This government document is issued by Commerce, Department for use in North Carolina
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https://www.google.com/url?client=internal-element-cse&cx=75d03469208f3471d&q=https://www.commerce.nc.gov/rural-development-divisiongrants-management-documents/rural/rural-grants/job-certification-form-04_07_17.doc&sa=U&ved=2ahUKEwjV6KvU5M-EAxVFGhAIHUgpCTg4ChAWegQIBxAB&usg=AOvVaw3Qw8u7flCWudfbdALf53Vu