Form 17

The pastor of this congregation presented his resignation to Presbytery at its meeting at __________________[place of the meeting] _______________________ on the ______________ day of _______________ in the year ______________. The resignation was accepted, to take effect on the ________________ day of ___________________ in the year ______________, and the pastoral relationship was dissolved. May the Lord guide the congregation to the choice of another under-shepherd.

(This form shall also contain presbytery's authorization and counsel regarding pulpit supply, administration of sacraments and moderating a call.)

____________________________ ______________________________ Clerk of Presbytery/Ad Interim Moderator of Presbytery/Ad Interim

This form should be sent to the Clerk of Session.