Membership Dues Transmittal

Department of Arizona

📋 Short Form (1–6 members)

Complete all sections. Add each member, select their code, and upload any required supporting documents. The form automatically switches between the Short Form (1–6 members) and Long Form (7+ members) based on your entries — no need to choose.

🎖️ Detachment Information

Detachment Name & Number *

— Select your detachment — ▾

Department

Division

Transmittal Date *

Transmittal # (auto — override if needed)

💰 Detachment Paymaster

Paymaster Name *

Email *

Address

Phone

City

State

Zip

🏛️ Department Paymaster

Name

Phone

💵 Payment

Total Amount Due *

Payment Method *

📊 National Dues Breakdown

Quantities are calculated automatically from member entries below.

Code & Description	Cost/Unit	Qty	Total
TOTAL DUE TO DEPARTMENT			$0.00

👥 Members

Maximum 51 members per transmittal. Form auto-selects Short (1–6) or Long (7+) layout.

✍️ Detachment Signature

The Detachment Paymaster signature is required. Draw your signature or type your name to auto-generate a cursive signature.

Detachment Paymaster Signature *

✏️ Draw

⌨️ Type Name

Sign here

Submission held for Department Paymaster review before processing. You will receive a confirmation email.

📋 How It Works

1. Select your detachment and fill in your paymaster info.

2. Add each member, select their code, and upload supporting documents where prompted.

3. Select Zelle (enter confirmation code) or Check (print and mail with payment).

4. Click Submit — the transmittal is held for Department Paymaster review.

5. You receive a confirmation email. Once approved, the final PDF is emailed to you and the Department Paymaster.

📖 Transaction Codes

N — New Member (Jul–Feb) $25
NAM — New Associate $25
NDM — New Dual Member $25
N* — New Member (Mar–Jun) $15
NAM* — New Associate $15
NDM* — New Dual $15
R — Renewal $20
RAM — Renewal Associate $20
RDM — Renewal Dual $20
R/I — Reinstatement $20/yr in arrears
T — Transfer (attach form) $20
L — Life Member (age-based)
COAN — Change Address (new)
COAO — Change Address (old)
CON — Change of Name
CARDG — Gold Card Replacement $20
CARDP — Plastic Card Replacement $10