CLERK OF CIVIL DISTRICT COURT FOR THE PARISH OF ORLEANS LAND RECORDS DIVISION (504) 407-0005 E-mail: 1340 Poydras Street, 4 Floor New Orleans, Louisiana 70112 TH civilclerklandrecords@orleanscdc.com Dale N. Atkins Clerk of Court And Ex-Officio Recorder Parish of Orleans REQUEST TO CANCEL MORTGAGE BY PRESCRIPTION PLEASE CANCEL THE FOLLOWING MORTGAGE RECORDED IN THE RECORDS OF THE PARISH OF ORLEANS AS SAME HAS PRESCRIBED. I HAVE EXAMINED THE MORTGAGE RECORDS OF THE LAND RECORDS DIVISION FOR A LIS PENDENS, REINSCRIPTION, REVIVAL, RENEWAL, OR LIS PENDENS OF THIS MORTGAGE. I HAVE NOT FOUND ANY REINSCRIPTION, REVIVAL, RENEWAL OR LIS PENDENS OF THIS MORTGAGE. THEREFORE, I REQUEST THE CANCELLATION OF THIS MORTGAGE BASED ON PRESCRIPTION. I AGREE TO INDEMNIFY AND HOLD HARMLESS THE CLERK OF COURT AND EX-OFFICIO RECORDER AGAINST ALL LIABILITY FOR CANCELING THIS MORTGAGE. MORTGAGE BY ____________________________________________________________________________ ___________________________________________________________________________________________ IN FAVOR OF ______________________________________________________________________________ ___________________________________________________________________________________________ ACT BEFORE ______________________________________________________________________________ DATE _____________________________________________________________________________________ RECORDED AS INSTRUMENT NUMBER _________________________, MORTGAGE INSTRUMENT NUMBER (MIN) ___________________, MORTGAGE OFFICE BOOK (MOB) __________________FOLIO _____________ PRINT NAME _______________________________________________________________________________ ADDRESS _________________________________________________________________________________ ___________________________________________________________________________________________ __________________________________________________________________________________________ PHONE ____________________________________________________________________________________ SIGNATURE _______________________________________________________________________________ DATE _____________________________________________________________________________________ PLEASE FURNISH CERTIFICATE OF CANCELLATION American LegalNet, Inc. www.FormsWorkFlow.com