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N. C. FIREMEN' S PENSION FUND <br /> DIVISIO T <br /> DEPARTMENT OF STATE AUDITOR <br /> 116 WEST JONES STREET <br /> RALEIGH, N. C. 27603 <br /> ANNUAL CERTIFICATION OF FIREMEN <br /> General Statutes, Chapter 118--23, requires that all certified fire departments certify annually <br /> to the North Carolina Firemen's Pension Fund a complete roster of its qualified Bremen. <br /> The following certification along with a complete roster of all active firemen* as of June 30 <br /> of each year mast be submitted to the North CaroLna Fir&men's Pension Fund, 116 W. Jones <br /> Street, Raleigh, No th Carolina on or before July 30th. Failure to submit this certification <br /> along,with a compl;e roster will result in the loss of the death benefit provided by the State. <br /> CERTIFICATION <br /> We, the Orange Coun-ty Board of Commissioziers <br /> County Commissioners, Board of Trustees, etc. <br /> in our capacity as a governing body of the_ lieW _Fire Depart- <br /> ment, certify that w have examined and find that attached roster is a true and accurate last of <br /> all active firemen* ;f the New Hope volunteer Fire Department, <br /> City of County of.. Oranae ��__� <br /> North Carolina. W� fu rther certify that the firemen listed on the roster have completed at least <br /> 36 hours of meetings and drills during the previous year. <br /> SIGNED: r <br /> TITLE: Chairman, Board of Commissioners <br /> DATE, July 24 , 3.978 <br /> ROSTER MUST BE A ACHED WITH NAMES IN ALPHABETICAL ORDER. <br /> Firemen on author zed "Leave of Absence" are to be included on the roster. <br />