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STATE OF NORTH CAROLINA DEPARTMENT OF STATE AUDITOR FIRE,MEN'S AND RESCUE SQUAD WORKER'S PENSIO~'~ FUND DIVISION ANNUAL CERTIFICATION OF FIREMEN General Statutes, Chapter [18-23, requires that all certified fire departments certify annually to the N. C. Firemen's Pension Fund a complete roster of its qualified firemen. The following certification along with a complete roster of'all active firemen~ as of June 30 of each~year must be submitted to the N. Co Firemen's Pension Fund, 116 W. Jones' St., Raleigh, N. C. on or before July 31. Failure to submit tbis certification alon$ ; with a complete roster will result in the loss of tbe death benefit provided by the State. CERTIFICATION We, the Cabarrus Co. Board of Commissioners in our capacity as the governing (Governing Body) body of the Flowes Store Fire Department, certify that we have examined and find that attached is a true and accurate list of all active firemen* of the Flowes Store Fire Departmenn, address 1015 Flowes Store Rd. County of Cabarrus , North Carolina. Concord N~C. 28025 Signed Title Date For Fire Department Chief Only I, Edwin E. Roy , Chief of tbe Flowes Store Fire Department, certify the attacbed roster is a true and accurate list of all eligible fire- men. (Eligible firemen are firemen who have inet the required 36 bouts of meetings ~nd drills during tbe last calendar year (July 1 - June 30). In addition, the term "eligibl~ firemen" shall mean those firemen who have joined the fire department within the calendar year and are in the process of completing the required 36 hours of meetings and dr~tls.) Aug. 2 1983 ~ Date ROSTER EIJST BE ATTACttED WITD N~qES IN At. PttABETICAL ORDER. *Firemen on authorized "Leave o[ Absence" are to be included on the roster. I'.~e~ever a new fireman is added co the roster dur~n~ the year, his or her name should be fo~,card ~o d~e Pension Fuad O~f~ce x~edta~elv.