§5173. Mortgage or privilege cancellation by financial institution; standard form A financial institution seeking to cancel a mortgage or privilege inscription pursuant to R.S. 9:5172 may use, and the recorder of mortgages for each and every parish in the state of Louisiana shall accept, the following form as fully compliant as a request for cancellation and act of release. The form contained in this Section is not the exclusive form to be accepted for filing, and any other form meeting the requirements of R.S.9:5172 may be used and filed for canceling the recordation of a mortgage or privilege: R.S. 9:5172 FORM: REQUEST FOR CANCELLATION OF MORTGAGE OR PRIVILEGE AND RELEASE BY LICENSED FINANCIAL INSTITUTION PURSUANT TO R.S. 9:5172 State of ____________________ Parish or County of ______________________ BE IT KNOWN THAT on this _______day of _____________, 20____, ____________________ (name of financial institution) herein represented by its undersigned duly authorized officer or officers, declares that it is a licensed financial institution as defined in R.S. 9:5172 et seq. and that one of the following statements is true and correct: (1) The institution was the obligee or the authorized agent of the obligee of the obligation secured by the mortgage or privilege described below when the obligation was extinguished, and the secured obligation has been paid or otherwise satisfied or extinguished; or (2) The institution is the obligee or authorized agent of the obligee of the secured obligation, and it releases the mortgage or privilege described below. The Clerk of Court and Ex-Officio Recorder of Mortgages for the Parish identified below is hereby expressly requested, authorized, and directed to cancel the recordation of the mortgage or privilege described as follows: A mortgage or privilege granted by: In favor of:______________________________________ Date of Instrument:_________________________ Parish of Recordation:_______________________ Recording Data:____________________________ Legal description is as follows or is hereby attached as Exhibit "A": _____________________________________________________________ ______________________________________________________________ ____________________________________________________________ ____________________________________________________________ ___________________________. (3) The recorder of mortgages shall not be liable for any damages resulting to any person or entity as a consequence of canceling a mortgage or vendor's privilege pursuant to this form. [Choose one of the two following signature options.] THUS DONE AND SIGNED before me, Notary Public, on the date set forth above. _______________________________________________ Name of officer and title Name of financial institution Requested mailing address City, state, and zip code _____________________________________ Notary Public (Printed name of notary and bar roll or notary number) OR THUS DONE AND SIGNED by the two undersigned authorized officers of the above named financial institution. ________________________________________________ Name of officer and title Name of financial institution Requested mailing address City, state, and zip code ________________________________________________ Name of officer and title Name of financial institution Requested mailing address City, state, and zip code Acts 2007, No. 337, §2; Redesignated from R.S. 44:109.1 by Acts 2010, No. 284, §1, eff. Jan. 1, 2011; Acts 2017, No. 62, §1.
