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STATE OF NORTH CAROLINA DEPARTN~ENT OF STATE AUDITOR FIRE~EN'S AND RESCUE SQUAD WORKER'S PENSION FUND DIVISION ANNUAL CERTIFICATION OF FI REMEN General Statutes, Chapter 118-23, 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. C~ Firemen's Pension Fund, 116 W. Jones St., Raleigh, N. C. on or before July 31. Failure to submit this certification alon~ with a complete roster will result in the loss of the death benefit provided by the CERTIFICATION We, the Cabarrus County Board of Commissioners ~n our capacity as the ~eoovernin~ (Govern£ng Body) body of the ~/~.~ I~'~ ~/0/. Fire Department, certify that we have examined a~d find that ~ttached is a true and accurate list of all active firemen* of the [4~Iq~;]-2~- V~ . Fire Department, address_~f~/~ ~W~>.~,u~C°unty of ~o~ , North Carolina. Signed Title Date For Fire Department Chief Onl~ , Chief of the , /¢,,~ ~Of Fire Deparrmenn, certify the attached ros[e~ is a true and acc6rate list of all eligible fire- men. (Eligible firemen are firemen who have met the required 36 hours of meetings and drills during the last calendar year (July 1 - June 30). In addition, the nerm "eligible firemen" shall mean those firemen who have joined the fire department within the caleedar year and are in the process of completing the requi~ed 36 hours of meetings and drills.) ROSTER MUST BE ATTACHED WITH N~ES IN ALPHABETICAL C RDER. *Firemen on authorized "Leave of Absence" are to be included on the roster. %',henever a newfireman is added to the roster during the year, his or her pame should be fo~.,,ard to the Pension Fund Office i~mediately..