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STATE OF NORTH CAROLINA DEPARTMENT OF STATE AUDITOR FIREMEN'S AND RESCUE SQUAD WORKER'S PENSIOH FUND DiViSiON ANNUAL CERTIFICATION OF FIREb~N General Statutes, Chapter 118-23, requires that all certified fire departments certify annually to the N. C. Firemen's Pension Fund a complete roster of its qualified firemen. The following certification along with a complete roster of all active firemen* as of i June 30 of each year must be submitted to the N. C. Firemen's Pension Fund, 116 W. Jones St., Raleigh, N. C. on or ~efore Oul~_3l. Failure to submit this certification a!on~ with a complete roster will result in the 1~-~ t~-~a death benefit provided bY the State. CERTIFICATION We, the Cabarrus County Board of Commissioners in our capacity as the governing (~overning Body) bddy of the Kannapolis Villaf~ Fire Department, certity that we have examined and find that attached ~{~ a true and accurate list of al! active firemen* of the Kannapolis Village Fire Department, address 113 S.E. Ave. County of Cabarrus , North Carolina. Kannaoolis Signed Title Date For Fire Department Chief Onl~ Robert P. Foil , Chief of the Kannapolis Village Fire Department, certify the attached roster is a true and accurate list of all eligible fire- men. (Eligible firemen are firemen who have met the required 36 hours of meetings and ~ drills during the last calendar year (July 1 - June 30). In addition, the term "eligible firemen" shall mean those firemen who have joined the fire department within the calend~r year and are in the process of completing the required 36 hou~ of meetings and drills.) June 6~ 1983 Date ROSTER MUST BE ATTACHED WITH NAb'ES IN ALPHABETICAL ORDER. *Firemen on authorized "Leave of Absence" are to be included on the roster. ~]enever a new fireman is added to the roster during the year, his or her pmme should be fon~ard to the Pension Fund Office i~n~ediatel~