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DocuSign Envelope ID:7AA1 DF54-A095-4AC1-8850-EOAFDAFDA435 <br /> rr <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 actin <br /> hh <br /> � � <br /> l., ( , )( LL <br /> Si nature <br /> / <br /> Sworn to and subscribed before me on the ® day of , 201 q. <br /> „, / r. ,,e,,,/,,i- <br /> My Commission Expires: / .9-, 10/67, 10/87 <br /> olit poi <br /> (Not.. :ignature and Seal) <br /> NOTARY :4” <br /> PUBLIC <br /> OF <br /> vSri///Y�C oo \`t <br />