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DocuSign Envelope ID:06AAB631-0851-4E11-9258-5EEFE2C2D429 <br /> Exhibit E <br /> Thein Tun Zan <br /> 114 Phoenix Dr. <br /> Chapel Hill,NC 27216 <br /> T o: 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.0 G.S 143-34(b) <br /> Sworn Statement: <br /> I, being duly sworn, say that I am Thein Tun Zan; 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 /> ter,,. •�� <br /> Signature <br /> Sworn to and subscribed before me on the day ofdlf , 2015 <br /> My Commission Expires: 'r!�j <br /> otary Signat ure and Seal) <br /> CRYSTAL BELLS COBLE <br /> NOTARY PUBLIC <br /> ORANGE COUNTY <br /> NORTH CAROLINA <br />