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STATE OF NORTH CAROLI~A DEPARTMEN"[ OF $'~ATE AtJDITOR ANNUAL CERTIFICATION OF FIRE~N General Statutes, Chapter 118-23, requires that all certified fire departments certify annually to the N. C. Fireman'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. Fireman's Pension Fund, 116 W. Jones St., Raleigh, N. C. on or before July 31. Failure to submit this certification along w.~h a complete roster will result in the loss of the death benefit provided by the State. CERTIFICATION We, the Cabarrus Board of Commissioners in our capacity as the governing (Governing Body') body of the Mt. Nitchall Fire Department, certify that we have examined and find that attached is a true and accurate list of all active firemen* of the Mt. ~litchel! F{re Department, address R~ 2 Box 268 County of CabaPrus · , North Carolina. Kanoapolis 2808~ Signed Title Date For Fire Department Chief Only l, '1 - ' "~.'. i./ z/~:~i Chief of the ./~.{~ .7'Z /~'~ Fire Department, ~ertify 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 las~ calendar year (July 1 - June 30). In addition, the term "eligible 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 drills.) F~e ~e~ Date ROSTER ~ST BE ATTACNED WITN NAMES IN ALPHABETICAL ORDER. *Firemen on authorized "Leave of Absence" are to be included on the roster. khenever a ~ew fire,man is added to ~he roster duri~ the year, his or her ~e should be fo~,,ard to the Pension ~hnd Office i~ediatel~.