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N. C. FIREMEN'S PENSION FUND <br /> <br /> DEPARTMENT OF STATE ADD}TOE <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br />General Statutes, Chapter 118-23, requires that all certified fire departments certify annually <br />to the Nodh Carolina Fitemen'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 ]une 30 <br />of each year must be submitted to the North Carolina Firemen's Pension Fund, 116 W. Jones <br />Street, Raleigh, North Carolina on or before July 30th. Failure to submit this certification <br />along with a complete roster will result in the loss of the'death benefit provided by the State. <br /> <br /> CERTIFICATION <br /> <br /> '~e, the Cabarrus County Commissioners <br /> <br /> m our capacity as the governing body of the. GeorQevi 11 e Fire Depart- <br /> men/, certify that we have examined and find that attached roster is a true and accurate list of <br /> all active firemen* of the_ Georgevil 1 e Fire Department, <br /> <br /> City of County of. CabarruS ., <br /> <br /> North Carolina. We further certify that the firemen listed on the roster have completed at least <br /> 36 hours of meetin~,s and drills during the prewous year. <br /> <br /> SIGNED: <br /> <br /> Chairman, <br /> TITLE: Cabarrus County Board'~f Commissioners <br /> <br /> DATE: <br /> <br /> ROSTER MUST BE ATTACHED WITH NAMES IN ALPHABETICAL ORDER. <br /> <br /> * Firemen on authorized "LeaVe o[ Absence" are to be included On the roster. <br /> <br /> <br />