Area IV is overseen by a male Director for the brothers, a female Co-Director for the sisters, and a Recording Secretary that could be either a male or female. A District Grand Lodge is overseen by District Grand Master. Some districts also have additional leaders for their district that are called Sub-District Grand Masters. The District Grand Household of Ruth is overseen by District Most Noble Governor.

– Florida – District Grand Lodge #27 District Grand Household of Ruth #16
Lodges Household
Harry Marsh No. 1225, Edgewater The Lily of The Valley Household No. 3538,
Sarasota No. 12267, Sarasota Sarasota
     – Louisiana – District Grand Lodge #21-A District Grand Household of Ruth #26
Lodges Household
Knox Enterprise No. 9499, Baton Rouge Hattie Household Ruth No. 6865, Baton Rouge

– Mississippi – District Grand Lodge #10 District Grand Household of Ruth #14
Lodges Household
H.M. Thompson Household or Ruth No. 189,
Jackson

     – Georgia – District Grand Lodge #__ District Grand Household of Ruth #__
Lodges Household

– Alabama – District Grand Lodge #__ District Grand Household of Ruth #__
Lodges Household
Genenesis No. 12268, Birmingham