Orange County NC Website
Browse       Search
DocuSign Envelope ID:62E994DC-D78F-4C76-A015-72824302185F <br /> Exhibit E <br /> Chapel Hill Institute of Cultural and Language Education, L.L.C. (CHICLE) <br /> 109 Conner Drive, Suite 2200 <br /> Chapel Hill,NC 27514 <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 /> It <br /> Sworn Statement: <br /> I, being duly sworn, say that I am the President of Chapel Hill Institute of Cultural and <br /> Language Education, L.L.C., in the State of North Carolina; and that the foregoing <br /> certification is true, accurate and complete to the best of my knowledge and was made <br /> and subscribed by me. I also acknowledge and understand that any misuse of State funds <br /> will be reported to the appropfate authorities for further action. <br /> Ii <br /> 1 • 1/ <br /> S'_n.ture <br /> Sworn to and subscribed before me on the ,I 'day of , 201 7. <br /> d � My Commission Expires: / °2 7"�0/fr <br /> (N. . y Signature and Seal) <br /> t NOTARY <br /> PUBLIC = <br /> v, <br /> 2- <br />