Congregational Remittance Form Click here to download and print a paper form. Or submit your information electronically here: Congregation Name*Congregation Number*Congregation Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Treasurer / Administrator's Name* First Last Treasurer / Administrator's Phone*(for if we have questions)Treasurer / Administrator's Email* (to receive a copy of your submission and for if we have questions)Remittance for*(Month and Fiscal Year)Check NumberPlease make checks payable, and send, to: NT-NL Synod, ELCA, 2620 W Grauwyler Road, Irving, TX 75061 Total Remittance Amount*Designations Our total remittance amount may go to Mission Support where needed most (NT-NL 52% / ELCA 48%) We would like to designate part of our total remittance amount to particular ELCA ministries We would like to designate part of our total remittance amount to particular NT-NL ministries Amount to Mission Support (NT-NL 52% / ELCA 48%)ELCA DesignationsAmount to ELCA World HungerAmount to Lutheran Disaster Response - U.S. onlyAmount to Lutheran Disaster Response - InternationalAmount to Campaign for the ELCAAmount to ELCA OtherDesignation for ELCA Other*Please provide the name(s) of the additional ELCA program(s) you want to support with the amount designated above.NT-NL DesignationsAmount to Bishop's Benevolence FundAmount to Bishop Associate's Benevolence FundAmount to DEM's Benevolence FundAmount to Briarwood Lutheran MinistriesAmount to Campus Ministry FundAmount to Lutheran Sunset MinistriesAmount to NTNL Mission Endowment FundAmount to NTNL Fund for LeadersAmount to Sierra Leone - Disaster ReliefAmount to Sierra Leone - GeneralAmount to Upbring(formerly Lutheran Social Services of the South)Amount to Mission Congregation SupportDesignation for Mission Congregation Support*If you would like to designate a particular NT-NL Mission StartAmount to NT-NL OtherDesignation for NT-NL Other*Please provide the name(s) of the additional NT-NL program(s) you want to support with the amount designated above. Δ