Special Pioneer Report (S-212) (1975)

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SPECIAL PIONEER REPORT

Name City Province or State

(Please print plainly)

Report for month of ... 19 ...

Total Books

Total Booklets

Total Hours

New Subs.

Ind. Mags.

Return Visits

Home Bi. Stud.

No. bro

ded'n

since

appd.

sp.pio.

(NOTE. If you are eligible for an allowance, and desire to receive it, please fill in the requested information below. If you did not devote 150 hours to the field ministry for the month, under Remarks please explain the circumstances. If you do not desire the allowance, under Remarks please write "No allowance desired.")

Remarks concerning report: ... Mall check for

Credit my literature account ...

Credit my magazine account ...

Travel allowance

Monthly allowance ...

Total allowance ...

The special pioneer is not to write in this space

Per...

(Number and date of check)

Audited O.K.

<tr><th rowspan="2">Mail check to my address, which is:

Street Address or Box No.

City

Province or State

Zone or Code

Signed

S-212

1/75

(Please see over)

Printed in U.S.A.