Fill and Sign the Dation En Paiement 497308573 Form

DATION EN PAIEMENT UNITED STATES OF AMERICA BY [_DEBTOR_1_] AND STATE OF LOUISIANA [_DEBTOR_2_] TO [_CREDITOR_] PARISH OF [_PARISH_] BE IT KNOWN THAT BEFORE the undersigned Notary or Notaries Public, duly commissioned and qualified in and for the respective Parishes of execution, and in the presence of the witnesses hereinafter named and undersigned PERSONALLY CAME AND APPEARED: [_DEBTOR_1_] , whose Tax Identification Number is [_TIN_1_] , and [_DEBTOR_2_] , whose Tax Identification Number is [_TIN_2_] , husband and wife, domiciled in [_Domicile_Parish_] , Louisiana, and having as their present mailing address [_Address_] ; referred to jointly herein as "APPEARER"; who declared and acknowledged to me, Notary, that APPEARER borrowed certain sums from [_CREDITOR_] , whose Tax Identification Number is [_TIN_3_] , hereinafter referred to as " CREDITOR ", on a certain mortgage loan obligation, namely: A certain promissory note executed [_Note_Date_] by APPEARER to the order of CREDITOR in the principal amount of [_$Amount_] , bearing interest at the rate of [_Rate%_] per annum and providing for [_Fee%_] attorney's fees in the event of being placed in the hands of an attorney for collection, payable [_Terms_] , which promissory note is paraphed for identification with that [_Type_] Mortgage dated the same date, recorded at Mortgage [_Recordation_] of the mortgage records of [_Recordation_Parish_] , Louisiana and bearing against the property described below. The parties hereto declare that as of this date there is due on the mortgage obligation the amount of [_$Principal_] , with interest at the rate of [_Rate%_] per day from [_Interest_Date_] until paid, together with [_Fee%_] of said principal and interest as attorney's fees. Wishing to be released from the said indebtedness and to reimburse the said CREDITOR for the indebtedness due and owing as hereinabove stated, and being unable to pay the amount represented by said note, and in accordance with the provisions of Articles 2655 to 2659, inclusive, of the Revised Civil Code of the State of Louisiana, APPEARER does hereby make unto the said CREDITOR a Dation En Paiement, whereby APPEARER does hereby transfer, convey, deliver, grant, assign and set over unto the said CREDITOR , here present and accepting, all and singular, the following described property: [_Property_Description_] The property conveyed herein has as its address [_Prop_Address_] . TOGETHER WITH all ancillary rights pertaining to or arising out of the ownership of the said property, including specifically, but not exclusively, all utility or other deposits, all escrow deposits, all prepaid insurance or return premiums and all other rights or credits of a similar nature, existing or arising hereafter. TO HAVE AND TO HOLD said property as herein described unto the said CREDITOR and assigns forever, with full and general warranty of title, free from any lien, mortgage or encumbrance whatsoever, except that Mortgage referred to above, and with full subrogation to all the rights and actions of warranty that APPEARER has or may have against all preceding owners or vendors. APPEARER specifically warrants that: (1) APPEARER knows of no adverse claim to the property or litigation affecting title to the property; (2) No petition in bankruptcy has been filed by or against any APPEARER ; (3) APPEARER knows of no notice from any public authority requiring any improvement or change in the property; (4) All parties who have furnished labor or services for maintenance, repair or improvement of the property have been paid in full; (5) APPEARER has not received notice from any environmental regulatory agency that the property described above is or may be subject to any notice or violation, penalty, assessment, administrative or judicial enforcement process directed toward remediation of environmental violations, contaminations, pollution or hazards, and APPEARER has no actual knowledge of any condition on or in the property that would subject CREDITOR , or any assigns of CREDITOR , to such enforcement; and (6) APPEARER has not received notice and has no knowledge of any private claim or threatened private claim by any individual or entity for liability of any kind whatsoever, including without limitation, personal injury, present or future medical costs, property damage, diminution in value or loss of resources, in any way related to the condition of the property. 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 CREDITOR in acquittance and discharge by the said CREDITOR to the said APPEARER of the indebtedness represented by the [_Note_Date_] promissory note. The said CREDITOR thereupon delivered to the Notary before whom it appeared, the [_Note_Date_] promissory note referred to above, as fully paid, cancelled and acquitted, and declared that the said note having been paid in full, CREDITOR , as the last holder of the said note, has marked said note paid, and does hereby authorize and direct the Recorder of Mortgages of the Parish of [_Recordation_Parish_] , State of Louisiana, to cancel and erase entirely from his records the inscription of said mortgage. APPEARER acknowledges and confirms that the debt due on the mortgage obligation referred to above is greater than the value of the property transferred herein. @@@Tax Receipts@@@ Tax receipts and/or certificates are annexed hereto showing payment of all state, parish, municipal and levee district taxes and past due charges for local improvement assessments assessed against the property. @@@Conveyance Cert.@@@ By reference to the certificate of the Register of Conveyances for the Parish of Orleans it does not appear that said property has been alienated by the vendor. The parties are aware that the certificate attached hereto is open, being not yet dated and signed, and relieve and release the undersigned notaries from all responsibility and liability in connection therewith. THUS SIGNED ON [_Date_1_] at [_City_Parish_1_] , 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: ____________________ _________________________ [_DEBTOR_1_] ____________________ _________________________ [_DEBTOR_2_] __________________________ [_NOTARY_1_] , NOTARY PUBLIC THUS SIGNED ON [_Date_2_] at [_City_Parish_2_] , 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: [_CREDITOR_] ________________________ BY: ___________________ [_AGENT_] [_Office_] ________________________ ___________________________ [_NOTARY_2_] , NOTARY PUBLIC  * * * * * * * * *  DATION EN PAIEMENT - F1ADAT1 : This act is a conveyance of immovable property to a mortgage creditor in satisfaction of the mortgage obligation. See R.C.C. 2655, et seq . For an agreement by which property is transferred in partial payment of debt, see document Partial Dation En Paiement - F1ADAT2. WORD KEY EXPLANATION [_DEBTOR_1_] Name of first party granting dation. Names of parties granting dation should agree with names in acquisition of property. For alternate appearances, see document Appearances - F1AAPP1. [_DEBTOR_2_] Name of second party granting dation. [_CREDITOR_] Name of creditor to whom property is transferred. [_PARISH_] Parish(es) in which agreement is executed. [_TIN_1_] Tax Identification Number of first debtor. For discussion of Internal Revenue Service reporting requirements, see document Request for Tax Identification Number - F1ASAL14. [_TIN_2_] Tax Identification Number of second debtor. [_Domicile_Parish_] Parish of debtors' domicile. [_Address_] Mailing address of debtors. [_TIN_3_] Tax Identification Number of creditor. [_Note_Date_] Date of mortgage note. [_$Amount_] Principal amount of mortgage note (with $). [_Rate%_] Interest rate on mortgage note (with %). [_Fee%_] Percentage attorney's fee on mortgage note (with %). [_Terms_] Recite payment terms of note. [_Type_] Describe type of mortgage (conventional, collateral, etc.) [_Recordation_] Recordation data on mortgage. [_Recordation_Parish_] Parish in which mortgage is recorded. [_$Principal_] Principal amount due on date dation is signed (with $). [_$Rate_] Interest per day (with $). [_Interest_Date_] Date from which interest accrues. [_Property_Description_] Description of property, with acquisition. [_Prop_Address_] Municipal number or address of the property conveyed. @@@Tax Receipts@@@ Include statement and receipts/certificates showing payment of taxes in conveyances of real property located in municipal corporations exceeding 300,000 inhabitants, as per R.S. 9:2921. @@@Conveyance Cert.@@@ Where real property located in the Parish of Orleans is conveyed, R.S. 9:2928 requires attachment of a certificate of the Register of Conveyances showing that the seller has not alienated the property. [_Date_1_] Date of execution by debtors. [_City_Parish_1_] City and parish where dation executed by debtors. [_NOTARY_1_] Notary before whom debtors execute dation. [_Date_2_] Date of execution by creditor. [_City_Parish_2_] City and parish where dation executed by creditor. [_AGENT_] Name of person appearing for creditor. [_Office_] Office held by person appearing for creditor. [_NOTARY_2_] Notary before whom creditor executes dation.