2021Bylaws

Form #9

PETITION FOR DISPENSATION

We, the undersigned petitioners, respectfully state that we are Nobles in good standing in the Order; that we reside in the proposed territory of the proposed new temple; are competent to form and open a temple of this Order; and to properly discharge the various duties thereof, according to the requirements of the articles of incorporation and bylaws of Shriners International. Further, having the welfare and prosperity of the Order at heart, we pray for a Dispensation empowering us to form and open a new temple at ________________________________________, state of _________________________, to be designated as ___________________________________________________ Shriners, with the following jurisdiction, _________________________________________________ and beg to recommend as provisional officers: Noble _ ___________________________________ , Provisional Potentate Noble _ ___________________________________ , Provisional Chief Rabban Noble _ ___________________________________ , Provisional Assistant Rabban Noble _ ___________________________________ , Provisional High Priest and Prophet Noble _ ___________________________________ , Provisional Oriental Guide Noble _ ___________________________________ , Provisional Treasurer Noble _ ___________________________________ , Provisional Recorder We are aware of §329.6 of the bylaws of Shriners International that provides: If the dispensation is granted, the members of the temple under dispensation are liable for dues for the fractional part of the year remaining after the date of the dispensation, and the temple is liable in full to Shriners International for the hospital levy and fees for new members created. A Noble who signs a petition for a dispensation becomes a member of the temple under dispensation on the date the dispensation is granted, and is amenable only to it thereafter for dues, hospital levy and assessments. The temple of which he was a member prior to the dispensation may retain the dues and assessments already received from him for the current year. name residence temple (Including County) ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________ ________________________

Note: Forms must be obtained from the Office of the Imperial Recorder

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