February 2017: v11
Form TC 433 AP Page 1 of 7
THE UNITED CHURCH OF CANADA
L’EGLISE UNIE DU CANADA
TORONTO CONFERENCE
Record of Appointment or Renewal Appointment (TC 433 AP)
PURPOSE:
This form is used to record terms and conditions when ministry personnel are
appointed to a Community of Faith.
Who uses it:
Community of Faith – completed by chair of Community of Faith interview team
When to use this form:
After negotiating terms of appointment with ministry personnel.
When NOT to use this form: Community of Faith negotiating with personnel for a congregational designated
ministry position.
Please Note:
• If this is an interim ministry appointment, page 7 of this form MUST be completed.
• If there is a manse, form PR 436 MI manse be completed and attached.
ROUTING:
□
□
□
□
□
Each party to print clearly and keep a copy for their own records prior to routing.
Community of Faith completes Parts A through D and sends an electronic copy to Conference (Settlement
administrative staff person) for review.
Conference reviews, as per Part E and reports back to the Community of Faith within three days. Repeat this
step until no further changes are requested by Conference.
The Community of Faith approves the request to appoint, completes Part F and forwards to the minister being
appointed.
Minister completes Parts G and sends an electronic copy to Conference (Settlement administrative staff
person) and to the Community of Faith
Conference (Settlement and Pastoral Relations Committee) completes Part H and forwards to Ministry and
Employment Unit. Copies are sent to Community of Faith and the person being appointed.
PART A:
PARTIES TO THE APPOINTMENT
Name of person being appointed: _________________________________________________________
Name of Community of Faith: ____________________________________________________________
Name of presbytery: ____________________________________________________________________
Name of Conference: ___________________________________________________________________
PART B:
TERMS OF THE APPOINTMENT
This appointment is categorized as:
Appointment to fill Vacancy
Interim (if so, complete parts J, K and L)
Supply
The person being appointed is currently a member of _____________________________ presbytery
whose good standing or conditions for and eligibility for appointment have been confirmed by that
presbytery. (as per The Manual.)
The person being appointed is agreed to be in increment category _________ based on _________years
of service, subject to confirmation by the Ministry and Employment Unit of the General Council office.
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.
February 2017: v11
Form TC 433 AP Page 2 of 7
Ministry Category of person being appointed: (select one with an `x`)
Ordained
Diaconal *
Designated lay minister *
Retired ordained
Retired diaconal *
Candidate supply *
Student supply *
Minister-in-training (Native Ministry) *
Designated lay minister applicant *
Ordained supply (non-United)
Diaconal supply (non-United) *
* Please check if Sacramental Privileges are being requested for this appointment
The terms of the appointment are found below:
1.
The appointment is
Fulltime (based on 40 hours per week) or
Part-time* based on ___ hours per week.
*Increment policy: Increments are calculated each calendar year and take effect January 1. Ministry
personnel must work a minimum of 750 hours per calendar year in order to achieve an increment. This
translates to a minimum of 15 hours per week.
2. The appointment will begin on the following date _______________________________;
(yyyy/mm/dd)
3. The appointment will terminate on the following date: ___________________________;
Refer to The Manual
(yyyy/mm/dd)
4. The appointment may be terminated by 90 days’ notice by the appointee or the Community of
Faith, subject to approval or abridgement by Toronto Conference;
5. The covenanted parties agree that this agreement incorporates the relevant terms found in the
Basis of Union and of The Manual, current version, as well as policies of the Community of
Faith, the presbytery/district, the Conference and the General Council.
6. Three weeks’ (21 days) study leave within each pastoral year (July 1 to June 30), including
Sundays.
7. Not less than three consecutive months of sabbatical leave after five consecutive years of
service to the Community of Faith that is party to this covenant;
8. Basic telephone / Communication amount as negotiated (excluding personal long-distance
phone) –or may consider alternative technologies that may be covered and/or required in
addition to the basic phone (e.g. cell, internet, pager etc.); Must not be less than basic phone
cost, and is not pro-rated.
9. Vacation of at least one month in each pastoral year (July 1 to June 30) including five Sundays.
10. Moving expenses (based on reasonable estimates and receipts).
11. The Community of Faith commits to the remuneration of the appointee through the ADP payroll
service (ADP company code ___________).
12. Adequate secretarial assistance defined as: ______________________________
13. Travel expense reimbursement (based on the current United Church Salary and Allowances
Schedule).
14. Additional terms as negotiated are appended in _____ (# of pages) to this form.
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.
February 2017: v11
Form TC 433 AP Page 3 of 7
Financial Remuneration for the Appointment: For new appointments with a start date of July 1, 2015
or later, use the new model (see #1 in the box below). For re-appointments between July 1, 2015 and
July 1, 2018 the Community of Faith has the option of using the old compensation model (see #2 in the
same box below) or the new model (see #1). Please refer to the current The United Church of Canada
Salary and Allowances Schedule for guidance prior to completing this form.
Round up all amounts to nearest dollar.
#
Terms
1
New
Appointments
or renewal
appointments
using COL
without manse
Use minimum salary for Community of Faith’s
Cost of Living (COL) Group Assignment ______
3
Salary negotiated in addition to annual
minimum.
Expressed in amount ($$) 
and as a percentage (%): _______ %
4
Manse and cost of heating over $500
Annual
(from Minimum
Salaries for
Ministry
Personnel)
Prorated or
Agreed-To
Amount
(based on ____
hrs/ week for 1 yr)
with manse
Minimum salary for increment category of
appointee.
2 Renewals
Minimum salary for increment category of
using Old
appointee.
Compensation Housing Allowance
Model
(Form PR 436 MI is attached. State fair rental value
of manse.) Where cost of heating a manse goes
above $500 per year, the Community of Faith must
pay the extra amount.
5
Basic telephone /communication amount – as
negotiated. (do not prorate this amount unless the person is
in an additional concurrent appointment)
6
7
Continuing education and learning amount
(at least the minimum as set out in the current
Minimum Salary and Allowances Schedule).
Other (please record any additional financial
remuneration and append the additional
agreements.)
TOTAL FINANCIAL REMUNERATION
(add all values between 1 and 7)
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.
February 2017: v11
Form TC 433 AP Page 4 of 7
PART C:
CURRENT POLICE RECORD CHECK
A current* satisfactory police records check was completed on ________________________(yyyy/mm/dd)
and has been received by the presbytery. * See the UCC Police Records Check Policy:
http://www.united-church.ca/sites/default/files/handbook_police-records-checks.pdf
_____________
____________________________________
___________________
yyyy/mm/dd
Signature: Interview team chair/secretary
_____________
____________________________________
yyyy/mm/dd
OR:
Signature: Interview team member
Printed name:
___________________
Printed name:
This is a renewal appointment. Police Checks will be confirmed by presbytery staff
PART D:
REFERENCE CHECK CONFIRMATION
The following two individuals were contacted and provided a positive reference:
________________________________
____________________
___________________
Reference name
Date contacted (yyyy/mm/dd)
Interview team member
________________________________
____________________
___________________
Reference name
Date contacted (yyyy/mm/dd)
Interview team member
OR:
This is a renewal appointment. Reference checks are not required for renewal appointments.
PART E:
REVIEW AND APPROVAL BY TORONTO CONFERENCE REVIEWER
Conference Reviewers have reviewed the proposed terms of appointment and found them compliant
with The Manual and related policies of The United Church of Canada, Toronto Conference and
_________________________ Presbytery, and the relevant provincial/territorial and federal legislation.
____________/_________/_________
yyyy/mm/dd
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.
February 2017: v11
Form TC 433 AP Page 5 of 7
PART F:
ACTION BY THE COMMUNITY OF FAITH
I confirm that _______________________________________ (Community of Faith) requests that
___________________________________(name of appointee) be appointed with the terms of
appointment recorded here, at a meeting held on ________________________ (yyyy/mm/dd)
at __________________________________________________________ (location).
_____________
yyyy/mm/dd
____________________________________
Signature: secretary or chair of governing body
___________________
Printed name:
If desired, a list of members’ signatures may also be appended.
PART G (a):
CONTACT INFORMATION FOR PERSON BEING APPOINTED
Name: ______________________________________________________________________________
Home Address: _______________________________________________________________________
Phone: (Day) ____________________ (Evening) ______________________ (Cell) __________________
Email: _____________________________________@________________________________________
PART G (b):
ACCEPTANCE BY THE PERSON BEING APPOINTED:
I agree to promote the work of God and the good of the church, and in particular to:
1. Participate fully in the collegial and supportive life of _________________________ Presbytery;
2. Be subject to the oversight and discipline of Toronto Conference, and to comply with the
policies of The United Church of Canada as outlined in The Manual, current version;
3. Accept the terms of this appointment recorded here;
4. Give reasonable care to the manse and furnishings, where applicable;
5. Fulfill my responsibility for obtaining insurance coverage for personal contents owned by me
where there is a manse;
6. Arrange my study leave and sabbatical (if applicable) in consultation with the Ministry and
Personnel Committee;
7. Determine the dates of my vacation in consultation with the Ministry and Personnel Committee;
I understand that this appointment requires approval by Toronto Conference.
_____________
yyyy/mm/dd
____________________________________
Signature: person being appointed
___________________
Printed name:
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.
February 2017: v11
Form TC 433 AP Page 6 of 7
PART H:
ACTION BY TORONTO CONFERENCE
I confirm that the Settlement and Pastoral Relations Committee of Toronto Conference approved the
terms of this appointment on ______________________ (yyyy/mm/dd).
__________
yyyy/mm/dd
PART I:
____________________________________
Signature: secretary or chair of Toronto Conference
Settlement & Pastoral Relations Committee
___________________
Printed name:
RECEIPT BY MINISTRY AND EMPLOYMENT UNIT
The signature below confirms receipt of this appointment and the terms recorded herein.
__________
yyyy/mm/dd
____________________________________
Signature: appropriate Ministry and Employment staff
___________________
Printed name:
This form and appended documents sets out the obligations of the covenantal parties under The Manual, current version, and
under the laws of the applicable province or territory.
(For Interim ministry appointments, please continue on to Parts K and L on following pages.)
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.
February 2017: v11
Form TC 433 AP Page 7 of 7
PART J:
CONFIRMATION OF STANDING AS INTERIM MINISTER
____________________________________________ (Name of person to be appointed) has been approved
as an interim minister by _____________________________Conference in _________________ (year).
The Toronto Conference Interview Committee has received and reviewed the most recent report on the
effectiveness of the interim minister and has recommended him/her for subsequent appointment as
interim minister effective _________________________________ (yyyy/mm/dd).
__________
yyyy/mm/dd
PART K:
____________________________________
Signature: Conference Interview Committee Chair/Designate
___________________
Printed Name:
COMMUNITY OF FAITH CONTRIBUTION TO
INTERIM MINISTRY SABBATICAL LEAVE FUND
The Community of Faith that is party to this appointment hereby agrees to provide a cheque payable to
the “Interim Ministry Sabbatical leave Fund” of The United Church of Canada in an amount equivalent
to two weeks’ salary and benefits, including housing allowance or fair rental value of the manse as
applicable, plus the employer’s costs. This is to be calculated for each year of interim service, or
prorated for service of less than a year (established by the Executive of the General Council, motion
2008-11-15-329). The payment will be remitted to the Financial Assistance Committee of the Ministry
and Employment Unit of the General Council Office no later than January 31 of each year following the
year in which the interim ministry appointment began.
__________
____________________________________
___________________
__________
____________________________________
___________________
PART L:
ADDITIONAL TERMS OF INTERIM MINISTRY APPOINTMENT
yyyy/mm/dd
yyyy/mm/dd
Signature: Chair/Secretary of governing body Community of Faith
Signature: Treasurer of Community of Faith
Printed Name:
Printed Name:
1. The Community of Faith agrees to appoint five to seven members to an Interim Ministry
Transition Committee.
2. Presbytery agrees to appoint two members to the Interim Ministry Transition Committee.
3. The interim minister agrees that s/he will NOT apply for settlement or call to a succeeding
pastoral relationship based on a change in ministry personnel status or declaration by the
presbytery/district of a vacancy in the Community of Faith (as per The Manual).
4. The goals for the interim ministry will be completed by the Interim Ministry Transition
Committee in consultation with the interim minister and presented to a meeting of the
Community of Faith for approval; preliminary goals are attached to this document.
This form sets out the obligation of the covenantal parties under The Manual, current version, and under the applicable
provincial/territorial and federal laws. The parties of this Interim Ministry appointment agree to abide by the policies and
guidelines of The United Church of Canada.
The use, retention and disclosure of personal information collected from this form is done in compliance with privacy legislation including, but
not limited to, the Personal Information Protection and Electronic Documents Act (1000,c.5). THIS FORM IS NOT VALID IF ALTERED.