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State Grant Certification – No Overdue Tax Debts <br /> <br />Page 1 of 2 <br />MS&NCD Form 0008 <br />Eff. July 1, 2005 <br />Revised July 18, 2006, 7/07, 8/09, 9/11 <br />All Ways Caring HomeCare <br /> <br /> <br />5/17/2023 <br /> <br />To: State Agency Head and Chief Fiscal Officer <br /> <br /> <br />Certification: <br /> <br />We certify that CNC / Access, Inc dba All Ways Caring HomeCare does not have any overdue tax <br />debts, as defined by N.C.G.S. 105-243.1, at the federal, State, or local level. We further understand <br />that any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c) is guilty of a <br />criminal offense punishable as provided by N.C.G.S.) 143C-10-1b. <br /> <br />Sworn Statement: <br /> <br />Sherry Pemberton and Timothy Lloyd being duly sworn, say that we are the Board Chair and National <br />Contracts Director, respectively, of CNC / Access, Inc of Durham in the State of North Carolina; and <br />that the foregoing certification is true, accurate and complete to the best of our knowledge and was <br />made and subscribed by us. We also acknowledge and understand that any misuse of State funds <br />will be reported to the appropriate authorities for further action. <br /> <br /> <br />______________________________ <br />Board Chair <br /> <br />______________________________ <br />National Contracts Director <br /> <br />Sworn to and subscribed before me on the day of the date of said certification. <br /> <br /> <br />_______________________________ My Commission Expires: __________ <br />(Notary Signature and Seal) <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />If there are any questions, please contact the state agency that provided your grant. If needed, you may contact the North <br />Carolina Office of State Budget and Management: <br /> NCGrants@osbm.nc.gov-(919)807-4795 <br /> <br />____________________ <br />1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after <br />the notice of final assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the <br />taxpayer entered into an installment agreement for the tax debt under G.S. 105 -237 within 90 days after the <br />notice of final assessment was mailed and has not failed to make any payments due under the installment <br />agreement.” <br />7/29/2023 <br />DocuSign Envelope ID: 05AE0BF1-7F33-40F9-942A-74F6CD86FEE3