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Residential Emergency Repair Program <br /> Certification of Non-Filing of Federal Income Tax Return <br /> Name: <br /> Name: <br /> Address: <br /> STATE OF HAWAII ) <br /> SS: <br /> COUNTY OF HAWAII ) <br /> The undersigned hereby certify that the borrower(s), pursuant to the laws and regulations as <br /> established by the United States Internal Revenue Service (IRS), did not file a Federal Income Tax <br /> Return for the tax year , and that the borrower(s) understand that misrepresentation of <br /> information or failure to disclose information will constitute just cause for the County to call the loan <br /> immediately due and payable. <br /> BORROWER <br /> BORROWER <br /> Subscribed and sworn to before me <br /> this day of , 20 <br /> Notary Public, State of Hawaii <br /> My commission expires: <br />