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PARISH OF BIENVILLE
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Before me, the undersigned authority, personally came and appeared
_______________________________________ who, being by me first duly
sworn, deposes and says:
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That there is recorded upon the Mortgage Records of Bienville Parish,
Louisiana, in Book _________ at Page __________ a certain
______________________________________ for $__________________________ in favor of _____________________________________
and against _____________________________________________.
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That said encumbrance has become unenforceable and has prescribed and preempted, and that
the effect thereof has ceased because of lapse of time;
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That he hereby requires the Clerk &
Ex-Officio Recorder of Mortgages of said Parish to cancel
said encumbrance in full;
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That affiant's interest in the property covered by said encumbrance is as follows:
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____________________________________
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Affiant
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Sworn to and subscribed before me this the ___________ day of
___________________, ________.
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_____________________________________________
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Deputy Clerk of Court & Ex-Officio Notary Public
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