N.C. Gen. Stat. § 40A-27

To the Clerk of the Superior Court of ____________: We, ____________, commissioners appointed by the court to assess the damages that have been and will be sustained by ________, the owner of certain property lying in the county of ____________, which ________ the condemnor proposes to condemn for its use, do hereby certify that we met on ________ (or the day to which we were regularly adjourned), and, having first been duly sworn, we visited the premises of the owner, and after taking into full consideration the quality and quantity of the property aforesaid, and all other inconveniences likely to result to the owner, we have estimated and do assess the compensation aforesaid at the sum of $ ________. Given under our hands, the ________ day of ____________, A.D. ________.