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Docusign Envelope ID:A24A576E-CC4E-4A07-BA5B-5968721C4755 <br /> Propio LS, LLC <br /> 10801 Mastin St. <br /> Suite 580 <br /> Overland Park, KS 66210 <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 /> r <br /> 1, being duly sworn, say that I am (� /iS� �ui �s« and that the <br /> foregoing certification is true, accurate and complete to the best of my knowledge and <br /> was made and subscribed by me. I also acknowledge and understand that any misuse of <br /> State funds will be reported to the appropriate authorities for further action. <br /> Ez -1 <br /> 9V ✓ ' <br /> Signature <br /> Sworn to and subscribed before me on the 1 day of , 2025. <br /> My Commission Expires: <br /> of gnature and Seal) <br /> 4+"EO SARAH SNOW <br /> MyAppointme t-•- n Expires <br /> rLMX 2917 0 z g <br />