FORM OR RECEIPT ON DISCHARGE OF A MORTGAGE
M., of [etc.] hereby acknowledges the receipt of all moneys...
Dated this .................... day of .................... 19....................
W. [signatures of witnesses or witness] [addresses and occupations...
1.The mortgage is comprised of the following deed or deeds....
2.The mortgagee executing the receipt is the original mortgagee.
The mortgagee executing the receipt derives title under the original...
[Here state the manner in which title is derived, listing...