\nWhen the execution of an instrument is proved by proof of the signature of the maker as provided by G.S. 47-12.1 or as provided by G.S. 47-13, the certificate required by G.S. 47-13.1 shall be in substantially the following form:\nSTATE OF______________________________________________\n(Name of state)\n_________________________________________ COUNTY\nI, _______________________________, a __________________________________\n(Name of officer taking proof) (Official title of officer taking proof)\nof___________________ COUNTY, _______________________________, certify that\n(Name of state)\n_______________________________________ personally appeared before me this day,\n(Name of person familiar with\nmaker's handwriting)\nand being duly sworn, stated that he knows the handwriting of______________________\n(Name of maker)\nand that the signature to the foregoing instrument is the signature of _________________\n(Name of maker)\nWITNESS my hand and official seal, this the ____ day of _________________, ____\n(Month) (Year)\n(Signature of officer taking proof)\n(Official title of officer taking _____________\n(Name of maker)\nWITNESS my hand and official seal, this the ____ day of _________________, ____\n(Month) (Year)\n(Signature of officer taking proof)\n(Official title of officer taking proof)\nMy commission expires\n(Date of expiration of officer's commission)\n(1951, c. 379, s. 3; 1999-456, s. 59.)
North Carolina Legal Code