Master Certificate of Election

MASTER CERTIFICATE OF ELECTION

Church Of God In Christ, Inc.

938 Mason Street, Memphis, Tennessee 38126

This is to certify that I, ______, am the duly appointed Jurisdictional Bishop of the ______, Jurisdiction

in the State of______. I also certify that, ______is the duly appointed Jurisdictional Secretary for the Jurisdiction. I further certify that the persons whose names appear below, were duly elected by our jurisdictional assembly, per the Constitution of the Church Of God In Christ to represent our Jurisdiction as delegates to all sessions of the General Assembly for the dates shown below, or any subsequent meetings held during this session.

NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Jurisdictional Bishop
Auxiliary Bishop
Supervisor
Supervisor (Without Charge)
Jurisdictional Bishop's Wife
Jurisdictional Bishop’s Widow
Emeritus Bishop’s Wife
Jurisdictional Secretary
National Elected Officer*
National Elected Officer*
National Elected Officer*
District Missionary
District Missionary
District Missionary
District Missionary
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials

*Per General Assembly Resolution, National Elected Officers who are not Pastors, Elders, Supervisors, or the Jurisdictional Bishop’s Wife.

NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Lay Delegate
Lay Delegate
Lay Delegate
Lay Delegate
Lay Delegate
Lay Delegate
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials
NAME / TITLE / DELEGATE VOTING CATEGORY / ADDRESS / CITY / STATE / ZIP
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
Pastor / Elder
OFFICIAL USE ONLY / Voting Categories / Pastor/Elders / District Missionary
Certified by: / Bishop / Jurisdictional Bishop's Wife / Lay Delegate
Certified by: / Supervisor / Supervisor( Without Charge) / Specials

In witness whereof, we have hereunto affixed our signatures of this the______day of ______, in the year Two Thousand ______

______

Jurisdictional Bishop Jurisdictional Secretary