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BEFORE ME, a Notary Public, personally came and appeared
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_________________________________________________ |
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who declared that: |
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1. |
Appearer was was the owner and holder of a certain promissory note signed by
_______________________________________________________ payable to the order of _________________________________________ dated ________________________________, in the principal sum of _________________________, paraphed “Ne Varietur” for identification with an act of Mortgage recorded in Mortgage Book ___________, Page _______, records of Bienville Parish, Louisiana, affecting the following described property, to-wit:
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2. |
Affiant was the last holder and owner of the promissory note. |
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The note has been lost or destroyed and cannot be presented for cancellation of the mortgage. |
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The note has been paid and satisfied in full by the maker. |
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5. |
Affiant authorizes the Clerk of Court and Ex-Officio Recorder of Mortgages for Bienville Parish to cancel the mortgage |
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Affiant has not sold, transferred or assigned the note to any other person or entity, and |
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Affiant agrees to indemnify any person or entity, including the Clerk of Court and Ex-Officio Recorder of Mortgages, for any damages resulting to such person or entity as a consequence of canceling the mortgage. |
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Affiant makes this affidavit in compliance with Louisiana R.S. 9:5168 for purposes of obtaining cancellation of the aforedescribed mortgage without production of the note, and authorizes substitution of this affidavit for the original note in conjunction with Louisiana R.S. 9:5167.
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THUS DONE AND SIGNED at Arcadia, Louisiana, this _________ day of ____________________, _________.
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WITNESSES: |
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| ____________________________ |
____________________________ |
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AFFIANT |
| ____________________________ |
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___________________________________________ |
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NOTARY PUBLIC |
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