The Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) is a form from the Jefferson Parish Clerk of Court, printed as an Affidavit of Lost Paraphed Promissory Note & Authorization to Cancel Mortgage (By Notary Public). It is one of the Mortgage & Conveyance release forms the Clerk publishes for cancelling mortgage inscriptions. A notary uses it to swear that a paid, paraphed promissory note cannot be found and to authorize the cancellation. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form is published by the Clerk at jeffparishclerk.gov.
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What is Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) – Jefferson Parish, LA?
The Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) is a Jefferson Parish Clerk of Court form in which a notary swears that a paid paraphed promissory note is lost and asks the Clerk to cancel the mortgage.
The printed title is Affidavit of Lost Paraphed Promissory Note & Authorization to Cancel Mortgage (By Notary Public), and it cites La. R.S. 9:5167(a). The affiant is a duly licensed notary public who, personally or through someone under his direction, satisfied the note. The affidavit states one of two situations: the notary received the note marked "Paid in Full" from the last holder and the note was lost or destroyed in the notary's custody, or the notary confirmed that the last holder received payment in full and sent the note, but it was never received.
The form expressly requests, authorizes and directs the Clerk of Court and Ex-Officio Recorder of Mortgages to cancel the recordation of the mortgage or privilege described on it. That description covers who granted the note, in whose favor, the amount and date of the note, the recording data (MOB, folio, Instrument No.) and the legal description of the property.
The Clerk publishes other release forms for different situations, including a separate Release by Affidavit of Lost Paraphed Promissory Note (by Title Insurance Company) and releases by an obligee of record under La. R.S. 9:5168 and 9:5169. This form is the notary version.
Who needs to file Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) – Jefferson Parish, LA?
This form is for a licensed notary public who satisfied a paraphed promissory note secured by a mortgage or privilege recorded in Jefferson Parish, cannot find the note, and wants the recorded inscription cancelled under La. R.S. 9:5167(A). The Clerk's forms page says its forms are samples intended for use by qualified notaries or attorneys only.
Conditions stated on the form:
- The notary (or someone under the notary's direction) satisfied the note.
- The note was either received marked "Paid in Full" and then lost or destroyed in the affiant's custody, or the last holder was paid and sent the note, which was never received.
- A due and diligent search has been made, the note cannot be located, and 60 days have elapsed since payment or satisfaction.
The affiant also agrees to be personally liable to, and to indemnify, the recorder of mortgages and anyone relying on the cancellation for damages if the recorded affidavit contains materially false or incorrect statements that cause an incorrect cancellation.
Do not expect help from the Clerk's staff: Clerk of Court employees are prohibited from giving legal advice or helping complete any form. Different releases apply if a title insurance company or an obligee of record is the one making the statement.
When to file Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) – Jefferson Parish, LA
Use this affidavit once a due and diligent search has failed to find the paraphed note and 60 days have elapsed since payment or satisfaction of the note; the form states both conditions. The form prints no other deadline.
The affidavit is the instrument that asks the Clerk to cancel the inscription, so it is submitted when you are ready to have the mortgage or privilege cancelled. It must be accompanied by a Request to Cancel Inscription(s) form and by the appropriate fees, according to the Clerk's forms page. The Clerk's page also says cancellations filed in Jefferson Parish must be in authentic form, executed before a Notary Public and signed by the affiant and two witnesses of lawful age.
Documents you need
- Request to Cancel Inscription(s) form, complete with MOB & Folio and/or Instrument Number and the name and address of the party requesting cancellation: the Clerk's forms page says it must accompany all cancellation documents.
How to fill out Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) – Jefferson Parish, LA
Confirm you may use this form
The form is a sample for qualified notaries or attorneys, and the affiant must be a duly licensed notary public. Clerk staff cannot help with completion.
Enter the state, parish and date
Under State of LOUISIANA, write the Parish/County, then the day, month and year in the line beginning "BE IT KNOWN THAT on this ___ day of _, 20".
Name the appearing notary
On the line after "appeared:", print the name of the duly licensed Notary Public who is making the affidavit.
Describe the note and parties
Complete Granted by, In favor of, Amount of Note and Date of note to identify the paraphed promissory note and the inscription to be cancelled.
Enter the recording data
Parish of Recordation is pre-printed as JEFFERSON. Fill in MOB, folio and Instrument No. exactly as recorded.
Add the legal description
Write the legal description of the subject property on the line provided.
Review the sworn statements
Confirm the statements about the note (marked "Paid in Full" and lost, or payment confirmed and never received), the indemnity, and the due and diligent search with 60 days elapsed. Do not sign unless they are true.
Complete the affiant's signature block
Sign and give the printed name, Notary or Bar Roll Number, commission expiration date, mailing address, City, State, LA ZIP and e-Mail Address.
Complete the Notary Public block
The notary before whom the affidavit is made signs above Notary Public and prints a name, Notary or Bar Roll Number and commission expiration date.
Review, download and assemble the package
Check every blank, then download or print the completed PDF from FillingPDF. Add the Request to Cancel Inscription(s) form and the fees, and have the witnesses sign as the Clerk requires, as described under How to submit.
How to submit Release by Lost Note Affidavit (by Notary Public — La. R.S. 9:5167(A)) – Jefferson Parish, LA
The form is directed to the Jefferson Parish Clerk of Court and Ex-Officio Recorder of Mortgages, and the form names no mailing address, portal or other channel. The Clerk's forms page at https://jeffparishclerk.gov/forms/ lists this form under Mortgage & Conveyance / UCC, Releases (Cancellations of Mortgage Inscriptions).
What the package needs, according to that page:
- Request to Cancel Inscription(s): every promissory note and release submitted for cancellation must be accompanied by this form, complete with MOB & Folio and/or Instrument Number and the name and address of the party requesting cancellation.
- Authentic form: the cancellation must be executed before a Notary Public and signed by the affiant and two witnesses of lawful age.
- Fees: all documents must be submitted with the appropriate fees. See the Clerk's Fees page for the amount; none is stated here.
- Retyping: the forms may be retyped to suit specific circumstances, but all language and required information must be preserved.
Clerk employees cannot give legal advice or help complete the form. The Clerk also publishes a Mortgage Release/Cancellation Manual with statutory citations and forms. FillingPDF lets you fill out and download the PDF; submission follows the Clerk's channels.
Common mistakes to avoid
- Submitting the affidavit without the Request to Cancel Inscription(s) form, which the Clerk says must accompany every promissory note and release submitted for cancellation.
- Leaving the recording data blank: the Request to Cancel Inscription(s) must carry the MOB & Folio and/or Instrument Number, and the affidavit asks for MOB, folio and Instrument No.
- Signing the affidavit before 60 days have elapsed since payment or satisfaction of the note, or before a due and diligent search has been made.
- Omitting the second notary's signature block, printed name, Notary or Bar Roll Number and commission expiration date below the affiant's signature.
- Filing the document without the two witnesses of lawful age that the Clerk requires for a cancellation in authentic form.
- Submitting it without the appropriate fees; the Clerk says all documents must be submitted with them.
- Retyping the form and dropping language or required information; the Clerk allows retyping only if all language and required information are preserved.
- Using this notary version when a title insurance company or an obligee of record is making the statement, since the Clerk lists separate release forms for them.
Frequently asked questions
What is the Release by Lost Note Affidavit (by Notary Public)?
It is a Jefferson Parish Clerk of Court form, printed as an Affidavit of Lost Paraphed Promissory Note & Authorization to Cancel Mortgage (By Notary Public). A notary swears the paid paraphed note is lost and authorizes the Clerk and Recorder of Mortgages to cancel the inscription under La. R.S. 9:5167(A).
Is this a Jefferson Parish property tax form?
No. Although people searching for jefferson parish property tax may find the Clerk of Court's forms, this is a mortgage-cancellation affidavit recorded against a mortgage or privilege. It does not report, assess or pay property tax.
Who can use this lost note affidavit?
A duly licensed notary public who satisfied the paraphed note. The Clerk says its forms are samples for qualified notaries or attorneys only, and its employees cannot give legal advice. Title insurance companies and obligees of record have separate release forms.
How long must I wait before signing the affidavit?
The affidavit states that 60 days have elapsed since payment or satisfaction of the note, and that a due and diligent search was made and the note cannot be located. Do not sign it until both statements are true.
What must I submit with the lost note affidavit?
Submit it with a Request to Cancel Inscription(s) form that gives the MOB & Folio and/or Instrument Number and the name and address of the requesting party. The Clerk also says all documents must come with the appropriate fees.
Does the cancellation need witnesses?
The Clerk's forms page says cancellations filed in Jefferson Parish must be in authentic form: executed before a Notary Public and signed by the affiant and two witnesses of lawful age. Orders for bond-related cancellations differ and need a judge's signature.
Where do I send this form?
The form is directed to the Jefferson Parish Clerk of Court and Ex-Officio Recorder of Mortgages and prints no address. Check the Clerk's forms page at https://jeffparishclerk.gov/forms/ and its Fees page for how and where to file.
Can I fill out this form online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file, record or notarize the affidavit; you submit it to the Clerk of Court yourself.
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