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! <br /> <br />/ ; ~ N, C, FIREMEN'S PENSION FUND <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br /> General Statutes, Chapter 118-~3, requires that all certified fire departments certify annually <br /> to the North Carolina Firemen'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 June 30 <br /> of each year must be submitted to the Nodl~ Carolina Firemen's Pension Fund, 116 9/. Jones <br /> StreeI,Raleigh, North Carolina on or before July 30th. Failure to submit this certification <br /> along.with a complete ins/er will result in the loss of the death benefit [~rovJded by the State. <br /> <br /> CERTIFICATION <br /> <br /> We, the Cabar_-,n~s Comn%y Cc~.issioners <br /> <br /> in our capacity as the governing body of the. Fire D,epart- <br /> menl, certify that we have examined and fi~ that attached roster is a lode and accurate list o[ <br /> all active firemen* of the Fire Department, <br /> City of_ ._ County of __ Ca~arr-a~ <br /> <br /> North Carolina. ~'e further certify (hal the firemen listed on the roster have completed at least <br /> 36 hours of meetings and drills during the prewons year. <br /> <br /> SIGNED: <br /> <br /> TITLE: <br /> <br /> DATE: <br /> <br /> ROSTER MUST BE A'ETACHED WITH NAMES IN ALPHABETICAL ORDER, <br /> <br /> Firemen on auth0tized "Leave of Absence" are to be included on the roster. <br /> <br /> 2.2. <br /> <br /> <br />