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68 <br /> B. Non-profit agencies only:Verification of 501(c)(3)Status Form <br /> IRS Tax Exemption Verification Form (Annual) <br /> f,Joyce Harper hereby state that I am Chief Executive Officer of <br /> (Printed Name) (Title) <br /> Freedom House Recovery Center("Organization"),and by that authority duly <br /> (Legal Name of Organization) <br /> given and as the act and deed of the Organization,state that the Organization's status continues <br /> to be designated as 501(c)(3) pursuant to U.S. Internal Revenue Code,and the documentation on <br /> file with the North Carolina Department of Health and Human Services is current and accurate. <br /> I understand that the penalty for perjury is a Class F Felony in North Carolina pursuant to N.C. <br /> Gen.Stat.§ 14-209, and that other state laws,including N.C.Gen.Stat.§143C-10-1,and federal <br /> laws may also apply for making perjured and/or false statements or misrepresentations. <br /> I declare under penalty of perjury that the foregoing is true and correct. Executed on this the <br /> 16 day of February __—,--2_0_26­_'_' <br /> (Signat e) <br /> 2 <br />