A, mortgage in [or assignee of] that certain mortgage hereinafter described, does hereby certify that said mortgage, dated the _____________ day of ____________, 20_____,
executed by _____________ to ______________, and recorded in the office of the Register of Deeds of ___________ County, Kansas, in book _______ at page _______, is, as to the property herein described, to wit: ______________, released and discharged. This release is given on the express terms and condition that it shall in no way affect the lien of the above mentioned mortgage on the remaining land described in said mortgage, but shall only be construed as a release from the lien of said mortgage of the land herein described.
Dated this __________ day of ________________, 20____________.
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