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The declaration statement confirms that the documentation on file with the North Carolina Department of Health and Human Services is current and accurate. It includes an acknowledgment of perjury penalties in North Carolina under N.C. Gen. 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I understand that the penalty for perjury is a Class F Felony in North Carolina pursuant to N.C. Gen. Stat. § 14-209 , and that other state laws, including N.C. Gen. Stat. § 143C-10-1, and federal laws may also apply for making perjured and/or false statements or misrepresentations.  \nI declare under penalty of perjury that the foregoing is true and correct. Executed on this the   day of   , 20   \n(Day of Month) (Month) (Year)  \n(Signature)","cbCaidyeFj90IKB0","https://ap.wps.com/l/cbCaidyeFj90IKB0","pdf",35724,"English","# Declaration\n## Organization status and documentation\n## Penalty for perjury and applicable laws\n## Execution date and signature","[{\"question\":\"What does the IRS Tax Exemption Verification Form (Annual) certify?\",\"answer\":\"It certifies that the organization’s 501(c)(3) status continues to be designated under the U.S. Internal Revenue Code and that the related documentation on file with the North Carolina Department of Health and Human Services is current and accurate.\"},{\"question\":\"What penalty acknowledgment does the form include?\",\"answer\":\"The form acknowledges that the penalty for perjury is a Class F Felony in North Carolina under N.C. Gen. 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