FOR LOST, MISPLACED, OR DESTROYED PROMISSORY NOTE
PER TITLE 45-721 (C)(1):
"KNOW ALL BY THESE PRESENTS:
"THAT I, the undersigned, hereby certify under penalties of perjury that:
"1. I was the last known holder of a certain promissory note (or the trustees named in the original deed of trust or substitute trustees appointed by an instrument of substitution recorded in the land records):
"2. Despite diligent search, I have been unable to locate the original promissory note which has been lost, misplaced or destroyed, (if the holder add: and neither the promissory note nor any interest therein has been transferred, assigned or negotiated to any other person);
"3. The promissory note has been fully paid and satisfied; and
"4. The deed of trust dated _________ securing said promissory note granted
by ________________ in favor of ____________________ securing _______________
and recorded in the land records on __________ in Liber _______ at Folio __________
at Instrument No. _________ and constituting a lien upon that piece or parcel of land located in the District of Columbia and known as:
"LOT _________ in SQUARE _________ (additional legal description, ex.
subdivision) as per plat recorded in Liber ________ at Folio _______ among the land
records is hereby RELEASED.
"WITNESS the hand and seal of the undersigned ______________________________
this _______ day of ____________, ____.
"STATE/DISTRICT of _______________)
"COUNTY of __________________)
"I the undersigned, a Notary Public in and for the aforesaid do hereby certify that
____________________ party to and who is personally well known to me as the person
who executed the foregoing Release Affidavit dated the ______ day of _________, ___, personally appeared before me in said jurisdiction and acknowledged the same to be his/her/its act and deed.
Given under my hand and seal, this _____ day of ___________, ____, and:
"My commission expires: _________________________
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