Orange County NC Website
Browse       Search
DocuSign Envelope ID:5FF56C04-3BB8-4567-932F-25B632A40E72 <br /> Exhibit E <br /> Silvia Lissette Saca <br /> 103 N. Crabtree Knoll <br /> Chapel Hill, NC 27514 <br /> To: Grange 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 fin-ther 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 Silvia Lissette Saca; and that the foregoing certification <br /> is true, accurate and complete to the best of my knowledge and was made and subscribed <br /> by me. 1 also acknowledge and understand that any misuse of State funds will be <br /> reported to the appropriate authorities for further action. <br /> e I <br /> Sworn to and subscribed before me on the _day of j OI6. <br /> I� <br /> My Commission Expires: <br /> (N8tary Signature and Seal) <br /> CRYSTAL BELLE COBLE � <br /> NOTARY PUBLIC <br /> ORANGE COUNTY <br /> NORTH CAROLINA <br /> a <br />