§ 47-43.3. Officer's certificate upon proof of instrument by proof of signature of maker.
When 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:
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,
(Name of person familiar with
maker's handwriting)
and being duly sworn, stated that he knows the handwriting of______________________
(Name of maker)
and that the signature to the foregoing instrument is the signature of _________________
(Name of maker)
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)