Fill and Sign the Act of Donation Louisiana Department of Wildlife and Form

REVOCATION OF ACT OF DONATION STATE OF LOUISIANA PARISH OF ______ BE IT KNOWN that on the ____ day of ______ 20 ___ , before me, the undersigned, a Notary Pu blic duly commissioned and qualified in and for the aforesaid Parish and State, and in the presence of the undersigned witnesses, personally came and appeared: ____________ , widow of ____________ , a person of the full age of majority and a resident of ______ Parish, Louisiana, whose mailing address is _____ _______ ; who declared that she does hereby revoke that certain mandate and Act of Donation granted by her to ____________ insofar and only insofar as the following described property is concerned: That certain parcel of land situated in the ______ Ward of ______ Parish, Louisiana, on the ______ side of ______ , measuring ______ feet front on ______ , by a depth of ______ feet, and being bounded North by ____________ ; South by ____________ ; East by ____________ ; and West by ____________ , and being designated as LOT ______ of Unit ______ , Block ______ of that certain plat of survey of the ______ Subdivision, recorded in Book ______ , Folio ______ , under Entry No. ______ , Conveyance Records of ______ Parish, Louisiana. Said Act of Donation was passed before ____________ , Notary Public, and dated and recorded the ___ day of ______ 20 ___ , in Conveyance Book ______ , Folio ______ , under Entry No. ______ of the records of ______ Parish, Louisiana. THUS DONE AND SIGNED on the date indicated above at ____________ , ______ Parish, Louisiana, in the presence of the undersigned Notary Public, qua lified in said State and Parish, and the undersigned competent witnesses, who have signed with the parties after due reading of the whole. WITNESSES: ____ __________________________ ______________________________ ____________ ______________________________ ______________________________ ____________ ___________________________ NOTARY PUBLIC