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N. C. FIREMEN'S PENSION FUND <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br />General Statutes, Chapter 118-23, requires that all certified fire departments certify annually <br />to the North Carolina Firemen'$ Pension Ftind a complete roster of its qualified firemen. <br /> <br />The following certification along with a complete roster of all active firemen* as of June 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 benefil provided by the Stale. <br /> <br /> CERTIFICATION <br /> <br />~/e, the Cabarrus County Commissioners <br /> <br />in our capacity as the governing body of the Poplar Tent Fire Depart- <br />ment, certify that we have examined and find that attached roster is a true and accurate list of <br />all active firemen* of the PoPlar Tent Fire Department, <br />City of County of CabarFu$ , <br />No/th Carolina. We further certify that the firemen listed on the roster have completed at least <br />36 hours of meetinl~s and drills during the prewousyear. <br /> <br /> SIGNED: <br /> <br /> TITLE: Chariman. Cabarrus Co. Boord of Commissioners <br /> DATE: <br /> <br /> ROSTER MUST BE ATTACHED WITH NAMES IN ALPHABETICAL ORDER. <br /> <br /> Firemen on authorized "Leave of Absence" are to be included on the roster. <br /> <br /> II <br /> <br /> <br />