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N. C. FIREMEN;S. PENSION FUND' <br /> DIVISION <br /> DEPARTMENT OF STATE AUDITOR <br /> lld WEST JONES STREET <br /> RALEIGH. N. G. 27603 <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br />General Statutes, Chapter 118-723, 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 ~0 <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 />We, the <br /> County Comralsstoners, Board of Trustees, otc, <br />in our capacity as th~ governing body of the Poplar Tent Fire Depart- <br />meat, certify that we have examined and find that attached roster is a true and accurate li~t of <br />all active firemen* of the Poplar Tent Fire Department, <br />City of Concord County of Caba~rus <br />North Carolina. <br /> <br /> SIGNED: <br /> <br /> TITLE: <br /> <br /> DATE: <br /> <br /> ROSTER MUST BE AITACHED, <br /> <br />* Firemen on authorized Leave of Absence are to be included on the roster. <br /> <br /> <br />