Release By Obligee Of Record
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1RELEASE BY OBLIGEE OF RECORD
Pursuant to R.S. 9:5169 (Formerly R.S. 44:106)
STATE OF ___________________________
PARISH OF ___________________________
BE IT KNOWN that on this _____________ day of ____________________________, 20 _______, before me the undersigned
Notary, duly commissioned and qualified in and for the above named Parish and State,
PERSONALLY CAME AND APPEARED:
_____________________________________________________________________________________ represented herein by:
________________________________________________________________________________________________________
Title: _________________________________________________, its duly authorized representative, who after being duly
sworn declared:
(Please initial only ONE caption below)
(
) The above named appearer is the obligee of record of the obligation secured by the mortgage or privilege
described below.
(
) The above named appearer is the assignee of record of the obligation secured by the below described
mortgage or privilege. Said Assignment is duly recorded at:
MOB _______________
FOLIO _______________
ENTRY NUMBER ______________________
The said secured obligation has been paid or otherwise satisfied or extinguished and further the said mortgage or privilege is
hereby released.
The Recorder of Mortgages in and for the Parish of ___________________________________ is hereby requested, authorized
and directed to cancel the recordation of the mortgage or privilege described as follows:
Mortgage or Privilege granted by
_______________________________________________________________________
In favor of _____________________________________________________________________________________________
In the sum of $ _____________________________________
Dated __________________________________________
Mortgage Book No. __________________ Folio __________________ Entry Number _______________________________
Of the official records of _____________________________ Parish, Louisiana, which affects the following described property:
WITNESSES:
___________________________________
SIGNATURE
_________________________________
Printed Name _______________________
PRINTED NAME
_________________________________
COMPANY NAME
_________________________________
___________________________________
TITLE:
_________________________________
Printed Name _______________________
ADDRESS:
_________________________________
_________________________________
TELEPHONE NO.
_________________________________
Sworn to and subscribed before me this _______________ day of ______________________________, 20 ______
________________________________________
Notary Public
Printed Name: ____________________________
ID or Bar Roll Number: _____________________
Commission Expires: _______________________
5/2012
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