Orange County NC Website
DocuSign Envelope ID:7C9F4211-92EE-4B94-AB23-EB164751 C56C <br /> Exhibit E <br /> Zahra Brooks <br /> 1000 Discovery Way <br /> Apt. 1017 <br /> Durham,NC 27703 <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 Zahra Brooks; 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 /> 1 /11A !VI <br /> Signature <br /> Sworn to and subscribed before me on the day of., f 2016. <br /> "4 6/04 <br /> My Commission Expires: G <br /> (Votary Signature and eal) <br /> . .. .......... <br /> CRYSTAL BELLE COBLE <br /> NOTARY PUBLIC <br /> ORANGE COUNTY <br /> NORTH CAROLINA <br />