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STATE OF NORTH CAROLINA DEPARTMENT OF. STATE AUDITOR FIREMEN'S AND RESCUE SQUAD WORKER'S PENSION FUND DIVISION ANNUAL CERTIFICATION OF FIRF~4EN General Statutes, Chapter 118-23, requires that all certified fire departments certify annually to the N. C. Firemen's Pension Fund a co~plate roster of its qualified firemen. The following certification along with"a Complete roster of all active firemen* aa of June 30 of each year must be submitted~to thegN. 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 l~s of the death benefit provided by the Stal~. CERTIFICATION We, the Cabarrus County Board of Commissioners in our capacity as the governing (~overning Body) b6dy of the Allen Fire~ Department, certify that we have e~a~in'gd and find that attached is ~ true and accurate list of all active firemen* of the Allen Fire Department, address Highway 601 County of Cabarrus , North Carolina. Concord Sign~ed Title Date For Fire Department Chief Only I, Tod D. Jo~fner , Chief of the Al!on Vol. Fire Department, certify the attached roster is a true and accurate 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 term "eligible firemen" shall mean those firemen who have jDined the fire department within the calend~r year and are in the process of completing the required 36 hours of meetings and drills.) June ~ 19d83 Date ROSTER MUST BE ATTACHED WITH NAMES IN ALPHABETICAL ORDER. - *Firemen on authorized "Leave of Absence" are to be i~cluded on the roster. Whenever a new fireman is added to the roster during the year: his or her name should be forward to the Pension Fund Office immediately.