In the Court of Common Pleas, Delaware County Ohio COURT CERTIFICATE OF RELEASE To: (Recorder or Clerk of Courts) Case No: The below lien is released satisfaction by proceeding of Delaware County, Ohio, (with or without) in the case of: -Vs.Plaintiff Type of Release: Mortgage Release Mechanic's Lien Vendor's Lien Assignment Lease Federal Tax Lien Bureau of Employment Other: Lien filed by: Name: Lien assigned to: (if applicable) Name: Date: Vol.: Pg: Date: Vol.: Pg: Certificate of Judgment Other (specify below) Defendant Lien filed against: Release of Property (Attach complete description if partial release; no description needed if full release.) (Full or Partial) Other Comments: Approved for Recording by: (Recorder's or Clerk's Office) Issued To: (Recorder or Clerk) JAN ANTONOPLOS, CLERK OF COURTS DELAWARE COUNTY, OHIO on Date Date Fee:$ Fee:$ By: Deputy Clerk Instructions 1. Complete one form for each release 2. Send to Delaware County Recorder's Office for approval and fee information on each Recorder's Release, and/or Send to Delaware County Clerk of Court's office for approval and fee information on each lien filed in the Clerk's office. 3. File each original Court Certificate of Release at the time of filing the Confirmation Entry. 4. File each original plus one copy if you would like a file-stamped copy returned to you. Appendix Form Number F38.05-39.01 ALL RELEASE INFORMATION MUST MATCH THE CONFIRMATION ENTRY American LegalNet, Inc. www.FormsWorkFlow.com