Orange County NC Website
DocuSign Envelope ID: 70B14FB4 -AE32- 4116- 89EE- 5DA48DF2569C <br />Exhibit E <br />Chapel Hill Institute of Cultural and Language Education, L.L.C. (CHICLE) <br />109 Canner 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 ofN.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 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 appropriate authorities for further action. <br />Signature <br />Sworn to and subscribed before me on the day of 2018 <br />oil, .%LYN <br />rr a s <br />i <br />otary Sign re and!3eal) <br />GBUG .� <br />C <br />My Commission Expires: 2,7 <br />L-- <br />