RTC ELECTRONIC REPORT FORM Please enter your information in the boxes below: * Indicates required field



* First Name: * Last Name: * Street Address: * City: State (US only): AK AL AR AS AZ CA CO CT DC DE FL FM GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY State/Province:

(Non-US only) * Zip/Postal code: * Country: Select one United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territories Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China, People's Republic of Christmas Island Cocos Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories FYROM Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard Island And Mcdonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kuwait Kyrgyzstan Lao Peoples Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe E-mail: * I am a

Non-Scientologist

Public Scientologist

Staff Member



Post: * I am a parishioner of: * I am staff of: Church of Scientology

Mission of Scientology

Other * Church: Select one (ACD) Asociacion Cultural Dianetica A.C. (ACT) Church of Scientology of Australian Capital Territory (ADED) Church of Scientology of Adelaide - Day (ADEF) Church of Scientology of Adelaide - Foundation (AKD) Church of Scientology of Auckland - Day (AKF) Church of Scientology of Auckland - Foundation (ALB) Church of Scientology of New Mexico (AMSD) Scientology Kerk Amsterdam - Day (AMSF) Scientology Kerk Amsterdam - Foundation (ANG) Église de Scientologie d'Angers (AOLA) Church of Scientology Advanced Organization of Los Angeles (AOSHAF) Advanced Organization & Saint Hill Africa (AOSHANZO) Scientology Advanced Organization & Saint Hill for Oceania (AOSHEU) Advanced Organization & Saint Hill Europe (AOSHUK) Advanced Organization & Saint Hill United Kingdom (ARH) Scientologi Kirken Jylland (ASHO) Church of Scientology American Saint Hill Organization (ASTD) Church of Scientology of Texas - Day (ASTF) Church of Scientology of Texas - Foundation (ATHENS) Eκκλησία της Σαηεντολογίας της Αθήνας (ATLD) Church of Scientology of Atlanta - Day (ATLF) Church of Scientology of Atlanta - Foundation (BAR) Esglesia de Scientology de Catalunya (BASD) Scientology Kirche Basel - Day (BASF) Scientology Kirche Basel - Foundation (BC) Church of Scientology of Battle Creek (BER) Scientology Kirche Bern (BHMD) Church of Scientology of Birmingham - Day (BHMF) Church of Scientology of Birmingham - Foundation (BRI) Church of Scientology of Brisbane (BRLN) Scientology Kirche Berlin (BRT) Church of Scientology of Brighton (BSA) Chiesa di Scientology dei Tre Laghi (BSND) Church of Scientology of Boston - Day (BSNF) Church of Scientology of Boston - Foundation (BTAD) Iglesia de Scientology Bogotá - Day (BTAF) Iglesia de Scientology Bogotá - Foundation (BUDAD) Szcientológia Egyház Központi Szervezet - Day (BUDAF) Szcientológia Egyház Központi Szervezet - Foundation (BUE) Iglesia de Scientology de Argentina (BUFF) Church of Scientology of Buffalo (BYO) Church of Scientology Bulawayo (CAMD) Church of Scientology of Cambridge - Day (CAMF) Church of Scientology of Cambridge - Foundation (CARACAS) Organizacion Dianetica A.C. Caracas (CCDUS) Celebrity Centre in Düsseldorf (CCFRZ) Celebrity Centre della Città di Firenze Chiesa di Scientology (CCINT) Scientology Celebrity Centre International (CCMUN) Celebrity Centre Scientology Kirche in München (CCNASH) Church of Scientology & Celebrity Centre Nashville (CCNY) Church of Scientology Celebrity Centre New York (CCP) Église de Scientologie Célébrity Centre Paris (CCVNA) Scientology Kirche Celebrity Centre Wien (CHI) Church of Scientology of Chicago (CINND) Church of Scientology of Greater Cincinnati - Day (CINNF) Church of Scientology of Greater Cincinnati - Foundation (CLE) Association Spirituelle de l'Église de Scientologie d'Auvergne (COL) Church of Scientology of Central Ohio (CSE) Scientology kerken voor Europa (CTA) Chiesa di Scientology di Catania (CTD) Church of Scientology Cape Town - Day (CTF) Church of Scientology Cape Town - Foundation (DALLASD) Church of Scientology Dallas - Day (DALLASF) Church of Scientology Dallas - Foundation (DCD) Founding Church of Scientology - Day (DCF) Founding Church of Scientology - Foundation (DETD) Church of Scientology of Michigan - Day (DETF) Church of Scientology of Michigan - Foundation (DKD) Scientology Kirken Danmark - Day (DKF) Scientology Kirken Danmark - Foundation (DUBLIND) Church of Scientology & Community Centre of Dublin - Day (DUBLINF) Church of Scientology & Community Centre of Dublin - Foundation (DURD) Church of Scientology of Durban - Day (DURF) Church of Scientology of Durban - Foundation (DUS) Scientology Kirche Düsseldorf (DVRD) Church of Scientology of Colorado - Day (DVRF) Church of Scientology of Colorado - Foundation (EDM) Church of Scientology of Alberta (FFT) Scientology Kirche Frankfurt (FH) The Fort Harrison Hotel (FSO) Church of Scientology Flag Service Organization (FSSO) Freewinds - Flag Ship Service Organization (GATOS) Church of Scientology of Los Gatos (GOT) Scientology Kyrkan i Göteborg (GUAD) Organizacion Cultural Dianetica Guadalajara (GVA) l'Église de Scientologie Genève (HAN) Scientology Kirche Hamburg e.V. Gemeinde Hannover (HAPI) Hubbard Academy of Personal Independence Scientology Edinburgh (HAR) Church of Scientology Harare (HARLEMD) Church of Scientology of Harlem - Day (HARLEMF) Church of Scientology of Harlem - Foundation (HAWD) Church of Scientology of Hawaii - Day (HAWF) Church of Scientology of Hawaii - Foundation (HBG) Scientology Kirche Hamburg e.V. (IFAD) Centro Cultural Latinoamericano A.C. (IFAR) Iglesia de Scientology de León (INGLED) Church of Scientology of Inglewood - Day (INGLEF) Church of Scientology of Inglewood - Foundation (JBGD) Church of Scientology of Johannesburg - Day (JBGF) Church of Scientology of Johannesburg - Foundation (JBGND) Church of Scientology of Johannesburg North - Day (JBGNF) Church of Scientology of Johannesburg North - Foundation (KC) Church of Scientology of Kansas City (KSD) 高雄山達基教會 - Day (KSF) 高雄山達基教會 - Foundation (LAO) Church of Scientology of Los Angeles (LAU) Église de Scientologie de Lausanne (LDND) Church of Scientology of London - Day (LDNF) Church of Scientology of London - Foundation (LIS) Igreja Portuguesa de Cientologia (LONG) Church of Scientology of Long Island (LVD) Church of Scientology & Celebrity Centre Las Vegas - Day (LVF) Church of Scientology & Celebrity Centre Las Vegas - Foundation (LYO) Église de Scientologie Lyon (MADD) Iglesia de Scientology de España - Day (MADF) Iglesia de Scientology de España - Foundation (MAL) Scientology Kyrkan i Malmö (MAN) Church of Scientology of Manchester (MELD) Church of Scientology of Melbourne - Day (MELF) Church of Scientology of Melbourne - Foundation (MEXCHD) Scientology México Centro Histórico - Day (MEXCHF) Scientology México Centro Histórico - Foundation (MILANOD) Chiesa di Scientology di Milano - Day (MILANOF) Chiesa di Scientology di Milano - Foundation (MMD) Church of Scientology of Florida - Day (MMF) Church of Scientology of Florida - Foundation (MOSCD) Религиозная группа «Московская саентологическая церковь» - Day (MOSCF) Религиозная группа «Московская саентологическая церковь» - Foundation (MTL) Église de Scientologie de Montréal (MUN) Scientology Kirche in München (MVD) Church of Scientology of Silicon Valley - Day (MVF) Church of Scientology of Silicon Valley - Foundation (MZA) Chiesa di Scientology della Brianza (NH) Church of Scientology of New Haven (NICE) Église de Scientologie Nice (NOV) Chiesa di Scientology di Novara (NYD) Church of Scientology of New York - Day (NYF) Church of Scientology of New York - Foundation (OCD) Church of Scientology of Orange County - Day (OCF) Church of Scientology of Orange County - Foundation (ODD) Organizacion de Desarollo y Dianetica (ORLD) Church of Scientology of Orlando - Day (ORLF) Church of Scientology of Orlando - Foundation (OSLO) Scientology Kirken Oslo (OTT) Church of Scientology of Ottawa (PADD) Chiesa di Scientology di Padova - Day (PADF) Chiesa di Scientology di Padova - Foundation (PAR) Association Spirituelle de l'Église de Scientologie d'Ile de France (PASAD) Church of Scientology of Pasadena - Day (PASAF) Church of Scientology of Pasadena - Foundation (PED) Church of Scientology of Perth - Day (PEF) Church of Scientology of Perth - Foundation (PEL) Church of Scientology Port Elizabeth (PHIL) Church of Scientology of Pennsylvania (PHX) Church of Scientology of Phoenix (PLY) Church of Scientology of Plymouth (POL) Organizacion Cultural Dianetica de Polanco (PORD) Chiesa di Scientology della città di Pordenone (PTAD) Church of Scientology of Pretoria - Day (PTAF) Church of Scientology of Pretoria - Foundation (PTLD) Church of Scientology of Portland - Day (PTLF) Church of Scientology of Portland - Foundation (PTR) Church of Scientology of Puerto Rico (QBCD) Église de Scientologie de Québec - Day (QBCF) Église de Scientologie de Québec - Foundation (ROMAD) Chiesa di Scientology di Roma - Day (ROMAF) Chiesa di Scientology di Roma - Foundation (SACD) Church of Scientology of Sacramento - Day (SACF) Church of Scientology of Sacramento - Foundation (SARD) Chiesa di Scientology della Sardegna (SDD) Church of Scientology of San Diego - Day (SDF) Church of Scientology of San Diego - Foundation (SEAD) Church of Scientology of Washington State - Day (SEAF) Church of Scientology of Washington State - Foundation (SFOD) Church of Scientology of San Francisco - Day (SFOF) Church of Scientology of San Francisco - Foundation (SLCD) Church of Scientology of Salt Lake City - Day (SLCF) Church of Scientology of Salt Lake City - Foundation (SNC) Church of Scientology Stevens Creek of San Jose (STB) Church of Scientology of Ventura (STL) Church of Scientology of Missouri (STM) Scientology Kyrkan i Stockholm (STPETE) Религиозная группа «Саентологическая Церковь города Санкт-Петербурга» (STTD) Scientology Gemeinde Baden-Württemberg - Day (STTF) Scientology Gemeinde Baden-Württemberg - Foundation (SUND) Church of Scientology of Sunderland (SYDD) Church of Scientology of Sydney - Day (SYDF) Church of Scientology of Sydney - Foundation (TAVD) המרכז לסיינטולוגיה ישראל - Day (TAVF) המרכז לסיינטולוגיה ישראל - Foundation (TCD) Church of Scientology of Twin Cities - Day (TCF) Church of Scientology of Twin Cities - Foundation (TOKYOD) サイエントロジー東京 - Day (TOKYOF) サイエントロジー東京 - Foundation (TORD) Church of Scientology of Toronto - Day (TORF) Church of Scientology of Toronto - Foundation (TPAD) Church of Scientology of Tampa - Day (TPAF) Church of Scientology of Tampa - Foundation (TRN) Chiesa di Scientology di Torino (VAND) Church of Scientology of British Columbia - Day (VANF) Church of Scientology of British Columbia - Foundation (VLYD) Church of Scientology of the Valley - Day (VLYF) Church of Scientology of the Valley - Foundation (VNA) Scientology Kirche Österreich (VRN) Chiesa di Scientology di Verona (VZA) La Iglesia de Scientology Valencia, Venezuela (WPG) Church of Scientology of Winnipeg (ZRH) Scientology Kirche Zürich * Mission: Select one (MOSHI) Church of Scientology Mission of Moshi (MSNAGUASCALIENTES) Centro De Dianética Hubbard De Aguascalientes, A.C. (MSNAKASAKA) Church of Scientology Mission of Akasaka (MSNALBANY) Church of Scientology Mission of Albany (MSNALBINO) Missione Della Chiesa Di Scientology Di Orobie (MSNALMATY) Центр Дианетики (MSNANAHEIM) Church of Scientology Mission of Anaheim (MSNANCHORAGE) Church of Scientology Mission of Anchorage (MSNANDRE) Igreja de Scientology do Brasil Miisao Santo André (MSNAOSTA) Missione Della Chiesa Di Scientology Di Aosta (MSNAVELLINO) Missione Della Chiesa Di Scientology Di Avellino (MSNAVIGNON) Église de Scientologie Mission d'Avignon (MSNAVRORA) Центр Дианетики (MSNBANGKOK) Church of Scientology Mission of Bangkok (MSNBANSKABYSTRICA) Centrum Dianetiky a Scientológie Banska Bystrica (MSNBARLETTA) Missione Della Chiesa Di Scientology Di Barletta (MSNBARNAUL) Центр Дианетики (MSNBARQUISIMETO) Church of Scientology Mission of Barquisimeto (MSNBATONROUGE) Church of Scientology Mission of Baton Rouge (MSNBELLEAIR) Church of Scientology Mission of Belleair (MSNBELLINZONA) Centro di Dianetics Hubbard Missione di Scientology di Bellinzona (MSNBERGAMO) Missione della Chiesa di Scientology della Bergamasca (MSNBILBAO) Church of Scientology Mission of Bilbao (MSNBISHKEK) Центр Дианетики (MSNBITZA) Центр эффективности личности (MSNBIYSK) Центр Дианетики (MSNBLAGOVETSCHENSK) Центр Дианетики (MSNBOISE) Church of Scientology Mission of Boise (MSNBORDEAUX) Eglise de Scientologie Mission de Bordeaux (MSNBOULDER) Church of Scientology Mission of Boulder County (MSNBOURNEMOUTH) Church of Scientology Mission of Dorset, Ltd. (MSNBRANDBLVD) Church of Scientology Mission of Brand Blvd (MSNBRATISLAVA) Dianetické centrum Bratislava (MSNBREMEN) Scientology Mission Bremen e. V. (MSNBRNO) Dianetické centrum Brno (MSNBRUNSWICK) Church of Scientology Mission of Brunswick (MSNBUDA) Szcientológia Egyház Buda Misszió (MSNCALC) Religious Foundation of Scientology of Kolkata (MSNCALI) Centro De Dianetica Y Scientology de Cali (MSNCAPITAL) 山達基教會首都中心 (MSNCAPITOL) Church of Scientology Mission of Capitol (MSNCASTROVALLEY) Church of Scientology Mission of Castro Valley (MSNCERCEDILLA) Misión de Scientology de Madrid (MSNCESKE) Dianetické centrum České Budějovice (MSNCHAMPAIGN) Church of Scientology Mission of Champaign-Urbana (MSNCHARTWELL) Church of Scientology Mission of Edenvale (MSNCHELIABINSK) Центр Дианетики (MSNCHELNY) Центр Дианетики (MSNCHIAYI) 山達基教會嘉義中心 (MSNCHICO) Church of Scientology Mission of Chico (MSNCHILE) Iglesia de Scientology Misión de Chile (MSNCHISINAU) Центр эффективности личности Кишинёва (MSNCLEVELAND) Church of Scientology Mission of Cleveland (MSNCOMO) Church of Scientology Mission of Como (MSNCOPENHAGENCITY) Church of Scientology Mission of Copenhagen City (MSNCOSENZA) Church of Scientology Mission of Cosenza (MSNCOSTARICA) Asociación Iglesia de Cienciología, Misión de Costa Rica (MSNDA-AN) 山達基教會大安中心 (MSNDEEPE) Church of Scientology Mission of Deep Ellum (MSNDIMITROVGRAD) Центр Дианетики (MSNDNEPR) Религиозная община церкви Саентологии «Днепр» (MSNDONG-CHI) Church of Scientology Mission of Dong-Chi (MSNDUNAUJVAROS) Szcientológia Egyház Dunaújváros Misszió (MSNEGER) Szcientológia Egyház Eger Misszió (MSNEKATERINBURG) Центр Дианетики (MSNELPASO) Church of Scientology Mission of El Paso (MSNFENG-YUAN) 戴尼提豐原中心 (MSNFOOTHILLS) Church of Scientology Mission of The Foothills (MSNFOVAROSI) Szcientológia Egyház Fővárosi Misszió (MSNFRESNO) Church of Scientology Mission of Fresno (MSNFU-SHING) 戴尼提復興中心 (MSNGIUSSANO) Missione della Chiesa di Scientology di Giussano (MSNGOEPPINGEN) Church of Scientology Mission of Goeppingen (MSNGUATEMALA) Church of Scientology Mission of Guatemala (MSNGUAYAQUIL) Church of Scientology Mission of Guayaquil (MSNGYORI) Szcientológia Egyház Győr Misszió (MSNHALIFAX) Church of Scientology Mission of Halifax (MSNHARKOV) Гуманитарный центр Хаббарда (MSNHARLINGEN) Church of Scientology Mission of Harlingen (MSNHELSINKI) Church of Scientology Mission of Helsinki (MSNHONGO) Church of Scientology Mission of Hongo (MSNHOUSTON) Church of Scientology Mission of Houston (MSNHSIAN) 戴尼提西岸中心 (MSNHUA-LIAN) 戴尼提花蓮中心 (MSNIZHEVSK) Центр Дианетики (MSNKALININGRAD) Центр Дианетики (MSNKALOCSA) Szcientológia Egyház Kalocsa Misszió (MSNKARLSRUHE) Church of Scientology Mission of Karlsruhe (MSNKARPATY) Centrum Dianetiky a Scientologie Karpaty (MSNKAZAN) Центр Дианетики (MSNKHABA) Центр Дианетики (MSNKIEV) Миссия Церкви Саентологии Киева (MSNKOMSOMOLSKONAMUR) Центр Дианетики (MSNKOSICE) Church of Scientology Mission of Kosice (MSNKRASNODAR) Центр Дианетики (MSNKREMENCHUG) Миссия Церкви Саентологии Кременчуга (MSNKUBAN) Центр Дианетики (MSNKYIVCENTER) мiссiя Киïв-центр (MSNLAHTI) Church of Scientology Mission of Lahti (MSNLEICHHARDT) Church of Scientology Mission of Leichhardt (MSNLEVICE) Church of Scientology Mission of Levice (MSNLIPTOVSKYMIKULAS) Dianetické centrum Liptovsky Mikulas (MSNLOSFELIZ) Church of Scientology Mission of Los Feliz (MSNLUGANO) Church of Scientology Mission of Lugano (MSNLUZERN) Church of Scientology Mission of Luzern (MSNMACERATA) Church of Scientology Mission of Macerata (MSNMALVERN) Church of Scientology Mission of Malvern (MSNMANILA) Church of Scientology Mission of the Philippines (MSNMARACAIBO) Asociacion Civil Cultural Dianetica y Scientology De Maracaibo (MSNMARGARITA) Centro De Dianetica y Scientology Margarita (MSNMARSEILLE) Church of Scientology Mission of Marseille (MSNMECHELEN) Scientology Kerk van België (MSNMEDELLIN) Church of Scientology Mission of Medellin (MSNMERATE) Missione Della Chiesa Di Scientology Di Merate (MSNMILWAUKEE) Church of Scientology Mission of Milwaukee (MSNMINSK) Центр Дианетики (MSNMISKOLC) Szcientológia Egyház Miskolc Misszió (MSNMODENA) Missione della Chiesa di Scientology di Modena (MSNMOORPARK) Church of Scientology Mission of Moorpark (MSNMUKACHEVO) Миссия Церкви Саентологии Мукачево (MSNMURMANSK) Центр эффективности личности (MSNNAPOLI) Church of Scientology Mission Napoli (MSNNEWDELHI) Religious foundation of Scientology of New Delhi (MSNNEWJERSEY) Church of Scientology Mission of New Jersey (MSNNEWORLEANS) Church of Scientology Mission of New Orleans (MSNNITRA) Dianetické centrum Nitra (MSNNIZHNEKAMSK) Центр Дианетики (MSNNIZHNY-NOVGOROD) Центр Дианетики (MSNNORWOOD) Church of Scientology Mission of Norwood (MSNNOVGORODII) Центр Дианетики (MSNNOVOKUZNETSK) Центр Дианетики (MSNNOVOSIBIRSK) Центр Дианетики (MSNNYIREGYHAZA) Szcientológia Egyház Nyíregyháza Misszió (MSNOCALA) Church of Scientology Mission of Ocala (MSNODESSA) Миссия Церкви Саентологии Одессы (MSNOLBIA) Church of Scientology Mission of Olbia (MSNOMSK) Центр Дианетики (MSNORENBURG) Центр Дианетики (MSNPANAMA) Iglesia de Scientology Panamá (MSNPARMA) Church of Scientology Mission of Parma (MSNPAVESE) Missione Della Chiesa Di Scientology Di Pavese (MSNPAVLODAR) Центр Дианетики (MSNPECS) Szcientológia Egyház Pécs Misszió (MSNPENZA) Центр Дианетики (MSNPERM) Центр Дианетики (MSNPILSEN) Dianetické centrum Plzeň (MSNPRAGUE) Dianetické centrum Praha (MSNPRESOV) Church of Scientology Mission of Presov (MSNQUETZALTENANGO) Instituto De Cienciologia Aplicada De Occidente (MSNQUITO) Church of Scientology Mission of Quito (MSNRAVE) Missione Della Chiesa Di Scientology Di Ravenna (MSNRDALE) Church of Scientology Mission of Riverdale (MSNREDWOODCITY) Church of Scientology Mission of Redwood City (MSNREGGIOEMILIA) Missione della Chiesa di Scientology di Reggio Emilia (MSNRENENS) Church of Scientology Mission of Renens (MSNRENO) Church of Scientology Mission of Sierra Nevada (MSNRIGA) Riga Mission (MSNRIMINI) Chiesa di Scientology Missione di Rimini e San Marino (MSNRIVERPARK) Church of Scientology Mission of Riverpark (MSNRONCADELLE) Missione Della Chiesa Di Scientology Roncadelle (MSNSALTLAKECITY) Church of Scientology Mission of Salt Lake City (MSNSALZBURG) Church of Scientology Mission of Salzburg (MSNSAMARA) Центр Дианетики (MSNSANANTONIO) Church of Scientology Mission of San Antonio (MSNSANFRANCISCO) Church of Scientology Mission of San Francisco (MSNSANJOSE) Church of Scientology Mission of San Jose (MSNSANTACLARA) Church of Scientology Mission of Santa Clara, Guatemala (MSNSANTACRUZ) Church of Scientology Mission of Santa Cruz (MSNSANTAFE) Church of Scientology Mission of Santa Fe (MSNSANTANGELO) Centro di Dianetics della Missione di Sant’Angelo Lodigiano (MSNSANTODOMINGO) Church of Scientology Mission of Santo Domingo (MSNSAOPAULO) Church of Scientology Mission of São Paulo (MSNSAOPAULOSOUTH) Associação Brasileira de Dianetics São Paulo (MSNSARATOV) Центр Дианетики (MSNSCST) Church of Scientology Mission of South Coast (MSNSEATTLE) Church of Scientology Mission of Seattle (MSNSENIGALLIA) Missione della Chiesa di Scientology di Senigallia (MSNSETAGAYA) Church of Scientology Mission of Setagaya (Aichi-ken) (MSNSEVASTOPOL) Центр Дианетики (MSNSEVERNAYA) Центр Дианетики (MSNSEVILLA) Church of Scientology Mission of Sevilla (MSNSHATILOVKA) Релiгiйна Громада «Церква Саєнтологiï Харкова Шатилiвка» (MSNSHERMANOAKS) Church of Scientology Mission of Sherman Oaks (MSNSILICONVALLEY) Church of Scientology Mission of Silicon Valley (MSNSKOPJE) Habardov Centar za Dijanetika i Skientologija (MSNSLAVUTICH) Миссия церкви Саентологии «Славутич» (MSNSONOMA) Church of Scientology Mission of Sonoma (MSNSTOCKTON) Church of Scientology Mission of Stockton (MSNSUMY) Миссия Церкви Саентологии Сумы (MSNSURGUT) Центр Дианетики (MSNSZEGED) Szcientológia Egyház Szeged Misszió (MSNSZEKELYUDVARHELYI) Asociata Centrul Dianetica Székelyudvarhely (MSNSZEKSZARD) Scientology Egyház IX. misszió (MSNSZOLNOK) Szcientológia Egyház Szolnok Misszió (MSNTAICHUNG) 山達基教會台中中心 (MSNTAINAN) 山達基教會台南中心 (MSNTAIPEI) 山達基教會台北中心 (MSNTAO-YUAN) 山達基教會桃園中心 (MSNTBILISI) Church of Scientology Mission of Tbilisi (MSNTECAMACHALCO) Church of Scientology Mission of Tecamachalco (MSNTECK) Church of Scientology Mission of Teck (MSNTOLYATTI) Центр эффективности личности (MSNTOULOUSE) Church of Scientology Mission of Toulouse (MSNTUCSON) Church of Scientology Mission of Tucson (MSNTULITSA) Центр Дианетики (MSNUFA) Центр Дианетики (MSNULM) Scientology Mission Ulm e.V. (MSNVALENCIA) Church of Scientology Mission of Valencia (MSNVALLE) Church of Scientology Mission of Valle (MSNVESZPREM) Szcientológia Egyház Veszprém Misszió (MSNVICENZACENTRO) Church of Scientology Mission of Vicenza Centro (MSNVICTORIA) Church of Scientology Mission of Victoria (MSNVITORIA) Mision de la Iglesia de Scientology de Vitoria-Gasteiz (MSNVLADIMRVOLYNSKIY) Миссия Церкви Саентологии Владимир-Волынского (MSNWESTPALMBEACH) Church of Scientology Mission of West Palm Beach (MSNWESTVALLEY) Church of Scientology Mission of West Valley (Chatsworth) (MSNWICHITA) Church of Scientology Mission of Wichita (MSNWIESBADEN) Scientology Wiesbaden Mission der Scientology Kirche e.V. (MSNYAKUTSK) Центр Дианетики (MSNYALTA) Центр Дианетики (MSNYUNG-KANG) 戴尼提永康中心 (MSNZAPOROZHIE) Миссия Церкви Саентологии Запорожья (MSNZUG) Church of Scientology Mission of Zug (MSNZURICH) Church of Scientology Mission of Zurich (MSNZVEZDNAYA) Центр Дианетики (SPISSKANOVAVES) Centrum Dianetiky A Scientologie Spisska Nova Ves (UZHGOROD) Миссия Церкви Саентологии Ужгорода (VILNIAUS) Church of Scientology Mission of Vilnius (VLDVSTK1) Центр Дианетики * Other: Case level: Training level: Occupation: Place of employment: Any additional information you want to provide about yourself:



IMPORTANT MESSAGE This report is to include facts; a fact is defined in HCO PL 26 April 1970R, Revised 15 March 1975, THE ANATOMY OF THOUGHT as A FACT is something that can be proven to exist by visible evidence. An OPINION is something which may or may not be based on any facts. If the report concerns something that is suspected or not a fact as per the definition above, please state this in your report and also note: TIME, PLACE, FORM and EVENT. * I am reporting on:

An org or portion of an org

Person(s)

Other

A Church A Mission Other * Church: Select one (ACD) Asociacion Cultural Dianetica A.C. (ACT) Church of Scientology of Australian Capital Territory (ADED) Church of Scientology of Adelaide - Day (ADEF) Church of Scientology of Adelaide - Foundation (AKD) Church of Scientology of Auckland - Day (AKF) Church of Scientology of Auckland - Foundation (ALB) Church of Scientology of New Mexico (AMSD) Scientology Kerk Amsterdam - Day (AMSF) Scientology Kerk Amsterdam - Foundation (ANG) Église de Scientologie d'Angers (AOLA) Church of Scientology Advanced Organization of Los Angeles (AOSHAF) Advanced Organization & Saint Hill Africa (AOSHANZO) Scientology Advanced Organization & Saint Hill for Oceania (AOSHEU) Advanced Organization & Saint Hill Europe (AOSHUK) Advanced Organization & Saint Hill United Kingdom (ARH) Scientologi Kirken Jylland (ASHO) Church of Scientology American Saint Hill Organization (ASTD) Church of Scientology of Texas - Day (ASTF) Church of Scientology of Texas - Foundation (ATHENS) Eκκλησία της Σαηεντολογίας της Αθήνας (ATLD) Church of Scientology of Atlanta - Day (ATLF) Church of Scientology of Atlanta - Foundation (BAR) Esglesia de Scientology de Catalunya (BASD) Scientology Kirche Basel - Day (BASF) Scientology Kirche Basel - Foundation (BC) Church of Scientology of Battle Creek (BER) Scientology Kirche Bern (BHMD) Church of Scientology of Birmingham - Day (BHMF) Church of Scientology of Birmingham - Foundation (BRI) Church of Scientology of Brisbane (BRLN) Scientology Kirche Berlin (BRT) Church of Scientology of Brighton (BSA) Chiesa di Scientology dei Tre Laghi (BSND) Church of Scientology of Boston - Day (BSNF) Church of Scientology of Boston - Foundation (BTAD) Iglesia de Scientology Bogotá - Day (BTAF) Iglesia de Scientology Bogotá - Foundation (BUDAD) Szcientológia Egyház Központi Szervezet - Day (BUDAF) Szcientológia Egyház Központi Szervezet - Foundation (BUE) Iglesia de Scientology de Argentina (BUFF) Church of Scientology of Buffalo (BYO) Church of Scientology Bulawayo (CAMD) Church of Scientology of Cambridge - Day (CAMF) Church of Scientology of Cambridge - Foundation (CARACAS) Organizacion Dianetica A.C. Caracas (CCDUS) Celebrity Centre in Düsseldorf (CCFRZ) Celebrity Centre della Città di Firenze Chiesa di Scientology (CCINT) Scientology Celebrity Centre International (CCMUN) Celebrity Centre Scientology Kirche in München (CCNASH) Church of Scientology & Celebrity Centre Nashville (CCNY) Church of Scientology Celebrity Centre New York (CCP) Église de Scientologie Célébrity Centre Paris (CCVNA) Scientology Kirche Celebrity Centre Wien (CHI) Church of Scientology of Chicago (CINND) Church of Scientology of Greater Cincinnati - Day (CINNF) Church of Scientology of Greater Cincinnati - Foundation (CLE) Association Spirituelle de l'Église de Scientologie d'Auvergne (COL) Church of Scientology of Central Ohio (CSE) Scientology kerken voor Europa (CTA) Chiesa di Scientology di Catania (CTD) Church of Scientology Cape Town - Day (CTF) Church of Scientology Cape Town - Foundation (DALLASD) Church of Scientology Dallas - Day (DALLASF) Church of Scientology Dallas - Foundation (DCD) Founding Church of Scientology - Day (DCF) Founding Church of Scientology - Foundation (DETD) Church of Scientology of Michigan - Day (DETF) Church of Scientology of Michigan - Foundation (DKD) Scientology Kirken Danmark - Day (DKF) Scientology Kirken Danmark - Foundation (DUBLIND) Church of Scientology & Community Centre of Dublin - Day (DUBLINF) Church of Scientology & Community Centre of Dublin - Foundation (DURD) Church of Scientology of Durban - Day (DURF) Church of Scientology of Durban - Foundation (DUS) Scientology Kirche Düsseldorf (DVRD) Church of Scientology of Colorado - Day (DVRF) Church of Scientology of Colorado - Foundation (EDM) Church of Scientology of Alberta (FFT) Scientology Kirche Frankfurt (FH) The Fort Harrison Hotel (FSO) Church of Scientology Flag Service Organization (FSSO) Freewinds - Flag Ship Service Organization (GATOS) Church of Scientology of Los Gatos (GOT) Scientology Kyrkan i Göteborg (GUAD) Organizacion Cultural Dianetica Guadalajara (GVA) l'Église de Scientologie Genève (HAN) Scientology Kirche Hamburg e.V. Gemeinde Hannover (HAPI) Hubbard Academy of Personal Independence Scientology Edinburgh (HAR) Church of Scientology Harare (HARLEMD) Church of Scientology of Harlem - Day (HARLEMF) Church of Scientology of Harlem - Foundation (HAWD) Church of Scientology of Hawaii - Day (HAWF) Church of Scientology of Hawaii - Foundation (HBG) Scientology Kirche Hamburg e.V. (IFAD) Centro Cultural Latinoamericano A.C. (IFAR) Iglesia de Scientology de León (INGLED) Church of Scientology of Inglewood - Day (INGLEF) Church of Scientology of Inglewood - Foundation (JBGD) Church of Scientology of Johannesburg - Day (JBGF) Church of Scientology of Johannesburg - Foundation (JBGND) Church of Scientology of Johannesburg North - Day (JBGNF) Church of Scientology of Johannesburg North - Foundation (KC) Church of Scientology of Kansas City (KSD) 高雄山達基教會 - Day (KSF) 高雄山達基教會 - Foundation (LAO) Church of Scientology of Los Angeles (LAU) Église de Scientologie de Lausanne (LDND) Church of Scientology of London - Day (LDNF) Church of Scientology of London - Foundation (LIS) Igreja Portuguesa de Cientologia (LONG) Church of Scientology of Long Island (LVD) Church of Scientology & Celebrity Centre Las Vegas - Day (LVF) Church of Scientology & Celebrity Centre Las Vegas - Foundation (LYO) Église de Scientologie Lyon (MADD) Iglesia de Scientology de España - Day (MADF) Iglesia de Scientology de España - Foundation (MAL) Scientology Kyrkan i Malmö (MAN) Church of Scientology of Manchester (MELD) Church of Scientology of Melbourne - Day (MELF) Church of Scientology of Melbourne - Foundation (MEXCHD) Scientology México Centro Histórico - Day (MEXCHF) Scientology México Centro Histórico - Foundation (MILANOD) Chiesa di Scientology di Milano - Day (MILANOF) Chiesa di Scientology di Milano - Foundation (MMD) Church of Scientology of Florida - Day (MMF) Church of Scientology of Florida - Foundation (MOSCD) Религиозная группа «Московская саентологическая церковь» - Day (MOSCF) Религиозная группа «Московская саентологическая церковь» - Foundation (MTL) Église de Scientologie de Montréal (MUN) Scientology Kirche in München (MVD) Church of Scientology of Silicon Valley - Day (MVF) Church of Scientology of Silicon Valley - Foundation (MZA) Chiesa di Scientology della Brianza (NH) Church of Scientology of New Haven (NICE) Église de Scientologie Nice (NOV) Chiesa di Scientology di Novara (NYD) Church of Scientology of New York - Day (NYF) Church of Scientology of New York - Foundation (OCD) Church of Scientology of Orange County - Day (OCF) Church of Scientology of Orange County - Foundation (ODD) Organizacion de Desarollo y Dianetica (ORLD) Church of Scientology of Orlando - Day (ORLF) Church of Scientology of Orlando - Foundation (OSLO) Scientology Kirken Oslo (OTT) Church of Scientology of Ottawa (PADD) Chiesa di Scientology di Padova - Day (PADF) Chiesa di Scientology di Padova - Foundation (PAR) Association Spirituelle de l'Église de Scientologie d'Ile de France (PASAD) Church of Scientology of Pasadena - Day (PASAF) Church of Scientology of Pasadena - Foundation (PED) Church of Scientology of Perth - Day (PEF) Church of Scientology of Perth - Foundation (PEL) Church of Scientology Port Elizabeth (PHIL) Church of Scientology of Pennsylvania (PHX) Church of Scientology of Phoenix (PLY) Church of Scientology of Plymouth (POL) Organizacion Cultural Dianetica de Polanco (PORD) Chiesa di Scientology della città di Pordenone (PTAD) Church of Scientology of Pretoria - Day (PTAF) Church of Scientology of Pretoria - Foundation (PTLD) Church of Scientology of Portland - Day (PTLF) Church of Scientology of Portland - Foundation (PTR) Church of Scientology of Puerto Rico (QBCD) Église de Scientologie de Québec - Day (QBCF) Église de Scientologie de Québec - Foundation (ROMAD) Chiesa di Scientology di Roma - Day (ROMAF) Chiesa di Scientology di Roma - Foundation (SACD) Church of Scientology of Sacramento - Day (SACF) Church of Scientology of Sacramento - Foundation (SARD) Chiesa di Scientology della Sardegna (SDD) Church of Scientology of San Diego - Day (SDF) Church of Scientology of San Diego - Foundation (SEAD) Church of Scientology of Washington State - Day (SEAF) Church of Scientology of Washington State - Foundation (SFOD) Church of Scientology of San Francisco - Day (SFOF) Church of Scientology of San Francisco - Foundation (SLCD) Church of Scientology of Salt Lake City - Day (SLCF) Church of Scientology of Salt Lake City - Foundation (SNC) Church of Scientology Stevens Creek of San Jose (STB) Church of Scientology of Ventura (STL) Church of Scientology of Missouri (STM) Scientology Kyrkan i Stockholm (STPETE) Религиозная группа «Саентологическая Церковь города Санкт-Петербурга» (STTD) Scientology Gemeinde Baden-Württemberg - Day (STTF) Scientology Gemeinde Baden-Württemberg - Foundation (SUND) Church of Scientology of Sunderland (SYDD) Church of Scientology of Sydney - Day (SYDF) Church of Scientology of Sydney - Foundation (TAVD) המרכז לסיינטולוגיה ישראל - Day (TAVF) המרכז לסיינטולוגיה ישראל - Foundation (TCD) Church of Scientology of Twin Cities - Day (TCF) Church of Scientology of Twin Cities - Foundation (TOKYOD) サイエントロジー東京 - Day (TOKYOF) サイエントロジー東京 - Foundation (TORD) Church of Scientology of Toronto - Day (TORF) Church of Scientology of Toronto - Foundation (TPAD) Church of Scientology of Tampa - Day (TPAF) Church of Scientology of Tampa - Foundation (TRN) Chiesa di Scientology di Torino (VAND) Church of Scientology of British Columbia - Day (VANF) Church of Scientology of British Columbia - Foundation (VLYD) Church of Scientology of the Valley - Day (VLYF) Church of Scientology of the Valley - Foundation (VNA) Scientology Kirche Österreich (VRN) Chiesa di Scientology di Verona (VZA) La Iglesia de Scientology Valencia, Venezuela (WPG) Church of Scientology of Winnipeg (ZRH) Scientology Kirche Zürich Area (Division) 1 2 3 3A 4 4A 5 6 6A 6B 6C 7 * Mission: Select one (MOSHI) Church of Scientology Mission of Moshi (MSNAGUASCALIENTES) Centro De Dianética Hubbard De Aguascalientes, A.C. (MSNAKASAKA) Church of Scientology Mission of Akasaka (MSNALBANY) Church of Scientology Mission of Albany (MSNALBINO) Missione Della Chiesa Di Scientology Di Orobie (MSNALMATY) Центр Дианетики (MSNANAHEIM) Church of Scientology Mission of Anaheim (MSNANCHORAGE) Church of Scientology Mission of Anchorage (MSNANDRE) Igreja de Scientology do Brasil Miisao Santo André (MSNAOSTA) Missione Della Chiesa Di Scientology Di Aosta (MSNAVELLINO) Missione Della Chiesa Di Scientology Di Avellino (MSNAVIGNON) Église de Scientologie Mission d'Avignon (MSNAVRORA) Центр Дианетики (MSNBANGKOK) Church of Scientology Mission of Bangkok (MSNBANSKABYSTRICA) Centrum Dianetiky a Scientológie Banska Bystrica (MSNBARLETTA) Missione Della Chiesa Di Scientology Di Barletta (MSNBARNAUL) Центр Дианетики (MSNBARQUISIMETO) Church of Scientology Mission of Barquisimeto (MSNBATONROUGE) Church of Scientology Mission of Baton Rouge (MSNBELLEAIR) Church of Scientology Mission of Belleair (MSNBELLINZONA) Centro di Dianetics Hubbard Missione di Scientology di Bellinzona (MSNBERGAMO) Missione della Chiesa di Scientology della Bergamasca (MSNBILBAO) Church of Scientology Mission of Bilbao (MSNBISHKEK) Центр Дианетики (MSNBITZA) Центр эффективности личности (MSNBIYSK) Центр Дианетики (MSNBLAGOVETSCHENSK) Центр Дианетики (MSNBOISE) Church of Scientology Mission of Boise (MSNBORDEAUX) Eglise de Scientologie Mission de Bordeaux (MSNBOULDER) Church of Scientology Mission of Boulder County (MSNBOURNEMOUTH) Church of Scientology Mission of Dorset, Ltd. (MSNBRANDBLVD) Church of Scientology Mission of Brand Blvd (MSNBRATISLAVA) Dianetické centrum Bratislava (MSNBREMEN) Scientology Mission Bremen e. V. (MSNBRNO) Dianetické centrum Brno (MSNBRUNSWICK) Church of Scientology Mission of Brunswick (MSNBUDA) Szcientológia Egyház Buda Misszió (MSNCALC) Religious Foundation of Scientology of Kolkata (MSNCALI) Centro De Dianetica Y Scientology de Cali (MSNCAPITAL) 山達基教會首都中心 (MSNCAPITOL) Church of Scientology Mission of Capitol (MSNCASTROVALLEY) Church of Scientology Mission of Castro Valley (MSNCERCEDILLA) Misión de Scientology de Madrid (MSNCESKE) Dianetické centrum České Budějovice (MSNCHAMPAIGN) Church of Scientology Mission of Champaign-Urbana (MSNCHARTWELL) Church of Scientology Mission of Edenvale (MSNCHELIABINSK) Центр Дианетики (MSNCHELNY) Центр Дианетики (MSNCHIAYI) 山達基教會嘉義中心 (MSNCHICO) Church of Scientology Mission of Chico (MSNCHILE) Iglesia de Scientology Misión de Chile (MSNCHISINAU) Центр эффективности личности Кишинёва (MSNCLEVELAND) Church of Scientology Mission of Cleveland (MSNCOMO) Church of Scientology Mission of Como (MSNCOPENHAGENCITY) Church of Scientology Mission of Copenhagen City (MSNCOSENZA) Church of Scientology Mission of Cosenza (MSNCOSTARICA) Asociación Iglesia de Cienciología, Misión de Costa Rica (MSNDA-AN) 山達基教會大安中心 (MSNDEEPE) Church of Scientology Mission of Deep Ellum (MSNDIMITROVGRAD) Центр Дианетики (MSNDNEPR) Религиозная община церкви Саентологии «Днепр» (MSNDONG-CHI) Church of Scientology Mission of Dong-Chi (MSNDUNAUJVAROS) Szcientológia Egyház Dunaújváros Misszió (MSNEGER) Szcientológia Egyház Eger Misszió (MSNEKATERINBURG) Центр Дианетики (MSNELPASO) Church of Scientology Mission of El Paso (MSNFENG-YUAN) 戴尼提豐原中心 (MSNFOOTHILLS) Church of Scientology Mission of The Foothills (MSNFOVAROSI) Szcientológia Egyház Fővárosi Misszió (MSNFRESNO) Church of Scientology Mission of Fresno (MSNFU-SHING) 戴尼提復興中心 (MSNGIUSSANO) Missione della Chiesa di Scientology di Giussano (MSNGOEPPINGEN) Church of Scientology Mission of Goeppingen (MSNGUATEMALA) Church of Scientology Mission of Guatemala (MSNGUAYAQUIL) Church of Scientology Mission of Guayaquil (MSNGYORI) Szcientológia Egyház Győr Misszió (MSNHALIFAX) Church of Scientology Mission of Halifax (MSNHARKOV) Гуманитарный центр Хаббарда (MSNHARLINGEN) Church of Scientology Mission of Harlingen (MSNHELSINKI) Church of Scientology Mission of Helsinki (MSNHONGO) Church of Scientology Mission of Hongo (MSNHOUSTON) Church of Scientology Mission of Houston (MSNHSIAN) 戴尼提西岸中心 (MSNHUA-LIAN) 戴尼提花蓮中心 (MSNIZHEVSK) Центр Дианетики (MSNKALININGRAD) Центр Дианетики (MSNKALOCSA) Szcientológia Egyház Kalocsa Misszió (MSNKARLSRUHE) Church of Scientology Mission of Karlsruhe (MSNKARPATY) Centrum Dianetiky a Scientologie Karpaty (MSNKAZAN) Центр Дианетики (MSNKHABA) Центр Дианетики (MSNKIEV) Миссия Церкви Саентологии Киева (MSNKOMSOMOLSKONAMUR) Центр Дианетики (MSNKOSICE) Church of Scientology Mission of Kosice (MSNKRASNODAR) Центр Дианетики (MSNKREMENCHUG) Миссия Церкви Саентологии Кременчуга (MSNKUBAN) Центр Дианетики (MSNKYIVCENTER) мiссiя Киïв-центр (MSNLAHTI) Church of Scientology Mission of Lahti (MSNLEICHHARDT) Church of Scientology Mission of Leichhardt (MSNLEVICE) Church of Scientology Mission of Levice (MSNLIPTOVSKYMIKULAS) Dianetické centrum Liptovsky Mikulas (MSNLOSFELIZ) Church of Scientology Mission of Los Feliz (MSNLUGANO) Church of Scientology Mission of Lugano (MSNLUZERN) Church of Scientology Mission of Luzern (MSNMACERATA) Church of Scientology Mission of Macerata (MSNMALVERN) Church of Scientology Mission of Malvern (MSNMANILA) Church of Scientology Mission of the Philippines (MSNMARACAIBO) Asociacion Civil Cultural Dianetica y Scientology De Maracaibo (MSNMARGARITA) Centro De Dianetica y Scientology Margarita (MSNMARSEILLE) Church of Scientology Mission of Marseille (MSNMECHELEN) Scientology Kerk van België (MSNMEDELLIN) Church of Scientology Mission of Medellin (MSNMERATE) Missione Della Chiesa Di Scientology Di Merate (MSNMILWAUKEE) Church of Scientology Mission of Milwaukee (MSNMINSK) Центр Дианетики (MSNMISKOLC) Szcientológia Egyház Miskolc Misszió (MSNMODENA) Missione della Chiesa di Scientology di Modena (MSNMOORPARK) Church of Scientology Mission of Moorpark (MSNMUKACHEVO) Миссия Церкви Саентологии Мукачево (MSNMURMANSK) Центр эффективности личности (MSNNAPOLI) Church of Scientology Mission Napoli (MSNNEWDELHI) Religious foundation of Scientology of New Delhi (MSNNEWJERSEY) Church of Scientology Mission of New Jersey (MSNNEWORLEANS) Church of Scientology Mission of New Orleans (MSNNITRA) Dianetické centrum Nitra (MSNNIZHNEKAMSK) Центр Дианетики (MSNNIZHNY-NOVGOROD) Центр Дианетики (MSNNORWOOD) Church of Scientology Mission of Norwood (MSNNOVGORODII) Центр Дианетики (MSNNOVOKUZNETSK) Центр Дианетики (MSNNOVOSIBIRSK) Центр Дианетики (MSNNYIREGYHAZA) Szcientológia Egyház Nyíregyháza Misszió (MSNOCALA) Church of Scientology Mission of Ocala (MSNODESSA) Миссия Церкви Саентологии Одессы (MSNOLBIA) Church of Scientology Mission of Olbia (MSNOMSK) Центр Дианетики (MSNORENBURG) Центр Дианетики (MSNPANAMA) Iglesia de Scientology Panamá (MSNPARMA) Church of Scientology Mission of Parma (MSNPAVESE) Missione Della Chiesa Di Scientology Di Pavese (MSNPAVLODAR) Центр Дианетики (MSNPECS) Szcientológia Egyház Pécs Misszió (MSNPENZA) Центр Дианетики (MSNPERM) Центр Дианетики (MSNPILSEN) Dianetické centrum Plzeň (MSNPRAGUE) Dianetické centrum Praha (MSNPRESOV) Church of Scientology Mission of Presov (MSNQUETZALTENANGO) Instituto De Cienciologia Aplicada De Occidente (MSNQUITO) Church of Scientology Mission of Quito (MSNRAVE) Missione Della Chiesa Di Scientology Di Ravenna (MSNRDALE) Church of Scientology Mission of Riverdale (MSNREDWOODCITY) Church of Scientology Mission of Redwood City (MSNREGGIOEMILIA) Missione della Chiesa di Scientology di Reggio Emilia (MSNRENENS) Church of Scientology Mission of Renens (MSNRENO) Church of Scientology Mission of Sierra Nevada (MSNRIGA) Riga Mission (MSNRIMINI) Chiesa di Scientology Missione di Rimini e San Marino (MSNRIVERPARK) Church of Scientology Mission of Riverpark (MSNRONCADELLE) Missione Della Chiesa Di Scientology Roncadelle (MSNSALTLAKECITY) Church of Scientology Mission of Salt Lake City (MSNSALZBURG) Church of Scientology Mission of Salzburg (MSNSAMARA) Центр Дианетики (MSNSANANTONIO) Church of Scientology Mission of San Antonio (MSNSANFRANCISCO) Church of Scientology Mission of San Francisco (MSNSANJOSE) Church of Scientology Mission of San Jose (MSNSANTACLARA) Church of Scientology Mission of Santa Clara, Guatemala (MSNSANTACRUZ) Church of Scientology Mission of Santa Cruz (MSNSANTAFE) Church of Scientology Mission of Santa Fe (MSNSANTANGELO) Centro di Dianetics della Missione di Sant’Angelo Lodigiano (MSNSANTODOMINGO) Church of Scientology Mission of Santo Domingo (MSNSAOPAULO) Church of Scientology Mission of São Paulo (MSNSAOPAULOSOUTH) Associação Brasileira de Dianetics São Paulo (MSNSARATOV) Центр Дианетики (MSNSCST) Church of Scientology Mission of South Coast (MSNSEATTLE) Church of Scientology Mission of Seattle (MSNSENIGALLIA) Missione della Chiesa di Scientology di Senigallia (MSNSETAGAYA) Church of Scientology Mission of Setagaya (Aichi-ken) (MSNSEVASTOPOL) Центр Дианетики (MSNSEVERNAYA) Центр Дианетики (MSNSEVILLA) Church of Scientology Mission of Sevilla (MSNSHATILOVKA) Релiгiйна Громада «Церква Саєнтологiï Харкова Шатилiвка» (MSNSHERMANOAKS) Church of Scientology Mission of Sherman Oaks (MSNSILICONVALLEY) Church of Scientology Mission of Silicon Valley (MSNSKOPJE) Habardov Centar za Dijanetika i Skientologija (MSNSLAVUTICH) Миссия церкви Саентологии «Славутич» (MSNSONOMA) Church of Scientology Mission of Sonoma (MSNSTOCKTON) Church of Scientology Mission of Stockton (MSNSUMY) Миссия Церкви Саентологии Сумы (MSNSURGUT) Центр Дианетики (MSNSZEGED) Szcientológia Egyház Szeged Misszió (MSNSZEKELYUDVARHELYI) Asociata Centrul Dianetica Székelyudvarhely (MSNSZEKSZARD) Scientology Egyház IX. misszió (MSNSZOLNOK) Szcientológia Egyház Szolnok Misszió (MSNTAICHUNG) 山達基教會台中中心 (MSNTAINAN) 山達基教會台南中心 (MSNTAIPEI) 山達基教會台北中心 (MSNTAO-YUAN) 山達基教會桃園中心 (MSNTBILISI) Church of Scientology Mission of Tbilisi (MSNTECAMACHALCO) Church of Scientology Mission of Tecamachalco (MSNTECK) Church of Scientology Mission of Teck (MSNTOLYATTI) Центр эффективности личности (MSNTOULOUSE) Church of Scientology Mission of Toulouse (MSNTUCSON) Church of Scientology Mission of Tucson (MSNTULITSA) Центр Дианетики (MSNUFA) Центр Дианетики (MSNULM) Scientology Mission Ulm e.V. (MSNVALENCIA) Church of Scientology Mission of Valencia (MSNVALLE) Church of Scientology Mission of Valle (MSNVESZPREM) Szcientológia Egyház Veszprém Misszió (MSNVICENZACENTRO) Church of Scientology Mission of Vicenza Centro (MSNVICTORIA) Church of Scientology Mission of Victoria (MSNVITORIA) Mision de la Iglesia de Scientology de Vitoria-Gasteiz (MSNVLADIMRVOLYNSKIY) Миссия Церкви Саентологии Владимир-Волынского (MSNWESTPALMBEACH) Church of Scientology Mission of West Palm Beach (MSNWESTVALLEY) Church of Scientology Mission of West Valley (Chatsworth) (MSNWICHITA) Church of Scientology Mission of Wichita (MSNWIESBADEN) Scientology Wiesbaden Mission der Scientology Kirche e.V. (MSNYAKUTSK) Центр Дианетики (MSNYALTA) Центр Дианетики (MSNYUNG-KANG) 戴尼提永康中心 (MSNZAPOROZHIE) Миссия Церкви Саентологии Запорожья (MSNZUG) Church of Scientology Mission of Zug (MSNZURICH) Church of Scientology Mission of Zurich (MSNZVEZDNAYA) Центр Дианетики (SPISSKANOVAVES) Centrum Dianetiky A Scientologie Spisska Nova Ves (UZHGOROD) Миссия Церкви Саентологии Ужгорода (VILNIAUS) Church of Scientology Mission of Vilnius (VLDVSTK1) Центр Дианетики Area (Division) 1 2 3 3A 4 4A 5 6 6A 6B 6C 7 * Other Organisation:

* Other:

* First Name: * Last Name: Other: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Additional person: First Name: Last Name: Copies of this

report go to: * Type of Report: Knowledge Report Alter-Is Report Error Report Misdemeanor Report Crime Report High Crime Report Technical Alter-Is Report Technical Noncompliance Report Things That Shouldn't Be Report

* Type your report:

I attest that the report is true and sent from the person it is said to be being sent from:

Name: 1. You can now preview your report and make corrections as needed in the form above. 2. Print copies of this report for anyone you have info'ed on it, as they will not be automatically forwarded by the electronic form. 3. Send your report.

Please enter the following in order to

help prevent automated submissions: In order to prevent automated submissions,

please enter the code shown below. [try a different image]

Enter the code shown:

Note: Please allow up to one minute or possibly longer (depending on your Internet connection) for your report to be processed.









