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Attachment E <br /> Benjamin Beaton <br /> 107 James Helen Ct. <br /> Willow Spring, NC 27592 <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 Benjamin Beaton; and that the foregoing certification is <br /> true, accurate and complete to the best of my knowledge and was made and subscribed by <br /> me. I also acknowledge and understand that any misuse of State funds will be reported to <br /> the appropriate authorities for further action. <br /> Signatur <br /> Sworn to and subscribed before me on the 26'-!�Lday of JUpp , 2014. <br /> My Commission Expires: A `� 2 2C7f8' <br /> (Notary'Signature and Seal) � <br /> 1.�``0%-ACK <br /> 4; <br /> PUB <br /> i��i yqM <br /> Ni <br /> ��'�~��` <br />