WA Mortgage (Statutory Form) 1

WHEN RECORDED RETURN TO:

Name: ________________________

Address: ______________________

City, State, Zip _________________

Stewart Title Guaranty Company LPB No. 50

MORTGAGE (STATUTORY FORM)

THE MORTGAGOR _________________________________________________

mortgage to _________________________________________________________

to secure payment of the sum of __________________________________________ _________________________________________________ Dollars ($ __________ ), according to the terms of promissory note ________ bearing __________ date, ______ _______________ the following described real estate, situated in the County of ____________________________ State of Washington:

And the mortgagor ___________ promise ___________ and agree _____________ to pay before delinquency all taxes, special assessments and other public charges levied, assessed or charged against said described premises, and to keep all improvements on said described premises insured against loss or damage by fire in the sum of ____________________________________

________________________________________ Dollars, ($ __________________ ) for the benefit of the mortgagee ____________ and to deliver all policies and renewals to the mortgagee

In case the mortgagor ________ shall fail to pay any installment of principal or interest secured hereby when due or to keep or perform any covenant or agreement aforesaid, then the whole indebtedness hereby secured shall forthwith become due and payable, at the election of the mortgagee.

Tax Account Number: _______________ DATED: ___________________

_________________________________ _____________________

________________________________ _____________________

STATE OF WASHINGTON )

ss.

COUNTY OF _________________ )

On this _________ day of ___________________, ______ before me, the undersigned, a notary public in and for the State of Washington, duly commissioned and sworn, personally appeared __________________________________________ known to me to be the individual(s) described in and who executed the within instrument and acknowledged that _____ signed and sealed the same as _______ free and voluntary act and deed, for the uses and purposes herein mentioned.

__________________________________________

Printed Name: ______________________________

Notary Public in and for the State of Washington

Residing at ______________________________

My appointment expires ______________________

STATE OF WASHINGTON )

ss.

COUNTY OF _________________ )

I certify that I know or have satisfactory evidence that ___________________________________________________ is the person who appeared before me, and said person acknowledged that _____ signed this instrument, on oath stated that ______ was authorized to execute the instrument and acknowledged it as _____________________________ of ________________________________________________ to be the free and voluntary act of such party for the uses and purposes mentioned in the instrument.

Dated: ___________________

___________________________________________________

Printed Name: _______________________________________

Notary Public in and for the State of Washington

Residing at _______________________________________

My appointment expires _______________________________