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N. C. FIREMEN'S PENSION FUND <br /> DIVISION <br /> DEPARTMENT OF STATE AUDITOR <br /> 116 NEST"10NES STREET <br /> RALEIGH, N. C. 27603 <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> General Statutes, C apter 118-23, requires that all certified fire departments certify annually <br /> to the North Caroli a Firemen's Pension Fund a complete roster of its qualified firemen. <br /> The fallowing cer . icatiom along with a complete roster of all active firemen's as of June 30 <br /> of each year must b 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 /> CERTIFICATION <br /> We, the DO.A.RI.7 OF ORAN « COUNTY C01,ZilSSIOMRS <br /> County Commissioners, Board of Trustees, etc. WJ <br /> in our capacity as he goveming body of the IEST_ORANGE —Fire Depart- <br /> ment, certify that wr have examined and find that attached roster is a true and accurate list of <br /> all active firemen*�f the 'CST OR N <br /> Fire Department, <br /> City of �' D County of,____QRAUGFj__. _ <br /> North Carolina. We further certify that the firemen listed on the roster have completed at least <br /> 36 hours of meetinis and drills during the previous year. <br /> „SIGNED;_ <br /> TITLE: Chairman Board of Commissioners <br /> DA'Z'E: July 24, 1978 <br /> ROSTER MUST BE ATTACHED VVITH NAMES IN ALPHABETICAL ORDER. <br /> * Firemen on authorized "Leave of Absence" are to be included on the roster. <br />