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)