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N, C. FIREMEN' S PENSION FUND <br /> DIVISION <br /> DEPARTMENT of STAVE AUDITOR <br /> 116 WEST BONES 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 firemen. <br /> The following cent fication along with a complete raster of all active firemen* as of June 30 <br /> of each year must te submitted to the North Carolina Firemen's Pension Fund, 116 W. Jones <br /> Street,Raleigh, N rth 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 BO OF O-Woll COUNTY 00111ta5STOlaS <br /> County Commissioners, Board of Trustees. etc. <br /> in our capacity as the governing body of the ETLAM VOLUN rat —Fire Depart- <br /> ment, certify that we have examined and find that attached roster is a true and accurate list of <br /> of the <br /> _ND VOLUIVDDa Fire Department, <br /> all active firemen <br /> City of—_ LD County of <br /> North Carolina. We further certify that the firemen listed on the roster have completed at least <br /> 36 hours of mee ings and drills during the previous year. <br /> SIGNED: <br /> TITLE: Chaimman Board of Commissioners <br /> DATE: !1 2 4,1. 1978 <br /> ROSTER MUST BE ATTACHED WITH NAMES IN ALPHABETICAL OROE;R. <br /> ' Firemen on au horixed "Leave of Absence" are to be included on the roster. <br />