FOP Active PC Tax Form

FOP Active PC Tax Form

FRATERNAL ORDER OF POLICE
Membership Report and PerCapita Tax Payment

FOR THE YEAR OF LAST HALF OF 2026.
Lodge Name
Lodge Number
Total Number of Members on National Membership Roster
Total Loss of Membership
New Members
Transfers In
Reinstated
Total Gain of Membership
TOTAL NUMBER OF MEMBERS PER CAPITA TAX IS DUE ON
Last Half
National $5.75
State Lodge $12.50
Total State FOP
Total National FOP
IMPORTANT: MUST BE SIGNED BY STATE SECRETARY
Lodge Secretary Signature*
Should be Empty: