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During your year as Master, a few members of your Lodge or the widow of a member might need help. You can request financial relief, in moderate amounts, from the Masonic Charitable Foundation.

The first step is to get an application form. A copy is attached.

The second step is to interview the recipient in order to obtain the information needed to complete the form.

These are the things the Foundation looks for in evaluating an application and deciding on the appropriate level of relief:

1. Application. Your application will receive a quick response if you submit a complete application with all the blanks filled in and with bills reflecting the outstanding obligations.

2. A narrative. The Foundation has no independent means of evaluating an application. It is always helpful if you enclose a letter giving some background on the individual and his or her situation.

3. Participation by the Lodge. It is not required, but it adds credibility to your application to show how much the Lodge, itself, has done to relieve the distress of a Brother or his family member.

4. Negotiation. Many applications indicate obligations far in excess of the Foundationís ability to relieve. Many Lodges take a very active role in assisting a Brother to negotiate or compromise his obligations. In a recent case, a Brother had medical expenses in excess of $41,000.00. The Brother and his Lodge very skillfully negotiated this down to slightly more than $6,000.00 which he, his Lodge and our Foundation were able to pay in full.

5. Allocation. When the application is complete, the background information provided, all other sources tapped, and the obligation reduced as low as it can be, the Foundation can respond quickly taking into consideration the extent of funds available and the needs of other applicants.


Before making an application for relief please read carefully the brochure giving information about applications for and policies governing Maine Masonic Charity_____Lodge, No.____ A. F.&A.M.
located at________________________________________ requests relief for the following beneficiary:
1.    Name__________________________________________________ Age______

2.    Address ___________________________________________________________

3. Masonic affiliation or connection (name of member)____________________________

4. Address of member named as Masonic connection, if living________________________

5. Is the beneficiary employed? (Yes or No) if unemployed, is beneficiary able to work?______
Is the beneficiary handicapped?____  If handicapped, in what way and to what extent _________

If beneficiary is not employed and is not handicapped, give reason for unemployment ___________________________________________________________________

6. Former business or occupation ________________________________________________

7. What has been the means of support? ___________________________________________

8. Living relatives (including wife, children, mother, father)   

Name Relationship Age Residence
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________
_________________ _________________ _________________ _________________

 9. Is the beneficiary a member of York Rites____Scottish Rites______Eastern Star______

10. To what other organizations does, or did, the relative named in Question No. 3 above belong?___________________________________________________________

11. Is the beneficiary receiving aid from other organizations?____If so, give names of the organizations and amounts received________________________________________

12. Has beneficiary served in the Armed Forces?___________If so, in which war and the branch and length of service_________

13. Real estate owned by beneficiary and/or spouse:______________________

    a. Location of property_____________________________________________

    b. Market value______________________ c. Amount of annual taxes____________________

    d. Is there a mortgage on the property?_________ If SO, how much? $________

    e. What is the amount of monthly or other payments being made on the mortgage and by whom? $________

    f. Who holds the mortgage?______________________

14. Indicate by an (X) the type of housing in which beneficiary is now living: Owned____Rented____

Boarding ; Lodging; Nursing Home - (Name and address)____________________________

If the beneficiary is living with a relative, give the name, relationship and address______________

If living with a non-related family, give name and address__________________________

15. Personal property of beneficiary Check and cash $_______________ savings $_______
securities $___; other personal property including automobile, etc. ____________

16. Amount of life insurance $ _______ Beneficiary of policy(s)________________

17. Is beneficiary eligible for retirement insurance under the Federal Social Security law? (Yes or No) Has beneficiary applied? __________ If not, give reason_________________________
Result of application_________________________________

18. Income per month from all sources including assistance from member of the family but excluding Masonic relief:

        Source                                                                                                      Amount per Month
____________________________________________________________ $_____
____________________________________________________________ $_____ 
____________________________________________________________ $_____
____________________________________________________________ $_____
19. Approximate amounts per month now being expended for:

Rent $__________ Care $________ Fuel $_________ Clothing $________ Food $_______
Medicine$____ Utilities $___ Other$_____ Explain_________________________________

If in a nursing home, what is weekly or monthly rate? $______________________________

20. The following bills are unpaid (please list name of company(s) and individual (s) owed and the amount of each unpaid bill or attach the bills to this application.) Give specifics

21. How much relief is requested by the beneficiary for the period ending March 31? $_______

22. How much relief is requested by the Lodge? $________

Is this request being made by vote of the Lodge or the elected Charity Committee? _________

23. Other information which will be helpful in considering this application _________________

Financial Condition of Lodge

24. Last annual communication date____________No. of members on that date ____

25. Annual dues per member $_________________ Assessments $______________

26. Total amount of dues collected as given in last Annual Report? $______________

27. Amount of uncollected dues at last Annual Communication? $_______________________

28. Balance of General Funds at last Annual Communication? $________________________

29. Debt of the Lodge or Association at last Annual Communication? $_________________

30. Amount of Charity Fund at last Annual Communication? $_____________________

31. Is the principal available for relief or only the income? __________________________

32. Approximate annual income from the Charity Fund $____________

33. Source of other funds for relief purposes ____________________________________________________________________________

34. What is the total amount of relief from all sources, excluding Grand Lodge funds, spent in the year ending at the last Annual Communication of the Lodge? $___________________

35. How much will the lodge provide for the beneficiary of this application? $____________

36. List all other charity cases to which the Lodge is now contributing and the amount of each:




$ __________
_____________________________________________________ $ __________
_____________________________________________________ $ __________
_____________________________________________________ $ __________
_____________________________________________________ $ __________

37. If relief is granted, is it proposed to disburse it to the beneficiary in one lump sum or in occasional payments?___________________________

38.  If the Lodge requests assistance from the Charitable Foundation for more than one beneficiary, list
names of all of them in order of need: 1st __________________________________

2nd _________________________ 3rd _______________________________

This application is made on behalf of ____________________________Lodge. No.____ by the undersigned. The Secretary will act as Almoner in the distribution of any grant that may be made by the Trustees of the Charitable Foundation to assist the Lodge in the relief of the beneficiary for whom this application is made.

Signed________________________________ W.M.

Type or print name_______________________ W.M.


Phone Number____________________


Type or print name _________________________

Address _________________________

Phone Number _________________________

Date _________________________

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Last modified: March 22, 2014