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DocuSign Envelope ID:9A043OD9-7ACC-4C25-8C5E-7A2CO072060E <br /> Attachment E <br /> Caterina Phillips <br /> 1403 Woodburn Road <br /> Durham,NC 27705 <br /> To: Orange County Department of Social Services <br /> Certifieation: <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.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 /> I, being duly sworn, say that I am Caterina Phillips; 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 fu -s will be reported to <br /> the appropriate authorities for further action.. <br /> Signature <br /> Sworn to and subscribed before me on the day of ,2015. <br /> My Commission Expires: ✓ <br /> ataxy Sieature and Seal) <br /> CRYSTAL BELLE COBLE <br /> NOTARY PUBLIC <br /> ORANGE COUNTY <br /> NORTH CAROLINA <br />