2022 Clergy Compensation Worksheet

This form is for submitting the approved clergy compensation package for a pastor to the Benefits office. A final clergy compensation form will be sent to pastors and the church in December that will include the withholding amounts for the pension and health plans.

Contact the Finance and Benefits offices at 605-990-7004 or 605-990-7005 if you need help.

Pastor Last Name

Pastor First Name

Church Parish *

Status *

Appointment time *

Full Time

3/4 Time

1/2 Time

1/4 Time

Effective Date

Breakdown of how Parish Expenses are shared among churches

Church Name #1

Percent *

Church Name #2

Percent

Church Name #3

Percent

Church Name #4

Percent

Section I: Income

A. Base Salary

B. Other (e.g. Social Security or health insurance allowance)

Description of Other Compensation

C: Total Compensation (Add lines A and B)

D. Designated Housing Exclusion - REQUIRED INPUT EVEN IF IT IS ZERO "0" *

Section III: Housing

A. Is Parsonage provided *

Yes

Cash Housing Allowance (when no parsonage is provided)

Section IV: Benefits and Reimbursement

Items in this secton are NOT considered as Income for the Pastor. These are expenses paid by the parish in the course of providing ministry on behalf of the parish.

A. Pension Direct Bill (Fund 3)

B. HealthFlex Direct Bill (Fund 4: $14,123)

C. Accountable Reimbursement Plan:

C1. Travel

C2. Continuing Education

C3. Other Reimbursed Expenses

D. Other Expenses Paid by Parish

Description - Other Expenses Paid by Parish

E: Total Benefits & Reimbursements (Add lines A-D) *

Name of Submitter*

Email Address or Phone Number*

When ready to submit if all required information has been input you will see the submit button in red. Click the button only once. You will see it gray out and it may take a few minutes to finalize. You should see a thank you note if it was successful. If not please call Leana 605-990-7785

2022 Clergy Compensation Worksheet

2022 Clergy Compensation Worksheet

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