State of South Carolina, County of ___________ : John Doe to Richard Roe. Mortgage dated _______, 20_______ ; recorded _________ ; For valuable consideration I,
_____________, the sole owner and holder of the above described mortgage, do hereby release and forever discharge from the lien of said mortgage the following described property, to wit: [description of property to be released], said mortgage to remain in full force and effect as to the remaining portion of the property therein described.
Witness my hand and seal this _______ day of ________, 20______.
Signed, sealed and delivered in the presence of:
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