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NOTICE OF APPOINTMENT BY COUNTY COMMISSIONERS <br /> TO THE COUNTY BOARD OF SOCIAL SERVICES <br /> <br /> Date <br /> <br /> Co6nty <br /> <br /> This is to notify the State Social Services Division <br /> that, in compliance with Section 108-11 of the General <br /> Statutes of North Carolina, the County Commissioners of <br /> the above-named county have named as their appointee to <br /> the Board of Social Services to serve for a term of three <br /> years the following person: <br /> Name: <br /> Address: <br /> <br /> ~ip code <br /> <br /> Effective date of appointment: <br /> <br /> Date of oath of office: <br /> (If appointee is a County Commissioner, an additional <br /> oath is not necessary; however~ please indicate on <br /> the line above if this is the case.) <br /> <br /> Race: <br /> <br /> Signature: , Clerk <br /> Board of County Commissioners <br /> <br />Please return this form to: <br />Mrs. Bonnie R. Allred <br />State Division-of Social Services <br />325 North Salisbury Street <br />Raleigh, North Carolina 27611 <br /> <br /> <br />