FORM CC-1505 MASTER 10/19
CERTIFICATE AND AFFIDAVIT OF SATISFACTION
COMMONWEALTH OF VIRGINIA VA. CODE §§ 55.1-339 to 55.1-345
........................................................................................................................................................... Circuit Court
is the location of the following record referenced by this certificate:
.......................................................................... ..................... ........................ .................................
DATE, [ ] DEED OF TRUST [ ] OTHER LIEN DEED BOOK NO. PAGE NO. INSTRUMENT NUMBER
..............................................................................................................................................................................
PARCEL IDENTIFICATION NUMBER/TAX MAP NUMBER
..............................................................................................................................................................................
NAME(S) OF GRANTOR(S)/MAKER(S)
..............................................................................................................................................................................
NAME(S) OF TRUSTEE(S)
$ .......................................................................................
AMOUNTS AND TOTAL OF NOTE(S)
I/WE, lien creditor, settlement agent, or title insurance company, who made payment in satisfaction of the above-mentioned
note(s) secured by the above-mentioned deed of trust or other lien, do hereby certify that the same has/have been paid in full,
and the lien therein created and retained is hereby released.
.............................................................. __________________________________________________________________________
DATE AUTHORIZED SIGNER
__________________________________________________________________
[ ]
LIEN CREDITOR
[ ] SETTLEMENT AGENT (RESA Registration No. ................................................. )
(Settlement Agent’s A
FFIDAVIT and NOTICE OF INTENT is attached.)
Pursuant to authority granted by Virginia Code § 55.1-339(E)
[ ] TITLE INSURANCE COMPANY (Title Insurance Company’s Affidavit and Notice of
Intent is attached.)
Pursuant to authority granted by Virginia Code § 55.1-339(E)
State/Commonwealth of ............................................... [ ] City [ ] County of .......................................................
Acknowledged, subscribed and sworn to before me this .................... day of ............................................... , 20 ...........
by
.........................................................................................................................................................................
LIEN CREDITOR, SETTLEMENT AGENT OR TITLE INSURANCE COMPANY
................................................................................. ________________________________________________________
PRINTED NAME OF NOTARY PUBLIC SIGNATURE OF NOTARY PUBLIC
(My commission expires ................................................. )
Registration No. .........................................................
VIRGINIA:
IN THE CLERK’S OFFICE OF THE CIRCUIT COURT
This certificate and affidavit of satisfaction was presented and, with the Certificate annexed, admitted to record on
.............................................. at ...................... m.
DATE TIME
Clerk’s fee of $ .......................... have been paid.
_____________________________________ , Clerk by __________________________________ D
eputy Clerk
