(To be sent by mail or e-mail to arrive at the area and continental office 30 days prior to planned closing date.)

Date: ___/___/___
Home Number: _________________ City: ___________________
Home teamworkers: _______________ _________________
_______________ ________________ _________________
______ Number of voting members
______ Number of non-voting members (excluding children)
______ Number of children

Please prayerfully read over and answer the following questions. We ask that all voting members read over and sign this form, then send it to your Reporting office at least 30 days before you're planning to close your Home.

1. Please briefly explain the purpose for disbanding your Home:

2. Date you are planning on closing the Home: ___/___/___

3. Date your PO box will close: ___/___/___

4. Have all stipulations of your rental contract been complied with? ________. If the period of your rental contract is not up, does the contract have a clause allowing you to break the contract?

5. Are you leaving the property in better condition than you found it, as per Dad's counsel? (See ML #2244:68.)

6. Does each member of your Home have a new Home to relocate to? Please give specifics:

7. Total amount of outstanding bills and liabilities:
Total amount of Home loan or Tool debts:
Number of voting members (18 and over) responsible for debts:
Are any voting members exempt from responsibility for debts? If so, please give names and reasons:

8. If Home has surplus funds (for example, a one-month buffer), what is planned for these funds? Please specify amount and plans:

9. If Home has other assets, such as a car, video, furniture, lit, etc., what is planned for these? Please specify item and plan: ______________________

10. HER funds: __________________
         Total amount received: __________
         Total amount on hand: __________
         If HER funds were used, please specify what for:

(On closing the Home, please return all HER funds to your CRO office.)

11. Who is responsible for finishing up business, paying debts, closing the Home, etc.? __________________________________________________

(For all the Home's voting members to sign)
I, the undersigned, have read and am in agreement with the above facts and proposals. (If any Home member is not in agreement with any of the above decisions, please explain--this can be in a separate note to your continental office.)

Copyright (c) 1998 by The Family