North Carolina General Statutes Chapter 47. Probate and Registration § 47-43.2. Officer's certificate upon proof of instrument by subscribing witness

When the execution of an instrument is proved by a subscribing witness as provided by G.S. 47-12, the certificate required by G.S. 47-13.1 shall be in substantially the following form:

STATE OF ․․․․․․․․․․ (Name of state)

․․․․․․․․․․ COUNTY

I, ․․․․․․․․․․, (Name of officer taking proof) a ․․․․․․․․․․ (Official title of officer taking proof) of ․․․․․․․․․․ COUNTY, ․․․․․․․․․․, (Name of state) certify that ․․․․․․․․․․ (Name of subscribing witness) personally appeared before me this day, and being duly sworn, stated that in his presence ․․․․․․․․․․ (Name of maker) (signed the foregoing instrument) (acknowledged the execution of the foregoing instrument.) (Strike out the words not applicable.)

WITNESS my hand and official seal, this the ․․․․․․․․․․ day of ․․․․․․․․․․, (Month) ․․․․․․․․․․ (Year)

My commission expires ․․․․․․․․․․ (Date of expiration of officer's commission)

Provided, however, that when instruments have been recorded upon proof of execution of the instrument by certificate of a judicial officer, showing that execution was proven by oath and examination of the subscribing witness, the date of such examination, and the signature of the officer taking the proof, such proof of execution shall be deemed sufficient on all instruments filed for registration prior to March 15, 1961.