Fill and Sign the Complete If Applicable the Undersigned is the Present Holder of the above Referenced Form

- 1 - Prepared by and after Recording Return to: Name: Firm/Company: Address: Address 2: City, State, Zip: Phone: Assessor’s Property Tax Parcel/Account Number:      ) )))))))))--------Above This Line Reserved For Official Use Only------------- PARTIAL RELEASE FROM MORTGAGE KNOW ALL MEN BY THESE PRESENTS that _______________________, do(es) hereby release from that certain mortgage dated _______________________, executed by _______________________, Mortgagor(s), to _______________________, “Mortgagee”, and recorded in Book __________, page ___________, Document/Instrument No. _____________, in the Office of the Town Clerk of the Town of _______________, Vermont, on [date] ______________, the following described real property: {Describe Property or Attach description and State "SEE ATTACHED EXHIBIT" This is a partial release and the above identified mortgage remains in full forc e and effect as to the remaining property. The undersigned is the present holder of the above described Mortgage. [Complete if applicable: The undersigned is the present holder of the above referenced mortgage, by assignment dated _____________ and recorded in Book __________, page ___________, Document/Instrument No. _____________, in the Office of the aforesaid recorder.] IN WITNESS WHEREOF, this instrument was executed, signed and delivered by the undersigned on this the ____ day of __________________, 20___. - 2 - __________________________________ {Type Name] Signed, Sealed and Delivered in the presence of: __________________________________ Witness __________________________________ Notary STATE OF __________________ COUNTY OF __________________ On this _______ day of __________________, ______________, before me personally appeared __________________________________ (name of person acknowledging) to me known to be the person who executed the foregoing instrument, and ________ he/she/they thereupon duly acknowledged to me that ________ he/she/they executed the same to be ________ his/her/their free act and deed. ______________________________ Notary Public Print Name: __________________ My commission expires:__________________ Mortgagee Name, Address, phone: Current property Owner(s) Name, Address, phone: