Know All Men by These Presents, that, ________, in consideration of the sum of
______________ dollars (receipt of which is hereby acknowledged), does hereby release, from the lien of that certain mortgage, dated the ____________ day of _______,
20________, executed by _________ to ___________ and recorded in the office of the
___________ of ____________ County, State of Oregon, in book of mortgages on page
________ that portion of the property covered by said mortgage and described as: [description of property].
In Witness Whereof ________ have hereunto set ___________ hand and seal the
_______ day of ____________, 20______.
Executed in the presence of :
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