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,I Right <br /> at <br /> Home- 105 W.Corbin St.,Suite 203 <br /> M Nonm Q,j vim Hillsborough,NC 27278 <br /> (919)241-5292 <br /> ATTACHMENT E <br /> OVERDUE TAXES <br /> Orange County Department of Social Services <br /> Conxact#68-2017 <br /> KAH Care,L.L.C.dba:tight at Home <br /> Date: July 8, 2014 <br /> To: Orange County Department of Social Services <br /> Certification: <br /> I certify that the KAH Care,LLC does not have any overdue tax debts,as defined by N.C.G.S. 105- <br /> 243.1', at 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. 143C-6-23(c)is guilty of a criminal offense punishabl.-as provided <br /> by N.C.G.S. 143C-10-1(b). <br /> Sworn Statement: <br /> Kenneth Helmuth being duly sworn says that he is the Board Chair of KAH Care,LLC of <br /> Hillsborough in the State of North Carolina; and that the foregoing certification is true,a4;curate and <br /> complete to the best of our knowledge and was made and subscribed by him. I also acknowledge and <br /> understand that any misuse of State funds will be reported to the appropriate authorities for further <br /> action. <br /> BoardMrr <br /> Sworn to and subscribed before me on the day of the date of said certification. <br /> My Commission Expires: <br /> (Notary Signature and Seal) <br /> 'G.S. 105-243.1 defines:Overdue tax debt.—Any part of a tax debt that remains unpaid 90 days or more after the notice of <br /> final assessment was mailed to the taxpayer.The term does not include a tax debt,however,if the taxpayer entered into an <br /> installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessmen:was mailed <br /> and has not failed to make any payments due under the installment agreement." <br /> Overdue Taxes—(07/08) Page 1 of 1 <br />