N.D. Cent. Code § 31-15-05

An unsworn declaration under this chapter must be substantially in the following form: I declare, under penalty of perjury under the law of North Dakota, that the foregoing is true and correct. Signed on the _____ day of _______, _______ at ____________________, ___________ (month) (year) (city or other location, and state) (country) ________________________________ (printed name) ________________________________ (signature)