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N. C. FIREMEN;S PENSION FUND .' <br /> DIVISION <br /> <br /> DEPARTMENT OF STATE AUDITOR <br /> <br /> 116 WEST ]ORES STREET <br /> R,4LEIGR, R, C. 27603 <br /> <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> <br /> General Statules, Chapter 118-23, requires that all certified fire departments certify annually <br /> to the North Carolina Firemea;s Pension Fund a complete roster of its qnalified 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 snbmit this cerlification <br /> along.with a complete roster will resul! in the loss of the death benefit provided by the Slate. <br /> <br /> CERTIFI CATION <br /> <br /> We, the Cabarrus County Board of Commissioners <br /> <br />in our capacity as the governing body of the Midland Vol. Fire' Depart- <br />ment, certify lhaI we have examined and find that atlached roster is a true and accurate ilsl of <br /> all active firemen* of the Mid'leaqd Vol. Fire Department, <br /> City of County of. Ca'barvus <br /> North Caroliua. <br /> <br /> SIGNED: <br /> <br /> TITLE: <br /> <br /> DATE: <br /> <br /> ROSTER MUST BE ATTACHED. <br /> <br />* Firemen on authorized "Leave of Absence" are to be included on the roster. <br /> <br /> <br />