North Carolina General Statutes Chapter 47. Probate and Registration § 47-43.4. Officer's certificate upon proof of instrument by proof of signature of subscribing witness

When the execution of an instrument is proved by proof of the signature of a subscribing witness as provided by G.S. 47-12.1, 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 person familiar with handwriting of subscribing witness) personally appeared before me this day, and being duly sworn, stated that he knows the handwriting of ․․․․․․․․․․, (Name of subscribing witness) and that the signature of ․․․․․․․․․․, (Name of subscribing witness) as a subscribing witness to the foregoing instrument is the signature of ․․․․․․․․․․ (Name of subscribing witness)

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

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