Release By Obligee Of Record Of Mortgage, Lien, Or Privilege Form
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1RELEASE BY OBLIGEE OF RECORD OF
MORTGAGE, LIEN, OR PRIVILEGE
(Pursuant to La. R.S. 44:106)
State of _____________________________
Parish/County of _________________________
Before me the undersigned Notary, duly commissioned and qualified in and for the
above named Parish/County and State, and in the presence of competent witnesses,
personally came and appeared: ___________________________________________________
represented herein by___________________________________________________________,
title ________________________________________, its duly authorized representative, who,
after being first sworn declared:
The above named appearer was the obligee of record of the mortgage or privilege
described below, when the mortgage or privilege was paid, extinguished, or otherwise
satisfied.
The obligation secured by the mortgage or privilege is hereby released and the Clerk
of Court and Recorder of Mortgages for the Parish of Jefferson is hereby expressly
requested, authorized and directed to cancel the recordation of the mortgage or privilege
described as follows:
A
mortgage,
lien,
or
privilege
granted
by
or
filed
against:
_______________________________________________________________________________;
In favor of: _____________________________________________________________________;
In the sum of: $____________________; Instrument dated _____________________________;
Recorded in the official records of Jefferson Parish, Louisiana, as Instrument No.:
___________________________ in MOB ________ page _______.
***Attach property description for partial release ONLY. If no property description is provided,
this document is intended as a FULL release of the aforesaid inscription.***
Witnesses:
_________________________________
Signature: ________________________________
Printed Name:_____________________________
_________________________________
Company: _______________________________
Title: _________________________ (Its duly authorized agent)
Mailing Address: _____________________________________________
City: ________________________ State: ________ ZIP: ___________
Sworn to and subscribed before
me this _______ day of _________________, 20_____.
______________________________________________
Notary Public
Printed Name: ________________________________
Notary or Bar Number :_________
Commission expires: __________________________
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