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Appendix H-11: Certificate – Transfer of Member
(Regulations 30, 90, 94, 95)
Parish of ............................................……. ...……........ 20 ..........(date)
It is hereby certified that M ..................…..…............. is a/are communicant member/s of the Presbyterian Church of Aotearoa New Zealand and as such leave/s at this date the congregation of the said church at ...........................………. .
Signed …………………………………….
Minister/Session Clerk/Roll Clerk
