10 





'0 



4.20 

333 

1 




Social-Beneficial Membership 
only Applicants for Beneficial Membi 
re Adopted as SOCIALS, pending reo 


Neighbors Expelled by Camp Trial—Chapter XLVU 


Change in Rate, Acct 









































































































































































































































































REPORT SOCIAL MEMBERSHIP ON PAGE 8 

PASS REPORT 


Exact Date of Delivery of Benefit Certificate 


ENTER DATE WHEN NEIGHBOR PAID ARREARAGES 
Neighbors Reinstated 














































































































































































REPORT SOCIAL MEMBERSHIP ON PAGE 8 Give Exact Date of Delivery of Benefit Certificate enter date when neighbor paid arrearages 

- — ' - - M . J Adoptions m.first liable Asst. No-1 Neighbors Reinstated 

PASS REPORT 


•O Note Carefully Sec 35 Every Beneficial member shall be liable 

Assessment No Xa-r * •jssstrsstrss^ SrauJSi'S: 

1 lOOGOOIUGUl 1 “ ----- first day of the month in which last assessment became payable, to the 

n y first day of the month in which next assessment is payable. 

_ , , . . • 1/ ^ . . . • . -/ If a new Camp, enter name of members adopted on date of organ- 

Levied for . nation, all being liable.—-Sec. 36. __ 

Due Head Officer beffi(%2**^T$, 19 NAME- ■ |No.oi8,C. | Rate | gh 


Camp 




Total Membership this Report. \Mi---pA \m ... 

Arrears for _ Neighbors reinstated :_' 7 " 

Benefit short last report __..._--- 


LJiUiU ,I~—====__ L_«- 


Draft or Money Order, $ _ Credit Slip, v 


Benefit . . . . 

Per Capita . . Credi 

or- Afr. - 

Supplies . . _...... • 

Certificate Fees __ Cash 

f Benefit, $ _ 


Returned 
Credit Slip ) . 

No. ) * — 


(. Per Capita, ■$-- __ 

Audited by _;_’_ Date _ 

Daily Report Number and Date Received 


Date Returned . 
Date Received . 


i fWJu>^ 

L5"0 




& 

tuWi 

P- 

1 


& 

'tfipij 

i 






..... 














































...... 














































Neighbors Reinstated 

c than sixty (60) days, but let 
months.—Sec. 67 


Neighbors Deceased—Secs. 60-65 


CANDIDATES REJECTED 








jm 

n ■ 

■ 

m 

■ 

■■ 










■B 


WSBMMgg 

SB 


mmihi 

9 

■■ 

mm 

m 

m 

■3 


u 

m 



fmiMiiMlI 


m 

0: 

B 


Social-Beneficial Membership 

only Applicants for Beneficial Members 
re Adopted as SOCIALS, pending receip 
Benefit Certificate—Sec. 29 


Beneficial Members Reinstated, for whom Arrearages 
_of Per Capita is Remitted with this Report 


NAME 





>stoffice<adress^o.- 
























































































































































































































































REPORT SOCIAL MEMBERSHIP ON PAGE 8 | Give Exact Date of Delivery of Benefit Certificate ENTER DATE WHEN neighbor paid arrearages 

-- ’ ~ Notice i Adoptions in .—first liable Asst. No-1 Neighbors Reinstated 

PASS REPORT 


Assessment No. .9..) 

Levied for . _ , 19t\. 

Due Head Office on or befo^r^ert^^T ._ 18, 

Camp 

j^ir^ Province 1 - 


Report only those Neighbors who are Suspended for the Non-payment of Assessment No.___Sec. 53 


Rate Summary 

of members (net) in goc 
ne, then amount paid by < 



„ - MEMBERS 

1 AMOUNT 

Total Membership this Report. ...fjfA—:. 

’3S 


■ Arrears for __ Neighbors reinstated 

Benefit short last report __ __ 

3- 

&>/ 







Total benefit due _ 


AT 0 . 

DRAW ALL REMITTANCES PAYABLE TO “HEAD BAI 
M. W. OF A., ROCK ISLAND, ILL.” (Sec. 286.) 

AKER, 


Date Returned 
Date Received 


Admitted by Card from Other Camps.—Sec. 82 

First Liable for Assessment N6_.... 


Neighbors Deceased—Secs. 60-65 

Last Paying Assessment No.. 

- NAME, , I Rate I 1"* I [ 


Transferred from Beneficial to Social 
Membership—Sec. 73 
Last Paying Assessment No.. 


Transferred from Social to Beneficial' 
_Membership->-S.ecs. 78-79 


Neighbors Expelled by Camp Trial—Chapter XLVII [ 4. 


( Transfer to New Plan 
) Increase of Insurance-Sec, 41 
Change in Rate, Acct. A Decrease of Insurance-Sec 44 


No. of B. C, Rale j ^ s ! I ' 




. 


u..rn 

. 3 

j CANDIDATES REJECTED 


NAME 1 

1 

How 

Rejected 

Date 

2___._ 



3. 



4. 






Social-Beneficial Membership 

Report only Applicants for Beneficial Membership w 
were Adopted as SOCIALS, pending receipt of 
Benefit Certificate—Sec. 29 

- 

NAME 

j DATE 

-1 



„/ • 



3_ 



4.. 



6 ..... 



6.. 



7..:_... 



8... 


; 

9. 



10 



11.. 



12... 



13_..... 



14 



16 



Beneficial Members Reinstated, for whom Arrearages 
of Per Capita is Remitted with this Report 

NAME 

1 .... 






3_.. 



4... 



5 ____ 






, V. 



*■—.—~.. 













Monthly Report of Social Membership 1 Combined Membership and Financial Statement 
(Report here only Social Membership Changes for the Month) Item With But One Bate Each for— | Members | Amount 

| Adopted as Social Members Since Las~Report (69-7l7~ f TO re a portTltem ll t P 5) remi l ted £ ° r last | k . U 


nent”No. 

bw Camp, Neighbors fix 


A.°. .£?_ 5 


Admitted by Transfer Card (Social) 
NAME I ' Fr0 “ I 


Withdrawn by Card (Social) 


2 Neighbors adopted since last report; 

now liable (names page 2) a.- 

3 Neighbors reinstated within sixty 
days from date suspended (names 

Item 1, page 3), one rate for 
each, amounting to- j .—_— — 

4 Neighbors leuastated, suspended 


Vhj/a 


Admitted by card (names Item 


Transferred from Soc: 
I ficial membership (n: 
Page 4) -- 



^of certificate (Item 5,| 
^ to new plan (Item 5,1 
error in rate (Item 5,1 


DEDUCTIONS 
8 Neighbors suspended 


--|y.y|g \m 14 


Deceased (Social) 
Name 


Suspended or Expelled (Social) 


10 Deceased Neighbors 
(Item 1, page Si¬ 
ll Neighbors transferred 


— -—- 13 Under Chapter III *u 

and Sec. 290-292, •“ ! 

... - - -, (Item 2, page 6)---- v- y .i 

" - -- Decrease of Cert._ _ __ H 4 *' 

- - - Change of occupation -i —_ 

— -- - ** Transfer to new plan_;_ _ jg oo 

Stated Error in rate- -- - I 0 4' O 1 

CWith _ Total Deduction- - - - ^ j 

t Paid | Date Paid Total membership in good standing LSfc4= -W- «&J 

I _ 16 Benefit arrears^Nei’bors reinstated(item3-4) -4. -V^ 

17 Benefit short last report_----1__ _*_ _ ***& 


Total Benefit due__ 

18 Per Capita arrears——Neighbors reinstated 

19 Per Capita short on previous report__ 

20 Pro Rata Per Capita for Ad^ptionsV ?his*report 


4r.cj p 

17 ” ‘ 









































































































































































































REPORT SOCIAL MEMBERSHIP ON PAGE 8 


PASS REPORT 


Assessment No._.JAA. 

Levied for... 191*. 

Due Head Office on or before _ _( Qcdt.—18, 19.1% 

Camp NO...&JL&.7?— 

JiL 


Please Fill in Camp Locatio 


Total Membership this Report. 

MFMBERS 

AMOUNT | 

4 3 ■ 

at 


■ Arrears for __Tr ..Neighbors reinstated 


XSi 

■■■ ^ 









Total benefit due. _■__ 


u 


Memoranda for Head Clerk 

Camp Clerks will leave blank space below for Head Offic# 

Draft or Money Order; $. _ Credit Slip, _ 


Benefit . , 
Per Capita 
Supplies . 
Certificate Fees\ 


Returned 
Credit Slip ) a 
No . ) * — 

Cash. 


[Benefit, $.. - 

shortage J 

a,or S ,d \ ~ 


Audited by ___I_ Date.. 


Daily Report Number and Date Received 


Date Returned 
Date Received 


Give Exact Date of Delivery of Benefit Certificate 


enter date when neighbor paid arrearages • 


Uce \ Adoptions in ___first liab 

1 Adoptions in.--first liable Asst. No..., 

"Dste of Adoption and delivery of Certificate held t 
identical."—Head Cons ' 


for payment of the a>?essmem current at date of delivery of his Cer 
fficate. * * * Assessment current includes the time from tht 

first day of the month in which last assessment became payable, to th< 
first day of the month in which next assessment is payable. 

If a new Camp, enter name of members adopted on date of organ- 


No. of B. C. Rate 


Neighbors Reinstated 1 

Within sixty (60) days from date of suspension—Sec. 66 | 

Item 1 NAME 

Rate 

No. of B. C. ] j 


(J: 


m 



^7 







ft 






8.__ _ 


9.. . 




10 






12...... 



13_...__ 

.... 



14_,__ 



15—_—__ 




16......._ 



17______ 



18_____ 




19.... 




20_ _ 




21_.' _ __ ___ _ 



PP 



23____ 




24..'.. 




25 __ 




26. . ...... 




27 



28...._•__ 



Neighbors Reinstated 

Suspended more than sixty (60) days, but less than six (6) 
months.—Sec. 57 

Application for reinstatement must be approved before six months 

w mm iaia-,1 jet 


Admitted by Card from Other Camps.—Sec. 82 

First Liable for Assessment Nb..._ 

Give Number of Former Camp 


Neighbors Deceased—Secs. 60-65 


NAME 

How 

Rejected 

Date 

2 ' 



3 



4.. 



1 ... 




Transferred from Beneficial to Social 
Membership—Sec. 73 

Last Paying Assessment No. 


Neighbors Expelled by Camp Trial—Chapter XLVII 


Change In Rate, Acct. 


nsurancr—Sec. 41 


1 Increase Rate Acct. Sus.—Sec, S7 
l Correction of Error in Rare 


Amoanl Rale 


CANDIDATES rejected 


Social-Beneficial Membership 

only Applicants for Beneficial Members 
re Adopted as SOCIALS, pending receip 
Benefit Certificate—Sec. 29 


Beneficial Members Reinstated, for whom Arrearages 
of Per Capita is Remitted with this Report 


Report only those Neighbors who are Suspended for the Non-payment of Assessment No... 


LAST KNOWN P. 0. ADDRESS 


STREET AND NUMBER 


Neighbors Whose Assessment and Dues Refused Under Provisions Chapter III. and Secs. 290-292 


Rate Summary 

Enter number of members (net) in good standing paying each 
rate opposite same, then amount paid by each group of rates. If 
correctly computed the total number of members and amount paid 
will aeree with “Total Membership in good standing” shown in 


Itftn 7 NAME 

Rate 

No. of B. C. 

No. Asst. 
Refused 

Wiy Suspended 

Was As- 
sessment 
Tendered? 

If so. When? 

Date Engaging 
in Liquor Traffic 

4 
















3 _ _ - 











Rale 

Ami. This 
Assessmeut 

No. 

Hbrs. 

Rst. 

Amt. This 1 
Assessment ] 

No. 

Hbrs. 

Bote 

51 


, 


■ m 



. J 























?r 











in 











r 











rn 











rr 











rm 











rr 











•rn 











-IT 


? i 









nn 











rr 











nn 




"nn 







nr 


f,(- 


POK 







i rn 











1 0” 











iin 











i in 











1 20 

1 ■ 







5.20 



1 26 








5.25 



1 30 








5.30 



1 36 




336 




5.35 



1 40 

...... 

(£0 


340 




6.40 



1 45 

f . 

r 

Kt* 


3.46 




6.45 



1 60 

fifi. 

I®. 


3.60 




6.50 



1 56 




3.66 




6.55 



1 60 




3.60 




5.60 



1 66 








5.65 







370 











376 







1 80 




380 







1 86 




383 







190 




390 







1 96 




3.96 





.... 


200 




4.00 











4.05 


















218 




415 







2.20 




4.20 







m 

!32 

m 

11 



..... 

_ 

_ 

_ 

..... 


t indicated above to be entered by Camp Clerk on blank lines 


Monthly Report of Social Membership 

(Report here only Soctal Membership Changes for the Month)} 


Adopted as Social Members Since Last Report (69-71) 
Item 1 NAME 


Admitted by Transfer Card (Social) 


1_:_'__ 


Withdrawn by Card (Social) 


Deceased (Social) 


Suspended or Expelled (Social) 


ItemJ NAME 

Suspended 

Date 

Expelled 

Date 

t ' 















4_ — - - - 


_ 



Social Members Reinstated j 

. • Per Capita Arrears Herewith | 

Item 6 NAME 

Am’t Paid 

Date Paid 

1 





„ ‘ 





■> 















e 





7 . - 






Combined Membership and Financial Statement 


With But One Rale Each 


rotal membership r 
report (Item 15) 
Assessment No. . 


liable (nai 

Neighbors a 
now liable 

Neighbors 


Camp, Neighbors firs: 

ice last report 
page 2)- 


date suspended 
page 3), one 


2 

Neighbors levitated, suspended] 
more than sixty days, but less 
than six months (names Item 2, 
page 3) - 

Admitted by card (names Item 1, 


Transferred from Social 1 
ficial membership (names 
Page 4) - 


DEDUCTIONS 
Neighbors suspended 

(names page 6)__ 

Neighbors withdrawn 
by card (Item 3, 


Neighbors ti 




(Item 2, page 5)_ 
Neighbors expelled 
(names Item 3, 

page 5)- 

Under Chapter III 
and Sec. 290-292, 
(Item 2, page 6)... 

Decrease of Cert- 

Change of occupation 
Transfer to new plan 


- Total Deduction.... 
Total membership in good standing j 
Benefit arrears. ^e i’bors reinstated: 
Benefit short last report_ 


Mem- 

Amt. 

J 

JL P. 




..... 


—- 




£2- 






Total, Benefit due 




-X* 

.... l. 


L 


jfj' 


?A\ 


40 


*y- 

j*> 

jUt 


JI 


JV 


< h 
2 t 

















































































































































































































































































































































Admitted by Card from Other Camps.—Sec. 82 

First Liable (or Assessment Nb_ 

Give Number of Former Camp 



CANDIDATE’S REJECTED 
NAME I „ Ho " 


Monthly Report of Social Membership Combined Membership and Financial 

(Report here only Social Membership Chang es for the Month) item Wit h But One Bate Each (or— | Members 

Adopted as Social Members Since Last Report (69-71) ( f ° r laSl (/? 

-----j-— J Assessment No.-—- Y~ 

Item-1, NAME Date 1 If for new Camp, Neighbors first 


| Amount *2 -Sj. 

3y f. 


Social-Beneficial Membership 

only Applicants for Beneficial Members 
re Adopted as SOCIALS, pending receip 


Neighbors Expelled by Camp Trial—Chapter XLVII 
Hem 3 NAME j No. of B. C. I Rate I i; as ! | ® a,e 



Withdrawn by Card—No. 80-82 


( Transfer to New PI 
\ Increase of Insurant 


Beneficial Members Reinstated, for whom Arrearages 


Change in Rate, Acct. -j p n f r ^R°A“, n s?.I-s C ec 44 S7 I of Per Capita is Remitted with this Report 

(Correction of Error in Rate_ ' -- 


Admitted by Transfer Card (Social) 
Item 2 NAME I r From ,, I 


Withdrawn by Card (Social) 
NAME ■ | 


page 3)--- 

S Admitted by card (names 


Page 5) —-- 

Transfer to new plan (Item 5, 

Page 5)-—-- 

Account error in rate (Item . 5, 

Page 5)- -- y 

Totals._-- 

DEDUCTIONS I Mem- I . . 


n ||_ 8 | Neighbors suspended 

- .r_= - r .or non-payment of 

Deceased (Social) _ ‘ h!s assessment 


10 Deceased Neighbors 

(Item 1, page 5)_. . 

11 Neighbors transferred 


mS NAME 

Suspe 

uded 

Expelled 1 
Date j 

















; - 





s of Cert.... 

of occupation _— 


?! i 

1 S'- 

•• pQ pH 

! Si 


E0f5 


“3 L m 




w 8.g S. SR- 

£ | -§ 

u s § | Y\] 





















































































































































































































































































































































































































































































































































































































































































































































































































k r” 

I V 

iL-^S 


report social membership on page 8 
PASS R EPORT _ 

Assessment NoJ- 

Levied for..... 191-1- 

Due Head Office ofijr before.19l%. 

Camp No.-fxl--""- 

Slate \ 















































































































































































































































































Semi-Annual Report..Camp No.. of ,.y | 

State of..™—— .for the Six Months Ended .-• / ~ ...19./41 


SOCIAL MEMBERSHIP 
SOCIAL MEMBERS Iff.GOOD STANDING 
For Whom Per Capita for the -V^.f^AA^trSemi-annual Ter: 


*NAME 

| Amount 

Adopted 



do 




Cr 




to 





/- 2--0? 


— 

kQ. 

ko 

1.720-.0.?. 

I” ZglQ' 

....... 

£>.a 


10 ..U/.2Zk.. 


<=>£ 

2-jS 1 

w...0L\^.ck^3 


'it 




A 


13... 




it. 








18..... 












19... 




20..... 




2l‘... 








23.:... 








25.!. 




26... 




27. .. 








































37 ..... 




38...... 








40..,... 




IT any of your Social Neighbors have 11 
cates of mcmbcrSlti|>. forward application .1 
(ration fee of $1.00 anti certificate will be is: 

ot received S 
0 Head Clerk 
sued. 

jcial certifi- 


i_ oL .. .$3. jolA^X .. 


Eceased Members (Benel 

arm*.liable for No.bt 


Semi-Annual Membership Statement 


cial leigbbois iu goo 


DEDUCTIONS 
Deceased [Item 2, pag 


Instructions to Clerks 

The per capita for the year is $1.20. It is 
required to bs paid strictly in advance, ene-half 
in January and one-half in July, to be ac¬ 
companied by the Semi-annual Report properly 
formulated. Each and every Camp is liable 
for all Neighbors, Beneficial and Social, in 
good standing on December 31st for first term 
per capita, and all Neighbors in good standing 
on June 30th are - liable for second term per 
capita. v . 

The Neighbor is required to pay local Camp. 
General fund dues, which includes per capita, 
in December and June, or in default stand sus¬ 
pended. The Society’s law forbids the Clerk 
from accepting from the Neighbor either' the 
dues or the assessment separately, but both 
must be tendered. He. cannot accept part pay: 
ment. 

For all Neighbors reported in good standing 
on the Pass Report for the month ending 
December 31st, together with all Social Neigh¬ 
bors and those adopted prior to January 1st, 
per capita for the first term must be remitted, 
and in the same manner Neighbors so reported 
for the month ending June 30th, per capita for. 
the second term must be remitted. 

Make all remittances of whatever character, 
forwarded the Head Office payable to the 
Society’s Head Banker at Rock Island, Ill., 
and in no instance to the Head Clerk, or drawn 
payable to his order. 

Clerks are earnestly requested, in the interest 
of their Neighbors as well as that of the general 
Society to correctly prepare this report, as 
nothing appears in it that is not essential to the 
business of the Society. It is the duty of the 
Clerk to formulate this report before the in¬ 
stallation of the Clerk-elect, for the next en¬ 
suing term. 

C. W. HAWES, Head Cleric, M. W. of A 


I Camp . 


CERTIFICATE OF MANAGERS AND SPECIAL AUDITOR 

' ...... 


The undersigned, Managers and Special Auditor of Camp No. IZJl.Q.. .. —-i upon our honor as Woodmen, certify that we have made a full and complete I 

check, audit; and examination of the books, records, and accounts of tlie Clerk and Banker thereof! that the Camp Cashaccount correctly exhibits the receipts to and disburse¬ 
ments from the Benefit and General funds of said Camp, for the semi-annual term ended_ ... .....19^T.. 

^.On . .. ......... A9/$P... there was in our Benefit and General funds (including clssessm-ent Jfo. 

.... jLsiAAtX?.....quarter, , dues): Benefit.fund ___; General fund, $.. ±?.MZ... . ■ 

We find as due Head Camp, including arrears for members reinstating on Assessment No. i account Per Capita for the...?5^^_.. I 

. ....A9/J(.. t L leaving a balance of $. in the Benefit fund, and in the General fund, at this date, j 

We find the cash representing these funds (including safety or other special funds) satisfactorily accounted for as follows 


a the General fund, at this date. 


In the custody of the Camp Banker ... . . , . ; ... . . . * . 

In the hands of the Camp Clerk ... . . . . : . .... . . 

On deposit.....--..—...... *...j.Bank 

Loaned on security approved by the Managers . ........ . . 

Total .... . . ... .... . . 


BENEFIT 

"GENERAL 

TOTAL 


$ / 6 F,C? 















We further certify that the Beneficial memberehip of the Camp, ........ 19^.%.., is-correctly indicated bn page 10 of Pass report attached 

and the Social membership on....19^7^.,ns correctly reported on page 15 of the Semi-annual report herewith. 

. : /P> „ ^ > 




Sick funds, 






Semi-Annual Report = ••• . Camp No. 

State of. b ...for the Six Months Ended. / 19/# 


SOCIAL MEMBERS IN GOOD STANDING SOCIAL MEMBERS SUSPENDED 

For Whom Per Capita for the.:.0-i*r<iffJJ<:Semi-annual Term For Whom Per Capita, for the. 

of.-/./../..7-..is Remitted. of .Uf./i .-£.IS NOT. Remitted 


. 6.0 

..i ...j.... £.6. Jt-.j-roj: 

.A w J.r.S.naS' 4... 

5. £.0 «... 

.. 4.0. 2rJko.T.f>9 e... 

7....CTTlA<Wwfc... i id^arl«ws^BrJ!r.... ........ i.ft. 7... 

.. 4 j 0 . hrJJr.O.t. . 8 ... 

........ . 6 . 0 . .. 9 ... 




Deceased Members (Beneficial) 

lied during—.liable for No.but not liable for Per i 


Semi-Annual Membership Statement . 


2 Social S eighbo.s ii. good standing 

3 Totals.;,... .... 


DEDUCTIONS 
4 Deceased [Hem 2, pap 


!!!?.: y.L.. Z±. J 

. .3. $:.. . 

...... G- 3-0 


rhom.Per Capital f -Q “J £> Q—y 


Capita due..—..- AJ.Il.I?. 


Instructions to Clerks 

The per capita for the year is $1.20. It is 
required to bs paid strictly in advance, ene-half 
in January and one-half in July, to be ac¬ 
companied by the Semi-annual Report properly 
formulated. Each and every Camp is liable 
for. all Neighbors, Beneficial and Social, in 
good standing on December 31st for first term 
per capita, find all Neighbors in good standing 
on June 30th are-liable for second term per 
capita. 

The Neighbor is required to pay local Camp 
Genera] fund dues, which includes per capita, 
in December and June, or in default stand sus¬ 
pended. The Society’s law forbids the Clerk 
from accepting from the Neighbor either the 
dues or the assessment -separately, but both 
must be tendered. He cannot accept part pay¬ 
ment. 

For all Neighbors reported in good standing 
on the Pass Report for the month ending 
December 31st, together with all Social Neigh¬ 
bors and those adopted prior to January 1st, 
per capita for the first’term must be remitted, 
and in the same manner Neighbors so reported 
for the month ending June .30th, per capita for 
the second term must be remitted. 

Make all remittances of whatever character, 
forwarded the Head Office payable to the 
Society’s Head Banker at Rock Island, III,' 
and in no instance to the Head Clerk, or drawn 
payable to his order. 

. Clerks are earnestly requested, in the interest 
of their Neighbors as well as that of the general 
Society to correctly prepare this report, as 
nothing appears in it that is not essential to the 
business of the Society. It is the duty of the 
.Clerk to formulate this report before the in¬ 
stallation of the Clerk-elect, for the next en¬ 
suing term. 

• C. W. IIAWES, 7/ead Cleric, M. W. of A. 


CERTIFICATE OF MANAGERS AND SPECIAL 


Camp 


.......state or.. 

...L&;,Zi.. 


9 7 fn (X' / 

The undersigned, Managers and Special Auditor of Camp No ...(/. f..3. _:-., upon our honor as Woodmen, certify that we have made a full and complete 

check; audit, and examination of the books, records, and accounts of the^Clerka^raBanker thereof; that the 'Camp^Cash^account correctly exhibits the receipts fo and disburse¬ 
ments from the Benefit'and General funds of said Camp, for the semi-annuJlHerm ended . pZ-XCft&rtZ.............. ~ _ "• ■■■■■: 

I J)n,...(.yJrAA-rPtdt . . jicIXI&/Z.....I _... .19/^.. there was in our Benefit and General funds (incliidiug. .dssessnwut Jfo./f\/.Z:...and 

.(wtelst_ quarter, 19^^.., dues): Benefit fund . ; j General fund \%..S./.T*.•.$?.?). . ... / 

: , We. find as due Head Camp, including arrears for members reinstating »on Assessment No.. X?..?.. account Per Capita for the^B££\--f#.. j 

.. jferN?..19/j/ $...-2..?yX P .... leaving a balance of $. J.SJ..L... .in the Benefit fund, and $.. 1&M.. .in the General fund, at this date. •. J : 

We find the cash representing these funds (including safety or other special funds) satisfactorily accounted for as follows . /- j 


In the custody of the Camp Banker . . , . . . . . 

•In the hands of the Camp Clerk . . ... . . . *, . . . .. . . ..» 

On deposit..:...................Bank 

Loaned on security approved by the Managers ... .. . > . . ... . . t -. 

- V. I Total . ... - .. • : ! .. .. .. . - 

We further certify that the Beneficial membership of the Camp, ..-- ZX„ 


BENEFIT 

"GENERAL 

TOTAL 

L /.J.,7.0.. 













We further certify that theBeneficial membership of the Camp, .. —.. ly../..., iscorrectly indicated on p; 

: Social membership on ..i^XAAXPki../. ...1 %/. !£.., is correctly reported on page 15 of ;the Semi-annual report herewith. 

, 7 


ctly indicated on page 10 of Pass report attached I 


: cannot be executed by Ibe Board of Managers and .