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NAME OF FiRE DiSTRiCT __~] i ~,,. Vnl. Fire D~p_t_~ COUNTY cabarruS <br /> <br /> fire DEPARTMENT <br />DISTR~CT IS SERVED BY ~!~ ep <br />M ail To The North Carolina State Department ol] nsurance. P. O. Box 26:187, Raleigh. N. C. 27611--11efore October 3 lat. <br />NOTI",. Thls. report must be f ct & t corn fieteb', must. be.Maned an sworn to anti rote reed to the [ nsoranceDepartment before <br />t)etoher :list, or the fire delno.tment ~.vill lose their partofthe Firemcn'sRelief Pund tax for thisyear.--I esuranc6Commissumc". <br /> NORTH CAROLINA ~'r-~ <br /> RURAL FIRE DISTRICT <br /> <br /> ~ REPORT OF FIRE CONDITIONS <br /> <br />To 'rlig COMMISSIONER OF INSURANCE, <br /> Raleign. N. C. <br /> As ,'equired by section 118-9 of the General Statutes of North Caroliua, 1. Auditor of said Coutity do hereby make <br />the following reput;t on the ...kI.X.e.n...V.~.~- ..................... Rucal Fire District, Guunty of .-..q.a...b-a--.~.T--u---s- ..................... <br /> FIRE DEPARTMENT INFORMATION <br /> <br /> Fire Dept. Personnel ...... 2.9 ................................ Fell Time ....Q .................................... Volunteer - 29 <br /> <br /> No. F.D. llohses or Stations ...... l .......................... No.'Pumpers ...... 2 .......................... No. Tankers 2 .. <br /> <br /> No. Othm' Special Purpose Vehicles ........... ~ ................................................................ Total Co's _.6. .......................... <br /> TYl e Water Supply! Mobile .................................. Hy( rants ....5..2. ......................... Combinatioe .............................. <br /> <br /> LOCAL FIREMI~N'S REIAEF FUND <br /> <br /> Names of Trustees of Firemen's Relief Fund appointed by Fire Department(two) ...................................................... <br /> ' illi s Tom Joyner <br /> <br /> No,ecs of Trustees of Fircmen's Relief Fund appointed by the County Commissioners (LWO) ...................................... <br /> 1{. MIL Ralph Hone~cutt ,1. ~ ~'i Aubrey noqer ...... <br /> Names of Trustee of l;'iremcn's Relief Fund hl)pointed by Insuran~:e CommissJouer {one) .......................................... <br /> <br /> 5. Mr. Kevin D..e...m~.s..e.y, ..S..F..: ......... If stone us bu;t year, check here( ) <br /> <br /> Treasurerofl"iremen'sRoliefFundNumber, 1 2 :3 4 ~Above(encirclewhich) <br /> Is yoor Fire Department a member of the North Carolina State l,'iremeo's Associatinn? ye s <br /> <br /> NORTH CAROLINA <br /> .................................................. Couoty. <br /> ....................................................................... Auditor/Finance nffieer of .................................................................... <br /> Count.',;; N. C. (lo hereby certify that the forego tg is a true. full, and correct rcpurt of the leire Departmeut and fire <br /> conditioas of ............................................ l~.ural Fire District. <br /> Under Section 118-9 of thc General Statutes of North Carolinu. <br /> <br /> Sworn to and subscribed before me, this .......................................... (lay of ........................................... 19 ............ <br /> <br /> [SEAL] ............................................................................................ <br /> NOTE: Thi~ report can not be accepted unless sworn to before a Notary or other officer with Seal. <br /> <br /> <br />