2025 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 treasurer in December that will include the withholding amounts for the pension and health plans.

Contact the Benefits office at 605-990-7785 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 #1 *

Percent

Church #2

Percent

Church #3

Percent

Section I: Income

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 *

Cash Housing Allowance (when no parsonage is provided)

Section IV: Benefits and Reimbursement

A. Pension Direct Bill (Fund 3)

B. HealthFlex Direct Bill (Fund 4: $15,791 - Full Time)

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 JoAnn605-990-7785.

2025 Clergy Compensation Form

Benefits

2025 Clergy Compensation Worksheet

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