INSTRUCTIONS FOR FILING ON-LINE

1. Access the Episcopal Church Web page at

http://www.episcopalchurch.org/gc/ or go directly to http://pr.dfms.org
2. Select Parochial Reports (Under "Useful Links") and left click File
Report to become linked to a menu that will ask for your Universal
Episcopal Identifier number (UEID) followed by your password. (If
you need these numbers, please contact Susan Hardaway, 888/210824-5387, ext. 4010)
3. Go to Update Name and Address to check this information. Make
any changes, then Save or click Cancel if nothing has changed since
last year.
4. Select Update File Information. Make any changes, then save
before returning to the system menu.
5. Choose Vital Statistics and Financial Statistics successively to
enter the needed data. Now go to Mark Report Complete. Click
Confirm to submit Parochial Report, then exit at the bottom of the
screen to exit the program.
6. Go to View/Print Parochial Report to obtain a hard copy to review.
Select the correct year and left click the Submit button for the report
to download. You can re-enter at will to make changes or updates
unless I have already accepted the report and closed it. If that should
happen just give me a call and I can reopen it When you are
satisfied, a signed copy should immediately be sent to your diocese.

CHURCH OFFICIALS FOR THE YEAR 2016

(Please print or type)
(Please do not change the titles. These are the titles as they are set up for the Quick Reference in the database)
Church ___________________________________________ Street Address ___________________________________________
Mailing Address (if different than above) ________________________________________________________________________
Church Phone Number _________________ Fax Number ____________________E-mail Address_________________________
TITLE
Senior Warden
(if Parish)
Bishops Warden
(if Mission)
Treasurer
Christian Ed
Director
Parish
Administrator
Secretary
Secretary
Secretary
Financial
Secretary
Communications
Music
Youth
Lay Ministry

NAME

MAILING
ADDRESS

PHONE
NUMBER

E-MAIL ADDRESS

CHURCH OFFICIALS FOR THE YEAR 2016

(Please print or type)
(Please do not change the titles. These are the titles as they are set up for the Quick Reference in the database)

PLEASE LIST ALL CLERGY (SALARIED ONLY):

TITLE

NAME

1.
2.
3.
4.
5.

NONSTIPENDIARY CLERGY
1.
2.
3.

OTHER PAID EMPLOYEES (NUMBER ONLY)

PAROCHIAL SCHOOL INFORMATION OR MOTHERS DAY OUT INFORMATION

(Circle the one that applies)
Name of school ________________________________________________ Phone ________________________
Address ______________________________________________________ Zip ___________________________
Headmaster, Principal, or Director ______________________________________________________________
Grade or age levels ____________________________________________ Capacity ______________________

SALARIES FOR 2016

Church _______________________________________ City _______________________
Instructions:
List the Title: Rector, Vicar, Assistant, etc., followed by the Annual Cash Salary for the year 2016.
Indicate whether Housing, Utilities, or Auto are provided and amounts. (Indicate amounts if provided by the congregation, e.g., if clergyperson is provided a church-owned rectory or if
utilities are paid by the Church.)
Please answer the question concerning Equity Allowances.
CLERGY POSITION

CASH SALARY
INCL. SECA

HOUSING
ALLOWANCE

UTILITIES
ALLOWANCE

PENSION

MEDICAL
INSURANCE

AUTO/TRAVEL
ALLOWANCE

CONTINUING
EDUCATION
ALLOWANCE

Is clergyperson who lives in a church-owned rectory provided with an Equity Allowance? Yes ___ No ___

If yes, amount $

OTHER SALARIES FOR 2016

Please enter actual amounts, not a check mark. If VOLUNTEER POSITION, indicate hours worked then remaining columns N/A. Additional spaces provided on the reverse side

LAY POSITION

VOLUNTEER
Yes or No

PART-TIME
# of Hours

FULL-TIME
# of Hours

ANNUAL
SALARY

YEARS OF
SERVICE

MEDICAL
INS. COST $

COVERAGE
EO,EC,ES,EF
XX If declined

PENSION
$ and %

Christian Ed Director

$ %

Lay Minister

$ %

Music Director

$ %

Organist

$ %

Parish Administrator

$ %

Secretary

$ %

Sexton

$ %

Youth Minister

$ %

Grounds & Maintenance

$ %

LAY POSITION

VOLUNTEER
Yes or No

PART-TIME
# of Hours

FULL-TIME
# of Hours

ANNUAL
SALARY

YEARS OF
SERVICE

MEDICAL
INS. COST $

COVERAGE
EO,EC,ES,EF
XX If declined

PENSION
$ and %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

$ %

Organists, nursery workers, etc. should be considered paid employees. An independent contractor must provide their own supplies, come on their own schedule, and have proof of
workers compensation and liability insurance (a copy should be kept on file at the church).
(Revised - 12/28/15)

CERTIFICATION OF INSURANCE - 2016

Church _______________________________________
City __________________________________________

INSURANCE

INSURANCE
CATEGORY

COVERAGE

NAME OF PRIMARY INSURANCE CARRIER

CANON I.6.1 (3)

Building(s)

Contents of Building(s)

Bonding

Medical
Insurance

Workers Compensation

Are all eligible employees offered medical

insurance under the Denominational Health Plan
(DHP)?
Yes or No
Is your congregation in compliance with the
diocesan policy regarding medical insurance
(see attached policy Revised 11/12/2015)
Yes or No
Covered with the Diocesan Workers Comp
Program?
Yes or No
If no, name of carrier ________________________

Signature __________________________________________ Date ___________________________

(Revised - 12/28/15)

Diocesan Policy Regarding Medical Insurance

BE IT RESOLVED, as part of the Employee Benefits Policy of the Diocese of West
Texas:
The Diocese of West Texas and all its congregations are required to:
1) Offer Medical Insurance and Dental Insurance coverage through The Episcopal
Church Medical Trust Denominational Health Plan (DHP) for all qualified employees
(those employees who work 1,500 hours or more per year and all eligible clergy).
2) All paid employees eligible for medical insurance have the option to choose any plan
that is offered through the diocesan plan; however, the standard plan will be the High
Deductible Health Plan (HDHP) with a corresponding Health Savings Account
(HSA). The employer will fund the HSA at one hundred (100) percent of the applicable
deductible. (IRS Regulations govern HSA contributions.)
Employers will fund fifty (50) percent of the applicable deductible in
January to the employee's HSA account (or in month one of eligibility for
new employees). The balance will be paid pro-rata for the remainder of the year.
Employees over the age of sixty-five (65) will have the benefit of a Health
Reimbursement Arrangement (HRA) as part of their plan that will act in the same
way as the HSA for qualified reimbursable medical expenses up to their
deductible.
3) At a minimum, the employer will provide employee-only (EO) coverage.
The employee contribution or "cost sharing" will be ten (10) percent of the cost of
medical/dental insurance chosen.
4) If the employee chooses an option other than the HDHP, the employee will be
responsible for the difference in premium costs through a payroll deduction in addition
to the cost sharing.
5) Employees may opt out of obtaining medical insurance coverage through The
Episcopal Church Medical Trust Denominational Health Plan if they have comparable
medical insurance coverage through other approved sources (e.g. spouse's employer's
plan, former employer's plan, Tri-Care, etc.), and in the case of clergy, have received
the approval of the Bishop.

Adopted by the Executive Board: November 12, 2015

VESTRY OR BISHOPS COMMITTEE FOR THE YEAR 2016

(Please print or type)

Church ____________________________________________________________________________________________________

NAME
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12
13.

MAILING
ADDRESS

PHONE
NUMBER

E-MAIL ADDRESS

14
15
16.
17.
18.
19.
20.
21.
22.

NECROLOGY
January 1 through December 31, 2015
CHURCH

CITY

The following deaths have occurred during the year of 2014 of those persons who
have served the diocese on Vestries, Bishops Committees, as Council Delegates,
as officers of the diocese, on the Diocesan Altar Guild, or on other diocesan
committees. Please note "none" if you have none to report.
NAMES:

STEWARDSHIP STATISTICS 2015 Actual & 2016 Estimate

Church ____________________________________________ City ___________________

2015 Stewardship/EMC/Planned Giving Contact Persons with E-mail __________________

___________________________________________________________________

S t e w a r d s h i p

2 0 1 5 / 1 6

Did you use the Herb Miller New Consecration Sunday

Stewardship Program in 2015 for the 2016 year?
Did you use the Walking the Way Stewardship Program (from
The Episcopal Network Stewardship TENS) in 2015 for 2016 year?
If not, what annual stewardship campaign did you use?
(Letter Campaign, Cottage Meetings, Festive Meal, Home Visitation,
combination, other (please explain.)

Did you see an increase in total dollars pledged for 2016?

YES

NO

YES

NO

YES

NO

If so, what was the percentage (%) increase in dollars pledged?

Did you see an increase in number of pledging units for 2016?

%
YES

If so, what was the percentage (%) increase in # of pledge units?

How many pledge units increased their giving from 2015 to 2016?

* # of actual pledging units for 2016 year

* # of potential pledging units (households) for 2016 year

* Total dollars pledged for 2016

Can the Department of Stewardship assist your church during 2016?

Describe below.

NO

YES

NO

DEFINITIONS
A Potential Pledging Unit is defined as a household, which may include a single person or a family.
An Actual Pledging Unit is any person, adult or child, or a family who has signed a pledge card or some
other pledge of record. The figure for actual pledging units should equal the number of signed pledge
cards.
NOTE: Typically, the number of Actual Pledging Units will be fewer than the number of
Potential Pledging Units. BY DEFINITION, THE TWO ARE NOT THE SAME.
This is the only way we have to gather this information as we plan for next year
Diocesan Contact: Nancy Stinson, nancy.stinson@dwtx.org, (888 or 210) 824-5387

Please return this form with your parochial report.

The Department of Stewardship consists of three primary divisions. Volunteer consultants are now
available to assist congregations in the following areas:
Annual Giving To assist with developing a commitment program tailored to your church
Capital Giving To assist with assessing the degree of readiness and planning the
education process that produces readiness in a congregation
Legacy Giving To assist with the development and implementation of congregational
Wills Clinics, Final Affairs Fairs, and to teach the ABCs of estate planning