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Notice Of Renunciation To Party Liable On Instrument
To: [Party Liable on Instrument]
The undersigned, [Name], of [Address], is the holder of a negotiable instrument executed on [Date] by [Drawer] and drawn on [Drawee], of [Address], for the payment of [$------] on [Date] to the order of [Payee], of [Address].
The undersigned renounces all claim that [Name] may have against you as [indorser or as the case may be] of the instrument described above.
Undersigned [the holder of a negotiable instrument]
*** If Required By State Law ***
This Section for Notary:
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.
[Name of Notary Public]
My commission expires: [date]