Record of Mortgage by Deposit of Title Deeds

To...

(Name of Mortgagee)

(Address)

Sir, I have to record that I have this day deposited with you the title-deeds (as per List hereto attached) relating to my immovable property situate at ... and consisting of land admeasuring about ... Sq.Metres and bearing S.No. ... with a building thereon being Municipal No. ... with intent to create a security thereof for repayment of the loan of Rs. ... lent and advanced by you to me, this day. with interest ..... p. c. per annum.

Dated this ... day of ...

Yours faithfully,

(Mortgagor)