The Surveyor's Notary Acknowledgement Must be Exactly in This Form:

North Carolina,....................County

I, a Notary Public of the County and State aforesaid, certify that......................................., a registered land surveyor personally appeared before me this day and acknowledged the execution of the foregoing instrument. Witness my hand and official stamp or seal, this ............. day of
................................., 20........

Seal or Stamp

Notary Public My Commission Expires:.............