KNOW ALL MEN BY THESE PRESENTS, that whereas _______________ by Indenture of Mortgage dated ____________________, and recorded in the Office of the Recorder of Deeds in and for the County of Indiana, Commonwealth of Pennsylvania, in Record Book Vol. ______, p. _____, granted and conveyed unto ________________ Bank, its successors and assigns, certain premises therein particularly described (hereafter the “Mortgaged Premises”), to secure the payment of a certain debt or principal sum of $______________, lawful money, with interest as therein provided.


            AND WHEREAS, the said __________________, has requested the said ___________________ Bank to release the premises hereinafter described, being part of said Mortgaged Premises, from the lien and operation of the said Mortgage.


            NOW THEREFORE, __________ Bank, with the intent to be legally bound hereby, and for valuable consideration received from the said ___________________, at the time of the execution hereof, the receipt whereof is hereby acknowledged, has remised, released, quit-claimed, exonerated and discharged, and by these presents does remise, release, quit-claim, exonerate and discharge unto the said ________________, his heirs and assigns:


ALL that certain





            To have and to hold the same, with the appurtenances, unto the said ___________, his successors and assigns, forever feed, exonerated and discharged of and from the lien of the said Mortgage, and every part thereof.  Provided always, nevertheless, that nothing herein contained shall in anywise affect, alter or diminish the lien or encumbrance of the aforesaid Mortgage on the remaining part of said Mortgaged Premises, or the remedies at law for recovering thereout or against the said __________, his heirs and assigns, the principal sum of said Mortgage, with interst secured by said Mortgage.


            IN WITNESS WHEREOF, the said ________ Bank has caused this Release to be signed by its ________ President, attested to by its _______________ and has caused to be affixed hereunto the common and corporate seal of the said corporation this _____ day of ____________, ______.





                                                                                    by: ____________________(SEAL)













            On this, the ________ day of _______________, 20___, before me the undersigned officer, personally appeared _________________, who acknowledged himself to be the ____________________ of __________ Bank, a corporation, and that he as such _________________, being authorized to do so, executed the foregoing instrument for the purposes herein contained by signing the name of the corporation by himself as ______________.


            IN WITNESS WHEREOF, I hereunto set my hand and official seal.




                                                                                                Notary Public





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