Mortgage Lien Release Form
Releasor’s Name (If Person)
First Name
Last Name
Releasor (If Company or Entity)
Address of Releasor
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mortgagor Name
First Name
Last Name
Property Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Legal Description
Mortgage Description
Mortgage Dated on
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Mortgage
Recorded on
Book
Page
Instrument #
Principal Amount $
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature of Releasor
Witness
Title
First Name
Last Name
Signature of Witness
Submit
Should be Empty: