Affidavit Of Lost Paraphed Promissory Note & Authorization To Cancel Mortgage (By Notary Public) Form
Download a blank fillable Affidavit Of Lost Paraphed Promissory Note & Authorization To Cancel Mortgage (By Notary Public) Form in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Affidavit Of Lost Paraphed Promissory Note & Authorization To Cancel Mortgage (By Notary Public) Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1AFFIDAVIT OF LOST PARAPHED PROMISSORY NOTE &
AUTHORIZATION TO CANCEL MORTGAGE (BY NOTARY PUBLIC)
(Pursuant to La. R.S. 9:5167(a))
State of _____________________________
Parish/County of ______________________
BE IT KNOWN THAT on this _______ day of _____________________, 20____, before me,
the undersigned Notary Public, appeared: ________________________________________________,
a duly licensed Notary Public, who, after being duly sworn, did depose and say that he or
someone under his direction did satisfy the paraphed promissory note described below and:
1)
Received the note marked “Paid in Full” from the last holder of the note;
and that the note was lost or destroyed while in the affiant’s custody; or
2)
Has confirmed that the last holder of the paraphed note received payment
in full and sent the note and the note was never received.
The Clerk of Court and Ex-Officio Recorder of Mortgages for the Parish identified below is
hereby expressly requested, authorized, and directed to cancel the recordation of the mortgage or
privilege described as follows:
Description of the paraphed promissory note, inscription to be cancelled, and the property:
Granted by: ______________________________________________________________;
In favor of: ________________________________________________________________;
Amount of Note: $______________________; Date of note: _______________________;
Parish of Recordation: _____________________________________;
Recording data: MOB _______ folio _______, Instrument No.: ___________________.
Legal description of subject property:
________________________________________________________________________________
The affiant agrees to be personally liable to and indemnify the recorder of mortgages
and any person relying upon the cancellation by affidavit for any damages that they may
suffer as a consequence of such reliance if the recorded affidavit contains materially false or
incorrect statements that cause the recorder to incorrectly cancel the recordation of a mortgage
or privilege.
The affiant has made a due and diligent search for the note, the note cannot be located,
and 60 days have elapsed since payment or satisfaction of the note.
Signature: ____________________________________
Printed Name: ____________________________________
Notary or Bar Roll Number: ___________ Commission expires: ___________________
Mailing Address: _____________________________________________
City: ____________________________ State: ________ ZIP: _____________
e-Mail Address: ________________________________________________________
______________________________________________
Notary Public
Printed Name: ________________________________
Notary or Bar Roll Number: ___________ Commission expires: ___________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Affidavit Of Lost Paraphed Promissory Note Or Release Instrument & Request For Cancellation Of Mortgage Or Privilege And Release (by Licensed Title Insurance Company)
Legal
Release By Obligee Of Record Of A Mortgage Or Vendor's Privilege (paraphed Promissory Note - Pursuant To La. R.s. 9:5168) Form
Legal
Form 4676 - Affidavit Of Lost/destroyed/stolen License/ Affidavit To Confirm Identification
Financial
Related Categories
Parent category: Legal