Pennsylvania Statutes Title 21 P.S. Deeds and Mortgages § 721-5. Form of satisfaction piece

Mortgagees, whether individuals or legal entities other than individuals, shall satisfy mortgages by a satisfaction piece in substantially the following form:

Made this ___ day of __________,

Name of Mortgagor:

Name of Mortgagee:

Name of Last Assignee:

Date of Mortgage:

Original Mortgage Debt:

Mortgage Recorded on __________, in the Office of the Recorder of Deeds of __________ County, Pennsylvania, in Book ___, Page ___/instrument number ___.

Brief Description or Statement of Location of Mortgaged Premises:

The undersigned hereby certifies that the debt secured by the above- mentioned mortgage has been fully paid or otherwise discharged and that upon the recording hereof said mortgage shall be and is hereby fully and forever satisfied and discharged.

The undersigned hereby authorizes and empowers the recorder of said county to enter this satisfaction piece and to cause said mortgage to be satisfied of record.

Witness the due execution hereof with the intent to be legally bound. (signature(s) of individual mortgagee(s) or representative(s) of legal entity)

(acknowledgment)