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Contract 468-2020 <br /> Premier Home Health Care Services, Inc. <br /> REMIRRATTACHMENT E <br /> home health care services,inc. <br /> OVERDUE TAXES <br /> Orange County Department of Social Services and Orange County Department on Aging <br /> Instructions: Grantee/Provider should complete this certification for all funds received. Entity <br /> should enter appropriate data in the yellow highlighted areas. The completed and signed form <br /> must be provided to the County Department of Social Services. <br /> June 17,2015 <br /> To: Orange County Department of Social Services <br /> Certification: <br /> We certify that Premier Home Health Care Services does not have any overdue tax debts, as <br /> defined by N.C.G.S. 105-243.1 1, at the federal, State, or local level. We further understand that <br /> any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c) is guilty of a <br /> criminal offense punishable as provided by N.C.G.S. 143C-10-1(b). <br /> Sworn Statement: <br /> Arthur Schwabe and Joseph V. Bavaro being duly sworn, say that we are the Board Chair and <br /> Chief Financial Officer,respectively, of Premier Home Health Care Services, Inc. of White <br /> Plains in the State of New York; and that the foregoing certification is true, accurate and <br /> complete to the best of our knowledge and was made and subscribed by us. We also _ <br /> acknowledge and understand that any misuse of State funds will be reported to the appropriate <br /> authorities fo further action. / <br /> Gam.. <br /> Bo Chair / <br /> CW Fiu ancial Officer <br /> Sworn to and subscribed before me on the day of the date of said certification. <br /> - MyA KTf�sl!.UUSbtRG "� �1, 261 <br /> (Notary Si ature and Seal)') PUBLIC STATE OF NEW YORK <br /> NO. 01L06043539 <br /> QUALIFIED IN DUTCHESS COUNTY <br /> COMMISSION EXPIRES JUNE 19,20 <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 <br /> notice of final assessment was mailed to the taxpayer.The term does not include a tax debt,however, if the taxpayer <br /> entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final <br /> assessment was mailed and has not failed to make any payments due under the installment agreement." <br /> Overdue Taxes—(07/08) Page 1 of 1 <br /> 445 Hamilton Avenue, 10th Floor,White Plains, New York 10601 Phone 914-428-7722 Fax 914-428-2404 <br />