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Form SC-04 ELK RIVER / Page la <br /> <br />Relief Association [Elk River Fire Relief Association I County [Sherburne I <br /> benefit level in effect for 2004 ] 4,000 [ <br /> Annual <br /> (If you change your benefit level before 12/31/04, the SC must be recalculated at the new level.) <br /> <br />Active Member Information - continued <br /> <br /> Fire Dept. Leaves To end of 2004 To end of 2005 <br /> Date of Age Entry of Years Years <br /> <br /> Birth on Date Absence Of Accrued of Accrued <br /> Name mm-dd-yy 12/31/04 mm-dd-yy (months) Service Liability Service Liability <br />26 3/8/2000 5 13,360 6 16,400 <br />27 3/8/2000 5 13,360 6 16,400 <br />28 3/8/2000 5 13,360 6 16,400 <br />29 8/31/2001 3 7,600 4 10,400 <br />30 9/9/2001 3 7,600 4 10,400 <br />31 112/28/2002 2 4,960 3 7,600 <br />32 12/28/2002 2 4,960 3 7,600 <br />33 12/29/2002 2 4,960 3 7,600 <br />34 3/1/2004 1 2,400 2 4,960 <br />35 3/1/2004 1 2,400 2 4,960 <br />36 3/1/2004 1 2,400 2 4,960 <br />37 ~ 3/1/2004 1 2,400 2 4,960 <br />38 3/1/2004 I 2,400 2 4,960 <br />39 3/1/2004 1 2,400 2 4,960 <br />40 <br />41 <br />42 <br />43 <br />44 <br />45 <br />46 <br />47 <br />48 <br />49 <br />50 <br />51 <br />52 <br />53 <br />54 <br />55 <br /> Subtotal of Page la Liability - Active Members Continued 84,560 122,560 <br /> <br /> <br />