State of _______________________}
Parish[or county] of _____________}
Personally before me, the undersigned authority, a Notary Public in and for the Parish [or county] of ____________, State of ___________, there came and appeared
____________, of full age of majority and a resident of _____________, State of
_________, who exhibited to me, Notary, as fully paid, cancelled and acquitted, a promissory note drawn and subscribed by __________________ to the order of and endorsed by __________________, for the sum of ___________________ dollars, dated the ______________ day of ___________, 20_______, identified by ______________,
Notary, on the ______________ day of __________, 20________, with an Act of
_______________ passed before him on said date and secured by mortgage granted in said Act upon the property more fully described in said Act upon the property more fully described in said Act.
And the said appearer declared that the said described note having been fully paid, he does hereby, as the last holder thereof, grant a full release of the above recited mortgage which secured its payment, hereby authorizing and requesting the Recorder of Mortgages [or outside New Orleans, the Clerk of Court and Ex-Officio Recorder of Mortgages] for the Parish of __________, State of Louisiana, to cancel and erase entirely on his records the inscription of said mortgage as the same appears recorded in his office in Book
________, Folio _________.
Whereupon, I, the said Notary, have cancelled the signature and notarial paraph on the said note and have annexed said note to the margin hereof for future reference.
Thus done and passed at __________, State of __________, on the _______ day of _______ in the presence of __________ and _________, the undersigned competent witnesses, who have signed hereto with the said appearer and with me, Notary, after due reading of the whole.
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