Pastoral Dissolution Covenant
Presbytery of Ohio Valley

Following the dissolution of a relationship, it is appropriate and necessary for the congregation and the pastor to understand that the pastor is to cease all pastoral functions with the former church.  Pastoral functions include, but are not limited to:  home, hospital, and nursing home visitation, personal counseling (including grief issues), and all liturgical functions including preaching, weddings, baptisms and funerals.  Per G-2.0905, former pastors and associate pastors shall not provide their pastoral services to members of their former congregations without the invitation of the moderator of session.  When reviewing items to include in Dissolution Agreement, consider fairness to pastor and to the congregation, length of pastoral tenure, and expedience of needed dissolution.

Dissolution Covenant between _________________Presbyterian Church of _______________, Indiana and (pastor) ____________________________.  Note years of relationship: _______yrs.
 Dissolution initiated by Pastor		 Dissolution initiated by Congregation/Session

Dissolution Date (by which all liturgical functions cease): ______________________________

Last Date in Pulpit: _________________.  Last Date in Church Building: _______________
(If applicable) Last Date in Manse under previous agreement of utilities and/or other supports: _______________________ (Note specifics if any rent and/or utilities required from pastor if Manse is not vacated by this date): 
_____________________________________________________________________________
Salary (including Housing Allowance) to be paid through (date): _____________ and/or note if any Termination Bonus Pay for pastor: $____________.  Note final payment date for these payments: _____________. (All salaries paid and/or Termination Pay are part of Effective Salary and therefore shall be accompanied by Board of Pension dues for retirement, & medical, or other retirement payments.)
Note any additional benefits being given departing pastor (if not already included in extra salary or Termination Pay):  unused vacation earned, study leave, medical supplement, book allowance, travel allowance, and Continued Education Funds already earned through dissolution date: 
_____________________________________________________________________________
_____________________________________________________________________________
Note any debts owed by minister to church or cosigned to lender by church and how pastor will complete restitution.  If over $5,000, enlist attorney to complete written repayment agreement.
_____________________________________________________________________________
_____________________________________________________________________________
Note other items:  ______________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

I covenant that as former pastor:
•	I affirm and agree to this Dissolution Covenant.
•	I will make remuneration of all financial obligations I have within the community so that the church will not be responsible to bear any burden on my behalf.
•	Upon vacating office, I will leave it in a clean and orderly fashion with all church belongings intact, returning all keys and removing all of my possessions.
•	If I will be vacating a church manse, I will leave it in a clean and orderly fashion with all church belongings intact by the date agreed upon, returning all keys and removing all of my possessions.
•	I will cease all pastoral functions listed above as of the effective Dissolution Date.
•	I will not return to provide pastoral services or liturgical leadership without a written invitation from the moderator.
•	If receiving BOP benefits or other benefits, I agree that by the Dissolution Date I will authorize and notify the appropriate entity to terminate those contributions and provide original signed copy to Clerk.  If BOP, this will include “Service Change” Form ENR-110 or BOP “Service Termination for Traditional Program Members” Form ENR-301, or any other updated change forms.

_____________________________________		_______________
Pastor								Date

We covenant as the members and officers of the congregation: 
•	We affirm and agree to this Dissolution Covenant.  
•	Understand that the aforementioned pastor will no longer be our pastor as of the effective Dissolution Date of the pastoral relationship.  
•	We promise that we will not ask or expect the former pastor to engage in any pastoral function after this date without an invitation from the session moderator.
•	If pastor has been receiving BOP or other benefits, we agree that by the Dissolution Date we will authorize and notify the appropriate entity to terminate those contributions.  If BOP, this will include “Service Change” Form ENR-110 or BOP “Service Termination for Traditional Program Members” Form ENR-301, or any other updated change forms.  We will make a copy for departing pastor and be responsible mailing or faxing completed forms to The Board of Pensions.

_____________________________________		_______________
Clerk of Session --Affirming Session Approval		Date

_____________________________________		_______________
COM Liaison							Date

_____________________________________		_______________
COM Moderator						Date

Copies to be provided:
•	Original to Stated Clerk of the Presbytery
•	COM Liaison
•	Clerk of Session
•	Pastor