(Top 3 inches reserved for recording data) REVOCATION OF APPOINTMENT OF AGENT TO RELEASE MORTGAGE by Title Insurance Company Minn. Stat. 507.401 DATE: Minnesota Uniform Conveyancing Blanks Form 20.7.6 (2011) (month/day/year) (insert name of title insurance company) a hereby revokes the appointment of under the laws of , ("Grantor"), as agent to execute and record certificates of release of mortgage under Minn. Stat. 507.401 on behalf of the Grantor effective at 12:01 a.m. The appointment of agent was recorded on as Document Number Office of the County Recorder (month/day/year) (insert name of agent) (or in Book of (check the applicable boxes) Registrar of Titles of Page County, Minnesota. (month/day/year) ), in the Grantor (name of Grantor) By: (signature) Its: By: (type of authority) (signature) Its: (type of authority) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Minnesota Uniform Conveyancing Blanks Form 20.7.6 State of Minnesota, County of This instrument was acknowledged before me on , by as (month/day/year) (name of authorized signer) (type of authority) and by as (type of authority) (name of authorized signer) of (name of Grantor) . (Stamp) (signature of notarial officer) Title (and Rank): My commission expires: (month/day/year) THIS INSTRUMENT WAS DRAFTED BY: (insert name and address) American LegalNet, Inc. www.FormsWorkFlow.com