1340 POYDRAS STREET SUITE 400 NEW ORLEANS, LOUISIANA 70112 Telephone (504) 592-9170 Facsimile (504) 592-4320
CHELSEY RICHARD NAPOLEON CHIEF DEPUTY CLERK
Dale N. Atkins
Clerk of Court and Ex-Officio Recorder
Parish of Orleans REQUEST TO CANCEL INSCRIPTION
The Clerk of Court and Ex-Officio Recorder for the Parish of Orleans, Dale N. Atkins, is hereby requested and authorized to cancel the following inscription(s): The inscription recorded in MOB____________ Folio____________ MIN____________, executed by_______________________________ dated____________________ in favor of ________________________________________________________________ being a (an)_______________________________ of the ___________________ recorded in MOB___________ Folio_____________ MIN_____________ executed by___________ ________________________________________________________________________ in favor of _______________________________________________________________ for the reason that the original obligation has been cancelled, but through inadvertence the above inscription remains open.
_____________________________________________
NAME (PRINT)
_____________________________________________ ADDRESS _____________________________________________
_____________________________________________ TELEPHONE
_____________________________________ _________________________________ SIGNATURE
DATE