Satisfaction of Mortgage Know All Men By These Presents: That......... the owner and holder of a certain mortgage deed executed by bearing date the day of , 20 , recorded in Book Page in the office of the Clerk of Circuit Court of Clay County, Slate of Florida, securing certain note in the principal sum of Dollars, and certain promises and obligations set forth in said mortgage deed upon the properly situate in said State and County described as follows, to wit: hereby acknowledge full payment and satisfaction of said note and mortgage deed and surrender the same as canceled and hereby direct the Clerk of the said Circuit Court to cancel the same of record. Witness had and seal this day of , 20 Signed, Sealed and Delivered in Presence of Signature of Witness Signature Print Name of Witness Print Name Signature of Witness Signature Print Name of Witness Print Name STATE OF FLORIDA COUNTY OF CLAY The foregoing instrument was acknowledged before me this________ day of_________________________________ . 20____ by_________________________________________________________________________________________ , who is personally known to me or has produced______________________________________________________________ as identification and who did/did not take an oath, _______________________________________ Signature of Notary/Deputy Clerk _______________________________________ Type or Print Name Prepared by: Prepared by: ______________________________ _________________________________________ _________________________________________