Remittance forms

Please submit one of the following forms with any payment submitted to the Diocese of Washington. Use of these forms ensures the payments are applied in the appropriate manner.

A. Monthly Statement Remittance Form

Parishes are encouraged to submit the bottom portion of their monthly statements when sending a payment to the Diocese. Two separate statements are sent out each month as needed: Giving/Special Offerings Statement & Health Insurance Statement. The annual giving committed by each parish is invoiced at the beginning of the year. The Giving/Special Offering Statement presents the outstanding amount due on this commitment. This statement also lists payments made toward the annual giving as well as special offerings received during the month. The Health Insurance Statement lists the both the invoices processed for monthly health insurance premiums and the payments received during the month. Only parishes or individuals who are enrolled in the Diocesan Health Insurance program would receive this statement. The Health Insurance Statement also keeps a running balance of the outstanding health premiums due. Finally, all payments should be sent to our bank lockbox, using the following address:

Convention of the Protestant Episcopal Church
of the Diocese of Washington
Department Number 0567
Washington, D.C. 20073-0567

B. Miscellaneous Remittance Form

This form should be used when making payments for conferences, seminars, special events, payments to the Bishop's discretionary fund, etc. The bottom half of the form is designated for account numbers and will be completed by diocesan staff.

View a completed sample MR Form [pdf]
Download the MR Form [pdf]

Please contact Eva Myking, director of administration, at 202/537-6537, with any questions concerning these forms or submitting a payment to the Diocese of Washington.