Illinois Statutes Chapter 765. Property § 935/50. Form of certificate of release

1. Name of mortgagor(s):․․․․․

2. Name of original mortgagee:․․․․․

3. Name of mortgage servicer (if any):․․․․․

4. Mortgage recording: Vol.:․․․․․Page:․․․․․or Document No.:․․․․․

5. The above referenced mortgage has been paid in accordance with the payoff statement and there is no objection from the mortgagee or mortgage servicer or its successor in interest to the recording of this certificate of release.

6. The person executing this certificate of release is an officer or duly appointed agent of a title insurance company authorized and licensed to transact the business of insuring titles to interests in real property in this State pursuant to Section 30 of this Act.

7. This certificate of release is made on behalf of the mortgagor or a person who acquired title from the mortgagor to all or part of the property described in the mortgage.

8. The mortgagee or mortgage servicer provided a payoff statement.

9. The property described in the mortgage is as follows: Permanent Index Number:․․․․․

Common Address:․․․․․

(Name of title insurance company)

By:․․․․․

(Name of officer and title or name of agent and name of officer / representative thereof)

Address:․․․․․

Telephone No.:․․․․․

This instrument was acknowledged before me on ․․․․․(date) by ․․․․․(name of person) as ․․․․․(officer for / agent of) ․․․․․(title insurance company).

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Notary Public

My commission expires on․․․․․