Mortgage or privilege cancellation by financial institution; standard form
La. R.S. 9:5173
in effect9:5173. 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.
Source: Louisiana State Legislature (legis.la.gov)URL: https://legis.la.gov/legis/Law.aspx?d=108153Fetched: 10/20/2026