§ 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, ____________________________, a ______________________________________
(Name of officer taking proof) (Official title of officer taking proof)
of ___________________ COUNTY, _______________________________, certify that
(Name of state)
____________________________________ personally appeared before me this day, and
(Name of person familiar with
handwriting of subscribing witness)
being duly sworn, stated that he knows the handwriting of ________________________,
(Name of subscribing witness)
and that the signature of __________________________ as a subscribing witness to the
(Name of subscribing witness)
foregoing instrument is the signature of _______________________________________
(Name of subscribing witness)
WITNESS my hand and official seal, this the ____ day of ______________, ________
(Month) (Year)
(Signature of officer taking proof)
(Official title of officer taking proof)
My commission expires _________________________________________________
(Date of expiration of officer's commission)