Dale N. Atkins
Clerk of Court and Ex-Officio Recorder Parish of Orleans REQUEST TO CANCEL MORTGAGE
The Clerk of Court and Ex-Officio Recorder for the Parish of Orleans, Dale N. Atkins, is hereby requested and authorized to cancel the following inscription(s): The _________________________________________________________________ recorded in Mortgage Division Book(s)*_________________________________________________________ paraphed by ________________________________________________________________________ with note executed by_________________________________________________________________ __________________________________________________________________________________ In the sum of $_______________________________________________________________ on ________________________ 20__________, which is now marked "PAID" and attached hereto.
_______________________________ Name (Print)
INSTRUMENT # _________________________
DISTRICT_______________________________ _______________________________ Address SQUARE________________________________
______________________________
LOT ____________________________________
_______________________________ Telephone Number
________________________________________ Signature
Date_____________________________________ *NOTE: If there are assignments and assumptions, they are to be added above.