THE SOCIETY FOR CREATIVE ANACHRONISM, INC.

TRANSFER TO ANOTHER SCA ACCOUNT FORM

Originating Branch: ________________________________________________________________

Destination Branch: ________________________________________________________________

Date: ________________________
Check Number: ________________________
Reason for Transfer: ___________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

I am recording this as: [ ] Transfer In-Kingdom
      [ ] Transfer to Kingdom Newsletter
      [ ] Transfer to Outside my Kingdom

You should record this as: [ ] Received from In-Kingdom
      [ ] Received from Kingdom Newsletter
      [ ] Received from Outside my Kingdom

Sender's Name: ______________________________________________________________________
Street Address: ______________________________________________________________________
City: ___________________________________________________________________
State or Province: ____
Zip or Postal Code: ____________________

Telephone: Home (____________________) Work: (____________________)
SCA Name: ________________________

cc: Kingdom Exchequer
Exchequer's File

(From p. 22 of the Report Form Packet)

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