Orange County NC Website
Browse       Search
June 27, 2011 <br />Lu Lu <br />1105 W. Hwy 54 Bypass, Apt L6 <br />Chapel Hill, NC 27516-2845 <br />To: Orange County Department of Social Services <br />Certification: <br />I certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at <br />the federal, State, or local level. I further understand that any person who makes a false <br />statement in violation of N.C.G.S. 143-6.2(b2) is guilty of a criminal offense punishable <br />as provided by N.C.G.S. 143-34(b). <br />Sworn Statement: <br />I, being duly sworn, say that I am Lu Lu; and that the foregoing certification is true, <br />accurate and complete to the best of my knowledge and was made and subscribed by me. <br />I also acknowledge and understand that any misuse of State funds will be reported to the <br />appropriate authorities for further action. <br />Sig~ture <br />Sworn to and subscribed before me on the a7~ day of ~ cam- , 2011. <br />L <br />otary Signature and Se 1) <br />My Commission Expires: '(J ~ U ~ ~ a o~5 <br /> <br />°~ %, <br />. <br />~ <br /> :, <br /> ~.~ <br />~.. <br />6 AQ3hl ~ F it ~ . ~ <br />tle~T. _..+ <br />