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Promissory Note Release

In consideration of full and final payment of the promissory note dated [Date], in the face amount of [$------], [Name] of [Address], herein the "Noteholder", releases and discharges [Name] of [Address], herein the the "Borrower", from any claims or obligations on account of this note.

The party signing this release intends that it bind and benefit both itself and any successors.

Dated:

Signature

[Name], Noteholder

This Section for Notary:

Acknowledgment

STATE OF -------)

) ss: [Date]

COUNTY OF ------)

On [Date] before me, [Name of Notary], notary, personally appeared [Name of Person(s) Involved], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

Witness my hand and official seal.

[Signature]

[Name of Notary Public]

My commission expires: [date]

(Seal)