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DocuSign Envelope ID: 3A41C8C3- 4643- 4E42- 9E22- 7ED4F266BDF8 <br />Exhibit E <br />Communication Services for the Deaf and Hard of Hearing <br />1175 Revolution Mill Dr., Studio 15 <br />Greensboro, NC 27405 <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 the Director of Comniunication Services for the Deaf <br />and Hard of Hearing, in the State of North Carolina; and that the foregoing certification is <br />tike, 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 appropi-Ae/Authorities for firrther action. <br />Signature <br />Sworn to and subscribed before me on the <br />(Notary Signai<rr and Seal) <br />qday of 1 , 201. <br />My Conunission Expires: 1 � - )' 'o <br />OFFICIAL SEAL, <br />Notary Public, North Carolina <br />COUNTY OF FORSYTH <br />•.�� NJIC EL E J NES <br />My Commission Expires t i.j <br />