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N. C. FIREMEN'S PENSION FUND <br /> <br /> ANNUAL CERTIFICATION OF PIREMEN <br /> <br /> General Statutes, Chapter 118-23, requires that all certified fire departments certify <br /> annually to the N. C. Firemen's Pension Fund a complete roster of its qualified firemen· <br /> <br /> The following certification along with a complete roster of all active firemen* as of <br /> June 30 of each year must be submitted to the N. C. Firemen's Pension Fund, 116 W. Jones <br /> St., Raleigh, N. C. on or before July 31. Failnre to submit this certification alon$ <br /> with a complete roster will result in the loss of the death benmfit provided by the Stat,.. <br /> <br /> CERTIFICATION <br /> <br /> We, the Caba??us Board of CommissionePs in our capacxty as the governing <br /> (Governing Body) <br /> body of the Ha~Pisbupg Fire Department, certify that we have examined <br /> and find that attached is a true and accurate list of all active firemen* of the <br /> Nap~isbu~_ Fire Department, address P.O. Box 325 County of <br /> CabapPus , North Carolina. HaPPisbuP~_~ 28075 ' <br /> <br /> Signed <br /> <br /> Title <br /> <br /> Date <br /> <br /> For Fire Department Chief Only <br /> <br /> l, William Guv Moore J~. , Chief of the Har~isbupg Fire <br /> Department, certify the attached roster ~s a true and accurate list of all eligible fire- <br />men. (Eligible fireman are firemen who have met the requzred 36 hours of meetings and <br />drills during the last calendar year (July t - June 30). In addition, the term "eligible <br />firemen" shall mean those firemen who h'ave joined the fire department within the calendar <br />year and are in the process of completing the requzred 36 hours of meetings and drills.) <br /> <br /> __ ,-//i</~'t~ .~, ~. ,.~-, ..... <br /> Fire Chief <br /> 7-10-82 <br /> <br /> Date <br />ROSTER I~IJST BE ATTACHED WITH NAMES IN ALPHABETICAL ORDER. <br /> <br />~Firemen on autborized "Leave of Absence" are to be included on the roster. <br /> <br /> <br />