PROVINCIAL GRAND LODGE OF SOMERSET - SOM4
It is with the utmost regret that I have to inform you of the passing to the Grand Lodge above of:-
Surname Given Name
UGLE No Masonic Rank
Date of Birth Date of Death   (Mandatory Field)
Address
Post Code
Email address of deceased
  Name and contact details (If different to original home address) of a surviving widow or partner.
 
  The Funeral arrangements are:
 
  He was also a member of the following Lodges:-
 
NOTES.

  1. This form is to be used to notify the Provincial Grand Secretary of the passing of a Lodge Member and should be completed and forwarded as soon as possible after the loss of a brother has been confirmed.

  2. Details must also continue to be recorded on Form SOM 2, as at present.

  3. This Form will be the only information source used in compiling the Obituary entry in the annual Provincial Reference Book.

Secretary

UGLE No.Name   (Mandatory Field)DateEmail   (Mandatory Field)

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