__________________ County, North Carolina
Signed and sworn to before me this day by (name of principal).
Date: ________________ Official Signature of Notary
Notary's printed or typed name, Notary Public
(Official Seal) My commission expires: _____________
-OR-
__________________ County, North Carolina
Sworn to and subscribed before me this day by (name of principal).
Date: ________________ Official Signature of Notary
Notary's printed or typed name, Notary Public
(Official Seal) My commission expires: _____________
N.C. Gen. Stat. § 10B-43