North Carolina General Statutes
Article 3 - Forms of Acknowledgment, Probate and Order of Registration.
§ 47-43.4 - Officer's certificate upon proof of instrument by proof of signature of subscribing witness.

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:
(Name of state)
I, ____________________________, a ______________________________________
WITNESS my hand and official seal, this the ____ day of ______________, ________
My commission expires _________________________________________________
(1951, c. 379, s. 3; 1999-456, s. 59.)