Fill and Sign the Louisiana Partial Form

STATE OF LOUISIANA PARISH OF [_PARISH_] PARTIAL RELEASE OF MORTGAGE, VENDOR'S LIEN AND RIGHT OF RESCISSION OR DISSOLUTION BE IT KNOWN, THAT ON [_Date_] , before me, [_NOTARY_] , a Notary Public, duly commissioned and qualified in and for the aforesaid parish and state, and in the presence of the undersigned witnesses: PERSONALLY CAME AND APPEARED: [_LENDER_] , Tax Identification Number [_TIN_] , a state chartered banking corporation having its principal place of business at [_Lender_Address_] , represented herein by [_AGENT_] , its duly authorized [_Office_] ; who exhibited to me, Notary, as last holder thereof, one certain promissory note described as follows: MAKER: [_Makers_] PAYEE: [_Payee_] AMOUNT: [_$Amount_] DATE: [_Note_Date_] INTEREST: [_Rate%_] MATURITY: [_Terms_] NOTARY: [_Note_Notary_] which note is paraphed for identification with an Act of Mortgage of the same date before said notary public. NOW THEREFORE, for good and valuable consideration, receipt of which is hereby acknowledged, and with full knowledge and intent that third parties may rely hereon, Appearer hereby waives, releases and renounces all vendor's liens, mortgages or other rights to the property herein described, and specifically renounces the right to rescind and/or dissolve for non-payment of the price, or for any other reason whatsoever, and hereby authorizes and directs the Recorder of Mortgages for the Parish of [_Filing_Parish_] to erase and cancel from the records of his office the inscription of the said mortgage recorded in [_Recordation_] of the mortgage records of said parish, but only insofar as it bears upon and affects the property described as follows, to- wit: [_Property_Description_] The property released herein has as its address [_Prop_Address_] . After mentioning on said note, the partial release herein granted, and after having paraphed said note "Ne Varietur" for identification herewith, I, said Notary, have returned the same to the said holder, who acknowledges delivery thereof. THUS DONE AND SIGNED in [_City_Parish_] , Louisiana, on the day, month and year herein first above written, in the presence of the undersigned competent witnesses, who hereunto sign their names with the said Appearer and me, Notary, after due reading of the whole. - 1 - WITNESSES: [_LENDER_] ___________________________ BY: _______________________ [_AGENT_] [_Office_] ___________________________ _____________________________ [_NOTARY_], NOTARY PUBLIC PARTIAL RELEASE OF MORTGAGE, VENDOR'S LIEN AND RIGHT OF RESCISSION AND/OR DISSOLUTION - F1BSEC11 : By this act, the holder of a mortgage releases its security interest in a specified immovable, including any rights that the mortgage holder may have as an unpaid vendor or vendor's lien holder. The notary before whom the act is passed must paraph the mortgage note for identification with the act. WORD KEY : EXPLANATION : [_PARISH_] Parish in which release is signed. [_Date_] Date on which release is signed. [_NOTARY_] Notary before whom release is signed. [_LENDER_] Name of holder of note and mortgage. [_TIN_] Tax Identification Number of lender. [_Lender_Address_] Mailing address principal place of business of creditor. [_AGENT_] Name of person appearing for creditor. [_Office_] Office held by person appearing for creditor. [_Makers_] Makers of mortgage note. [_Payee_] Party to whom mortgage note is payable. [_$Amount_] Amount of mortgage note (with $). [_Note_Date_] Date of mortgage note. [_Rate%_] Interest rate (with %). [_Terms_] Indicate how mortgage note is payable. [_Note_Notary_] Notary who paraphed mortgage note for identification with mortgage. [_Filing_Parish_] Parish in which mortgage is filed. [_Recordation_] Recordation data on mortgage. [_Property_Description_] Description of property released. [_Prop_Address_] Municipal number or address of the property released. [_City_Parish_] City and parish in which release - 2 - is signed. - 3 -