Fill and Sign the Dation En Paiement Form

DATION EN PAIMENT _____________ TO _____________ BEFORE ME, the undersigned Notary Public, and in the presence of th e subscribing witnesses, personally came and appeared: _____________ , being of the full age of majority and a resident of _______ Parish, Louisiana, whose current mailing address is _____________ ; who declared and acknowledged to me, Notary, that A ppearer is indebted to _____________ on a mortgage obligation, namely: Collateral Mortgage by _____________ in favor of _____________, dated _______ __, 20 __, in the sum of $ _______, evidenced by one certain promissory note of a like amount, dated _______ __, 20__, and payable on demand, bearing ____% per annum interest from date until paid, and ____% on the aggregate amount of principal and interest as attorney's fees in case of suit for collection; said Collateral Mortgage recorded on _______ __, 20__, in Mortgage Book ____, Folio ____, under Entry No. ____ of the records of _____________ Parish, Louisiana. Appearer further declared and acknowledged to me , Notary, that she is indebted to _____________ on a Consumer Security Agreement, obligation, namely: Consumer Security Agreement by _____________ in favor of _____________, dated _______ __, 20__, for the sum of $_______ . _____________ acknowledges that on this date the total amount owed by her under the Collateral Mortgage loan and Consumer Security Agreement described above, is the total sum of _____________ and ____/l00 ($_______) Dollars. Wish ing to be released from the said indebtedness and t o reimburse the said _____________ for the indebtedness due and owing as hereinabove stated, and being unable to pay the amount represented by said notes, and availing itself of the provisions of Articles 2655 to 2659 inclusive of the Revised Civil Code of the State of Louisiana, _____________ does hereby make unto the said _____________ a dation en paiement by herein transferring, conveying, delivering, granting, assigning and setting ov er unto the said _____________, here present and accepting, all and singular, the following described property: (1) That certain tract or parcel of land situated in the Parish of _____________ , Louisiana, on the _______ side of _______, in Section _______, Township _______ ____ ___, Range _______, fronting on the _______ side of _______ _______ (_______ ') feet, with a depth between parallel lines of _______ (_______ ') feet on its East side, and _______ and _______ /l00 (_______ ) feet on its Western side, with a rear width of _______ (_______ ') feet, and being known and designated as Lot ____ on that certain plat of partition on Lot _______ of the Estate of _______ prepared by _______, Registered Land Surveyor, dated _______ __, 20__, a copy of which is attached to an Act of Sale recorded in Conveyance Book _______ , Folio _______, Entry No _______, _______ Parish, Louisiana. Being the same property acquired by _____________ from _____________ in that certain Act of Partition dated _______ __ , 20 __, and filed for record in Conveyance Book ____ , Folio _______, under Entry No. _______ of the Conveyance Records of _______ Parish, Louisiana, and ratified by Acts filed of record in Conveyance Book ____, Folio ____, and Conveyance Book ____ , Folio ____ of the Clerk's Records of _______ Parish, Louisiana. And being the same property acquired by _____________ from _____________ by Act of Sale recorded in Conveyance Book ____, Folio ____, Entry No. ____, _______ Parish, Louisiana. (2) A _____________, bearing VIN # _______ . This transfer includes all of the rights of _____________ in and to any insurance policies presently covering the above described property and in and to any escrow account or prepaid items arising out of or connected with the mortgage loan described above. TO HAVE AND TO HOLD said property as herein describ ed unto the said _____________ and assigns forever, with full and general warranty of title, free from any liens, mortgages or encumbrances whatsoever, an d with full subrogation to all the rights and actions of warranty which they have or m ay have against all preceding owners or vendors. This transfer and conveyance of said property by the said Appearer is made and accepted for and in consideration of the indebtedness aforesaid and is received by the said _____________ in full acquittance and discharge by the said _____________ and the said Appearer of the indebtedness represented by th e mortgage note hereinabove described. The said _____________ , through its undersigned representative, has in th e presence of the undersigned Notary and witnesses, marked the above described note paid, cancel led and acquitted, and declared that the said note has been paid in full, and _____________ , as the last holder of the said note, does hereby authorize and direct the Recorder of Mortgages of the Parish of _______, State of Louisiana, to cancel and erase entirely from his records the inscription of said mortgage. Appearer acknowledges and confirms that the debt by Appearer to _____________ is greater than the value of the immovable property transferred herein. THUS DONE AND SIGNED on _______ __, 20__, in the City of _____________, Parish of _______ , Louisiana, in the presence of the undersigned Notary Public, qualified in said State and Parish, and the undersigned competent witnesses, who have signed with the parties after due reading of the whole. WITNESSES: __________________________ ______________________________ _____________ ______________________________ __________________________ _____________ BY: __________________________ ___________________________ NOTARY PUBLIC STATE OF LOUISIANA PARISH OF _______ AFFIDAVIT BE IT KNOWN that on this ____ day of _______, 20____, before me, _____________________, a Notary Public duly commiss ioned and qualified in and for the Parish of _______, State of Louisiana, therein residing, and in the presence of the witnesses hereinafter named and undersigned: _____________ , being of the full age of majority and a resident of _______ Parish, Louisiana, whose current mailing address is _____________ ; who declared and acknowledged to me, Notary, that s he has owned the properties now being transferred to _____________ (hereinafter known as _____________) continuously for a period in excess of three (3) years, and her possession thereof has been peaceable and undisturbed, and title to said properties has never been disputed or questioned to her knowledge, nor does she know of any facts by reason of which the title to or possession of said property might be di sputed or questioned, or by reason for which any claim to any of said property might be asserted adversely to her. She knows of no action or proceeding, whatever, whi ch is now pending in any State or Federal Court in the United States, to whi ch she is a part nor does she know of any Federal Court Judgment, Federal tax lien, or any other federal or state lien of any kind or nature whatever which now constitutes a lien or charge upon the real properties described herein. She has received no notice from any public authority, requiring any improvement, alteration or change to be made in or about said property. There are no unpaid bills or claims for labor or services performed or material furnished or delivered during the last twelve months for alterations, repair work or new const ruction on the hereinafter described immovable property. Appearer herein acknowledge s and confirms that the debt due by appearer to _____________ is equal to or greater than the value of the pro perties described herein. The properties referred to herein is described as follows: (1) That certain tract or parcel of land situated in the Parish of _______, Louisiana, on the _______ side of _______, in Section _______, Township _______ _______, Range _______, fronting on the _______ side of _______ ____ (_______ ') feet, with a depth between parallel lines of _______ (____') feet on its East side, and ____ and ____/l00 (____) feet on its Western side, with a rear width of _______ (_______ ') feet, and being known and designated as Lot ____ on that certain plat of partition on Lot ____ of the Estate of _______ prepared by _____________, Registered Land Surveyor, dated _______ __ , 20 __, a copy of which is attached to an Act of Sale recorded in Conveyance Book ____, Folio ____, Entry No ____, _______ Parish, Louisiana. Being the same property acquired by _____________ in that certain Act of Partition dated _______ __, 20__, and filed for record in Conveyance Book ____, Folio ____, under Entry No. ____ of the Conveyance Records of _______ Pa rish, Louisiana, and ratified by Acts filed of record in Conveyance Book ____, Folio ____, and Conveyance Book ____, Folio ____ of the Clerk's Records of ____ Parish, Louisiana. And being the same property acquired by _____________ , et ux from _____________ by Act of Sale recorded in Conveyance Book ____ , Folio ____, Entry No. ____, _______ Parish, Louisiana. (2) A _____________, bearing VIN # . THUS SIGNED on _______ _____, 20 , in the City of _____________, Parish of _______ , Louisiana, in the presence of the undersigned Not ary Public, qualified 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 RESOLVED that __________________, ______________ of the Corporation, is hereby authorized and directed to acquire, by means of a dation en paiment, for and in behalf o f _____________, the following described properties, to -wit: (1) That certain tract or parcel of land situated in the Parish of _______, Louisiana, on the _______ side of _______, in Section _______, Township _______ _______, Range _______, fronting on the _______ side of _______ ____ (_______') feet, with a depth between par allel lines of ____ ( ____') feet on its East side, and ____ and ____/l00 (____) feet on its Western side, with a rear width of ____ (____') feet, and being known and designated as Lot ____ on that certain plat of partition on Lot ____ of the Estate of _____________ prepared by _____________ , Registered Land Surveyor, dated _______ __, 20__, a copy of which is attached to an Act of Sale recorded in Conveyance Book ____, Folio ____, Entry No ____, _______ Parish, Louisiana. Being the same property acquired by _____________ in that certain Act of Partition dated _______ __ , 20 __, and filed for record in Conveyance Book ____, Folio ____, under Entry No. ____ of the Conveyance Records of _______ Parish, Louisiana, and ratified by Acts filed of record in Conveyance Book ____, Folio ____, and Conveyance Book ____ , Folio ____ of the Clerk's Records of _______ Parish, Louisiana. And being the same property acquired by _____________ , et ux from _____________ by Act of Sale recorded in Conveyance Book ____ , Folio ____, Entry No. ____, _______ Parish, Louisiana. (2) A _____________, bearing VIN # _______ . The consideration to be given by _____________ for the above- described properties shall be the release of the present owner of the properties, _____________, from all obligations arising out of the following note and mortgage: Collateral Mortgage by _____________ in favor of _____________, dated _______ __ , 20 __, in the sum of $ _______, evidenced by one certain promissory note of a like amount, dated _______ __, 20__ and payable on demand, bearing ____% per annum interest from date until paid, and ____% on the aggregate amount of principal and interest as attorney's fees in case of suit for collection; said Collateral Mortgage recorded on _______ __, 20__, in Mortgage Book ____, Folio ____, under Entry No. ____ of the records of _______ Parish, Louisiana; and all obligations arising out of the following Consumer Security Agreement: Consumer Agreement Agreement by _____________ in favor of _____________, dated _______ __, 20__, for the sum of $_______ . The said ________________________ is fully authorized to execute all docume nts and perform all actions necessary or proper to accomplish the aims of this resolution. * * * I certify that I am the duly qualified and acting Secretary of _____________, and that the above and foregoing constitutes a true and correct copy of a resolution duly adopted at a meeting of the Board of Directors of _____________ , held on _____________________, 20____ , at which meeting a quorum was present and voted i n favor of said resolution. _____________________________ _____________