A person establishing an account under this section shall sign a statement containing language substantially similar to the following in a conspicuous manner:
"CREDIT UNION (or name of institution)
PERSONAL AGENCY ACCOUNT
G.S. 54-109.63
I understand that by establishing a personal agency account under the provisions of North Carolina General Statute 54-109.63 that the agent named in the account may:
I also understand that upon my death the money remaining in the account will be controlled by my will or inherited by my heirs.
_________________________"
The language may be on a signature card or in an explanation of the account that is set out in a separate document whose receipt is acknowledged by the person or persons establishing the account.
N.C. Gen. Stat. § 54-109.63