Trade Mark		Reg. U.S. Pat Off.:
PHILANTHROPIC WORK REPORT
	Date        	
The Supreme Council, Order of the Amaranth, Inc., has secured for all Grand Courts and Courts of the Order of the Amaranth, INCOME TAX EXEMPTION.  In order to maintain this exemption, the Supreme Council must file annually with the united States Treasury Department (I.R.S.) a financial statement listing all receipts  ans expenditures.  An important item of this report is the charitable work done each year in each Subordinate Court and Grand Court.
Please cooperate by answering completely the following questions and be prepared to justify figures if audited by Internal Revenue Service.
Name of Court / Grand Court 	     		No. 	   	
Location of Court		     	
Address
	     		     	     	
City	State/Prov	ZIP/Postal Code
Contributions and amounts to -- 	Hours	Amount
1	Home and Hospitals	    	$0.00	
2	Educational Funds	--	0.00	
3	Local Charities	    	0.00	
4	Relief for worthy members (not remittance of dues)	    	0.00	
5
a	Other charitable works
Amaranth Diabetes Foundation	
--	
0.00	
b	Masonic Home	--	0.00	
c	Knights Templar Eye Foundation	--	0.00	
d	Shriner’s Crippled Children’s Hospitals & Burns Unit	    	0.00	
e	Other Masonic Groups (Less Youth Groups)	--	0.00	
f	Masonic Youth Group	    	0.00	
		TOTAL	$0.00	
(Seal)
Grand Secretary/Secretary
In each of the above categories report Cash Donations, Estimated value of Clothing (new and used) and furniture.  Volunteer hours identified to Category 1, 3, 4, 5 shall be computed by the following formula.  Number of Volunteer hours multiplied by the current Minimum hourly rate will give the dollar amount.  Category 2 may be computed with the actual hourly rate.
Category 1 -	Include cash donations, volunteer hours, clothing, furniture, etc.
Category 2 -	Include all cash donated to and for educational institutions and scholarship funds.
Category 3 -	Include all recognized charities, Salvation Army, Cancer, Heart, Kidney, Scouts, Meals on Wheels, Paramedics, Ambulance Service, Prison Support, Volunteer Fire and Police work, Direct contributions to needy (other than members), Senior Citizen Volunteer Hours, Food Baskets & canned goods donated, etc.
Category 4 -	Include donations to Emergency Relief, sash assistance, volunteer hours.  (Do not include the amount of dues remitted as it only costs the Court the amount of their per capita tax).
Category 5 -	Include items (a) through (f) only.
Courts under the jurisdiction of a GRAND COURT, return to Grand Secretary.
Courts under the jurisdiction of the SUPREME COUNCIL, return to Supreme Secretary.
GRAND SECRETARIES, return compiled report of your jurisdiction to the Supreme Secretary by April 1 each year.