STATE OF NORTH CAROLINA IN THE GENERAL COURT OF JUSTICE
DISTRICT COURT DIVISION
__________ COUNTY
______________________,
Plaintiff
v.
______________________,
Defendant(s).
I,__________________ , am the custodian of the records of the and do certify that the attached records of [FILL IN] are true, accurate, correct and complete copied and that they are kept in the regular course of our day to day employment. The records are a complete set of the records that we have in our office regarding the [FILL IN TYPE OF RECORDS] of [FILL IN]. I am more than 18 years old and otherwise competent.
This the ____day of __________, 20_____.
_________________________
Sworn to and subscribed before me,
this ________ day of ____________, 20____.
__________________________________ ______________________________
Notary Public (Printed Name) Notary Public (Signature)
My Commission Expires: _____________