j 111du2Fs
name:

r,a:s,rrence

J:,a~t·.•

----

.-RDNlli:&._F~ir_s_t_____

·i~i
---Fo-R-oF_F_lc_E_U_s_e_o_N_LY
__ ___,J

disfellowshippingor disassociation

McAlester

3Lt769

OKLA
City

,gregation number

,,

--(-l,-, s-,-,1-1,-1-rr,-.-,,-.)-

9-1-05
Date-o"'f"'a'-n-n_o_u_n_ce_m_e_n_t_o_f
__

Date of birth

k jf applicable:

~H~-~-l\-1-id_d_le
_____

State

D Elder O Ministerial

servant D Regular pioneer (If so, include 8·202 with this form.) 0 Special pioneer
D Listed with the branch office as the person to receive literature and/or magazine shipments for the
congregation, (If so, immediately submit llll S-36 and/or M-206 form, showing a new name and address.)

DISFELLOWSHIPPING. Specify offense(s)
for. wb.i><h..dis!'eUow.JJhipp!l,I
.(Sslt'ks9.J92-§,):

::.¥il1.g., ... 1.o,:;;eL9 .G.Gn.d.n.ut.,

At 2ny point, did the wrongdoer confess to the committee?

Yes·

Ch;Ll.<:l .Abw,"'

( "e.xl.lal.)....

If not, what evidence substantiated the wrongdoing?

DISASSOCIATION. Specify by what action (s) the person
disassociated himself (such as resignation, non-neutral activity,
failure to abstain from blood, or joining another religion):
Did the indindual submit a signed letter of resignation? _____

If not) what evidence substantiated the disassociation?

ea detailed summation of the case, explaining exactly what took place. (Use additional sheet only if inore space is needed.) For a
"ellowshipping, include the reasons why you judged the person to be unrepentant. For a disassociation, include what led to

perron'S·decisioniho\Vhe respondedto efforts to assist him1and what convincedyou that his position ,;vasadamant.

Please

see

attached

sheet.

;i.
"
11

·'

he individual appeal your decision? _,_,N~n,_
__ (If so, follow the instructions on the reverse side regarding appeals.)
ividual was previously d!sfellowshippodor disassociated show:
n'sfuUnameatthattime
Ronnie
H I,a:wrence
regationthattooktheaction
McJlle,;t:er
'<Lt769
Name of congregation
should sign fhlll formLand

,,,.

powell,Fred
:ated

sed Date:
/01

Watts,Mike

Date of previous action 5-1 9 9 9

Dateofpreviousreinstatement J l

M'c~lester
City

State

d~/n~.sheets. (Typ~ nfie be!ow e~~h s~~e.)
uJ-t

Powell,Ken

I JI~.
Weiher,Walter

1 rr2t>lo

2000-

OKLA

2

....,_

':i{CttL41/:

,,.f -

Pratt

FOR OFFICE USE ONLY

-~-+-~~~~(Mont , Day, Year)
CAREFULLY READ INSTRUCT[ONS ON REVERSE SIDE

Printedin U.S.A.