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1 <br /> DocuSign Envelope ID: r8378o58e2084Er4~^C81~^AC7048010eA <br /> oommun/ty.ompowormernjund <br /> 208 N.Columbia Street,Suite 100 • Chapel Hill, NC, 37514,9l9`ZOO'0l33 <br /> info@communityempowe,mentfund.or0 • www.communityempowermentfund.org <br /> July 27, 2016 <br /> To: Orange County Department of Social Services <br /> Certification: <br /> We certify that the Community Empowerment Fund does not have any overdue tax deb\a, as <br /> defined by N.C.G.S. 105-243.11. 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 /> Eric Breit and Jennifer Sherwin being duly sworn, say that we are the Board Chair and Board <br /> Tm*asuror, respectively, of Community Empowerment Fund of Chapel Hill in the State of NC; <br /> and that the foregoing certification is true, accurate and complete to the best of our knowledge <br /> and was made and subscribed by us. We also acknowledge and understand that any misuse of <br /> State funds will be reported to the appropriate authorities for further action. <br /> -. ‘-- A) <br /> B -^dChair <br /> ' ) '.' -~fir <br /> ^- -r -jo'e-- ~��� ' <br /> '*-pdTre.:urer <br /> Sworn to and subscribed before me on the day of the date of said certification. <br /> / <br /> ' / My Commission Expires: 5261� <br /> ( tary signature .°d6~~|) <br /> ' G.S, 105-2481 defines: Overdue tax debt.—Any part ofe <br /> �nohceoffino|auowoonentwaumoDedtothntaxpaye�Tho�rmdoesmtinduk# dnb . howawer. ifUhetaxpeyo/ <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 />