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									              Please type or Print                                                     FORM D7-102                                                         OFFICE USE ONLY
              Page        of                                                                                                                                      Voucher
                                                                                 SEVENTH DISTRICT                                                          Information/Comments
                                                                     OMEGA PSI PHI FRATERNITY, INC.
                                                                     REPORT OF DISTRICT DUES/FUNDS

  Chapter Name                                                                                        Chapter Number

  Chapter                                                                                             Chapter Type
  Mail Address                                                                                        (G, U, I)
                        Member Detail Information                                                                    Summary of Funds Submitted
                                                                Dist Life          Dues                         District Life    Late                               Nat’l Dues                  Reclaimed by
                                              Control #
     Names/or Description of Item                              Member /          $7.40 (U)        Initiation    Membership       Fee      Other                       Paid?                        Brother
                                             (0000 for msp)
                                                              Prepaid MSP       $15.25 (G)                     500 / 250(1/2)   $3.00                                 Y/N                        (control #)
         Sample Member #1                    00123467                               $15.25                       $250.00       $3.00                                      Yes                    765432100




         Total by Items:
 OPPF Process Date                Initials                    D.R.          D.K.R.S.              D.K.F.         Chapter               State Rep                           Total YTD
                             Office Use Only

Name                                            Date
                                                                                                                                  Remittance by money order, certified or cashiers
Address                                          Day Phone
                                                                                                                                            check or bank draft number
City                          State              Zip                     Position
                                                                                                                                  ...........................................................................
Email                                                                                                                                                Send Three (3) copies to
IHQ Email address           @oppf.org                                                                                              (1)District Representatives for candidates being
                                                                                                                                   initiated into the fraternity and life membership
Notification as to the disposition of this submission will be sent to the IHQ Assigned Email Address                                                                  or
provided. Your Chapter Officer IHQ Email credentials may be obtained from your state or District KRS.                                            (2)District KRS for all others
            If a member has been reclaimed, please enter the control number of the brother who reclaimed                    *An updated Form 53 must accompany this form*
             him in the last column so that he may be given appropriate credit for his reclamation effort.
                                                                                                                                                                      Revised 12/8/2008

								
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