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N. C. FIREMEN'S PENSION FUND <br /> DIVISION <br /> DE!~ARTMENT OF STAT~ AUDITOR <br /> 11{ WEST JONF~ STREET <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br />General Statutes, Chapter 118-23, requires that all certified fire departments certify <br />annually to the N. C. Fireman'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. Fireman's Pension Fund, 116 W. Jones <br />St., Raleigh, N. C. on or before July 31. Failure to submit this certification alon~ <br />with a complete roster will result in the loss of the death benefit provided by the State. <br /> <br /> CERTIFICATION <br /> <br />We, the Cabarrus Board of Commissioners in our capacity as the governing <br /> (Governing Body) <br />body of the Midland 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 /> Midland Fire Department, address Rt. ~ Nidland 28107 County of <br /> ~ba~pus , North Carolina. <br /> <br /> Signed <br /> <br /> Title <br /> <br /> Date <br /> <br /> For Fire Department Chief Only <br /> <br />I, Allen Burner% , Chief of the 1.1idland Fire <br />Department, certify the attached roster ~s a true and accurate list of all eligible fire- <br />men. (Eligible firemen mre firemen who have met the required 36 hours of meetings and <br />drills during the last calendar year (July 1 - June 30). In addition, the term "eligible <br />firemen" shall mean those firemen who have joined the fire depsrtment within the calendar <br />year and are in the process of completing the required 36 hours of meetings and drills.) <br /> <br /> Fire Chief <br /> 7-1-82 <br /> [)ate <br /> <br />ROS%ER MUST BE ATTACHED WITH NAMES IN ALPHABETICAL ORDER. <br /> <br />*Firemen on a~thorized "Leave of Absence" are to be included on the roster. <br /> <br /> <br />