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STATE OF NORTH CAROL;r';A <br /> DEPARTI,'~ED.~T OF S'FATE <br /> FII~EI,;EN'S AND RESCUE ~0UAO WORKER'S PENSION FUND DIVISION <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br /> General Statutes, ChapLer 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 firemel~* 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. Dr before July 31. Failure to submit this certification along <br />with a complete rostez will result in the loss of the death benefit provided by the State. <br /> <br /> CERTIFICATION <br /> <br />We, the Caba~rus Board of Commissioners in our capacity as the governing <br /> (Governing Body) <br />body of the Allen 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 /> Allen Fire Department, address P.O. Box 1083 County of <br /> , North Carolina. Concord 28025 <br /> <br /> Signed <br /> <br /> Title <br /> <br /> Date <br /> <br /> For Fire Department Chief Only <br /> <br /> I, Ted D. Joyne~ , Chief of ~he Allen Volunt~e? Fire <br />Department, certify the attached roster is a true and accurate list of all eligible fire- <br />men. (Eligible firemen are 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 department within the calendar <br />year and are in the process of completing the required 36 hours of meetings, and drills.) <br /> <br /> june 30, }982 <br /> Date <br /> <br />ROSTER MUST BE ATTACHED WITH NAMES IN A~LPHABETICAL ORDER. <br /> <br />*Firemen on authoriMed "Leave of Absence'! are to be included on the roster. <br /> %~]enever a new fireman is added to the roster during the year, his or her name should be <br /> fom~ard to the Pension Fumd Office iramediately. <br /> <br /> <br />