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6 <br /> Complete required fields below <br /> I certify that I have read and understand the terms of this Agreement with the North Carolina <br /> State Bureau of Investigation, Criminal Information and Identification Section, and I will uphold <br /> the Agreement. <br /> Orange County, North Carolina <br /> I certify that the following person(s) personally appeared before me this day, each <br /> acknowledging to me that he or she signed the foregoing document: <br /> BY: Travis Myren <br /> Printed Name of AGENCY Authorized Official Signature of AGENCY Authorized Official <br /> Date: <br /> Official Signature of Notary Public f <br /> i <br /> Notary's Typed or Printed Name <br /> i <br /> My Commission Expires <br /> i <br /> I <br /> (Seal) <br /> I <br /> i <br /> i <br /> I <br /> i, <br /> i <br /> i <br /> CS 1 OFFICIAL USE ONLY <br /> i <br /> This Access Agreement becomes effective on <br /> MONTH/DAY/YEAR <br /> i <br /> Approved by: <br /> i <br /> Denied by: <br /> i <br /> i <br />