C R E D E N T I A L S Commandery No. I CERTIIY, That on this date the following are the three principal officers of Commandery No. Templar working under the jurisdiction of The Grand Commandery of of North Carolina, to wit: is the IMPORTANT is the Generalissimo (Put Seal of the is the Capt. General Commandery here)

Witness my hand and the seal of said Commandery, this day of , 20 . Recorder INSTRUCTIONS: 1: If any of three principal officers named in this Certificate attend the Grand Commandery this Certificate MUST be filled in by the Recorder, under seal of and delivered to one of those officers, to be presented to the Credentials Committee. 2: If neither of the three officers named in this Certificate can attend Grand Commandery, then, each may appoint his proxy, on the appropriate form below, but this Certificate MUST be presented along with all of the proxies, to the Credentials Committee: · 3: The three officers named in this Certificate may not appoint the same Sir as their proxy. 4: All proxies and representatives MUST be members in good standing of the Commandery they represent. Do Not Detach The Foregoing Certificate From The Proxies, Keep Them All Together PROXY OF THE COMMANDER I, , Commander of Comrnandery No. K. T., do hereby appoint Sir Knight a Knight Templar, and a member of said Commandery in good standing, as my proxy, at the Annual Conclave of The Grand Commandery, K. T. of North Carolina to be held in the City of , N. C., on the day of , 20 . Witness my hand and seal, this the day of , 20 . (SEAL) Commander PROXY FOR GENERALISSIMO I, , Generalissimo of Comrnandery No. K. T., do hereby appoint Sir Knight a Knight Templar, and a member of said Commandery in good standing, as my proxy, at the Annual Conclave of The Grand Commandery, K. T. of North Carolina to be held in the City of , N. C., on the day of , 20 . Witness my hand and seal, this the day of , 20 . (SEAL) Generalissimo PROXY FOR CAPTAIN GENERAL I, , Captain General of Comrnandery No. K. T., do hereby appoint Sir Knight a Knight Templar, and a member of said Commandery in good standing, as my proxy, at the Annual Conclave of The Grand Commandery, K. T. of North Carolina to be held in the City of , N. C., on the day of , 20 . Witness my hand and seal, this the day of , 20 . (SEAL) Captain General