Acknowledgment of instrument signed by one person: North Carolina ________________________ County I, _____________________________, a Notary Public for said County and State, do hereby certify that ____________________________ personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the ______ day of ______________, 20 ____. (Official Seal) Notary Public My commission expires _______________________, 20 ____. * If you ever had to write this out yourself – you would replace “foregoing instrument” with “attached in the blank with whatever the document was – (ie: attached medical record) ” you would fill page 26 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc. Acknowledgment of instrument signed by two or more persons: North Carolina ________________________ County I, _____________________________, a Notary Public for said County and State, do hereby certify that ____________________________ and ________________________ personally appeared before me this day and acknowledged the due execution of the foregoing instrument. Witness my hand and official seal, this the ______ day of ______________, 20 ____. (Official Seal) Notary Public My commission expires _______________________, 20 ____. * If you ever had to write this out yourself – you would replace “foregoing instrument” with “attached in the blank with whatever the document was – (ie: attached medical record) ” you would fill page 28 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc. Proof by subscribing witness: North Carolina ________________________ County I, _____________________________, a Notary Public of County, , certify that ____________________________, personally appeared before me this day, and being duly sworn, stated that in his presence ________________________ (signed) (acknowledged the execution of) the foregoing instrument. Witness my hand and official seal, this the ______ day of ______________, 20 ____. (Official Seal) Notary Public My commission expires _______________________, 20 ____. * If you ever had to write this out yourself – you would replace “foregoing instrument” with “attached in the blank with whatever the document was – (ie: attached medical record) ” you would fill page 32 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc. Proof by other person: signature of person who executed North Carolina ________________________ County I, _____________________________, a Notary Public of County, , certify that ____________________________, personally appeared before me this day, and being duly sworn, stated that he knows the handwriting of ________________________ and that the signature to the foregoing instrument is the signature of . Witness my hand and official seal, this the ______ day of ______________, 20 ____. (Official Seal) Notary Public My commission expires _______________________, 20 ____. page 34 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc. Acknowledgment by signing officer: North Carolina ________________________ County This ________ day of __________, 20____, personally came before me, ____________________, Notary Public for said County and State, _______________, who, being by me duly sworn, says that he is _______________ of the ____________________, a corporation, and that the seal affixed to the foregoing instrument in writing is the corporate seal of said company, and that said writing was signed and sealed by him in behalf of said corporation by its authority duly given. And the said ________________ acknowledged the said writing to be the act and deed of said corporation. Witness my hand and official seal, this the ______ day of ______________, 20 ____. (Official Seal) Notary Public My commission expires _______________________, 20 ____. page 48 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc. Jurat used for Affidavit if can person is willing to swear: Sworn to and subscribed before me this ________ day of _______________, 20 ____. (Official Seal) ________________________________ Notary Public My commission expires __________________, 20 ____. pages 93-97 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc. Jurat used for Affidavit if can person will not swear: Affirmed to and subscribed before me this ________ day of _______________, 20 ____. (Official Seal) ________________________________ Notary Public My commission expires __________________, 20____. pages 93-97 in Notary Public Guidebook for North Carolina 2001 © American LegalNet, Inc.