WA Indemnification of Lost Deed of Trust and Original Note and Request for Full Reconveyance 1

Stewart Title Guaranty Company

INDEMNIFICATION OF LOST DEED OF TRUST AND ORIGINAL NOTE

AND

REQUEST FOR FULL RECONVEYANCE

Dated: ____________________________

That certain note dated ___________________________________, in the principal

sum of: ________________________________________________,

executed by: ________________________________________________________,

in favor of: __________________________________________________________,

has been lost, misplaced, or destroyed.

That said note is the note secured by that certain Deed of Trust dated:____________________between ______________________________

as Grantor, Stewart Title Guaranty Company (the Company) as Trustee and

________________________________________________________________, as

Beneficiary, recorded _________________________under Recording Number: ________________________ records of ____________________________County, Washington, which Deed of Trust has also been lost, misplaced or destroyed.

That in consideration of the issuance by the Company of its reconveyance of said Deed of Trust without the surrender to it of the aforementioned note and Deed of Trust for cancellation and retention, the beneficiary hereby agrees to hold the Company free and clear of all liability and responsibility of any loss, damage and expense that may arise or that the Company may suffer by reason of issuance of such reconveyance without having possession of the original note and Deed of Trust.

The undersigned beneficiary is the legal owner of the note and all other indebtedness secured by the above-described Deed of Trust. Said note, together with all indebtedness secured by the Deed of Trust has been fully paid and satisfied, and you are hereby requested and directed, on payment to you of any sums owing to you to reconvey, without warranty to the parties entitled thereto, all the estate held by you hereunder.

__________________________________________________________________

Beneficiary Beneficiary

ALL SIGNATURES MUST BE NOTARIZED

The execution of this form is no assurance that the trustee will act. The decision to act is reserved for the approval of management.

STATE OF WASHINGTON)

ss.

COUNTY OF _________________ )

On this _____________ day of ___________________, _______ before me, the undersigned, a notary public in and for the State of Washington, duly commissioned and sworn, personally appeared ________________________________________ known to me to be the individual(s) described in and who executed the within instrument and acknowledged that _______ signed and sealed the same as _______ free and voluntary act and deed, for the uses and purposes herein mentioned.

______________________________

Notary Public

Printed Name: _________________

My appointment expires: _________

Individual Capacity

STATE OF WASHINGTON)

ss.

COUNTY OF _______________ )

On this _____________ day of ___________________, _______ before me, the undersigned, a notary public in and for the State of Washington, duly commissioned and sworn, personally appeared ________________________________________ known to me to be the individual(s) described in and who executed the within instrument and acknowledged that _______ signed and sealed the same as _______ free and voluntary act and deed, for the uses and purposes herein mentioned.

______________________________

Notary Public

Printed Name: _________________

My appointment expires: _________

Individual Capacity

STATE OF WASHINGTON)

ss.

COUNTY OF _________________ )

I certify that I know or have satisfactory evidence that _____________________________ is the person who appeared before me, and said person acknowledged that _____ signed this instrument, on oath stated that _____ was authorized to execute the instrument and acknowledged it as _______________________ of ___________________________________________ to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument.

Dated: _________________________

______________________________

Notary Public

Printed Name: _________________

My appointment expires: _________

Representative Capacity

No guidelines are available for this form at this time.