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DocuSign Envelope ID:CD6526B8-31F8-4494-98D6-FFE6244E4DOF <br /> Attachment F <br /> Deborah Leisey <br /> 60 Surnmexsweet Lane <br /> Chapel Hill, NC 27516 <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 finther understand that any person who makes a false <br /> statement in violation of N..0 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 /> 1, being duly sworn, say that I am Deborah Leisey; 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 furthe ction. <br /> Signature <br /> Sworn to and subscribed before me on the_/,S­4k - day of , fc , 2015 <br /> My Commission Expires: OS 4/o <br /> ary Signature eal) <br /> CARS. JANE'Y <br /> ,} NOTARY PUBLIC <br /> COMMONWEALTH OF MASSAC#USETIS <br /> MY COMMISSION EXPIRES <br /> MAY 25, 2018 <br />