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Complaint: COMPLAINT FOR RECOVERY OF CIVIL PENALTY PURSUANT TO N.C.G.S 45-36.3 1., _ and _ are citizens and residents of, and and are citizens and residents of. 2., is a with an office and doing business in the State of and is not suffering under any disability. 3. On or about, and executed a promissory note to _, secured by a Dee of Trust, dated, and recorded on, in Book, at page in the office of the County, North Carolina, Register of Deeds. 4. Subsequently acquired or was assigned the aforesaid note and Deed of Trust 5. On or about and purchased the property described in the aforesaid Deed of Trust and the sum of $ was paid to in full and final satisfaction of the indebtedness out of the proceeds of the sale. 6. More than 60 days has passed since received full satisfaction if the indebtedness secured by the aforesaid Deed of Trust and defendant has neglected and refused, after notice and demand, to comply with the provisions of N.C.G.S. 45-36.3(a), in that has not canceled the Deed of trust of record nor has forwarded the note and Deed of Trust with payment and satisfaction acknowledged in accordance with the provisions of N.C.G.S. 45-37. 7. On, Attorney in compliance with the Requirements of N.C.G.S. 45-36.3(b), notified of the obligation to discharge and release the lien of the aforesaid Deed of Trust. More than thirty (30) days have elapsed since s receipt of said notice.

8. s unwarranted refusal and neglect to discharge and cancel the lien of the Deed of Trust of record constitutes a cloud on title to the property and violates the provisions of N.C.G.S. 45-36.3. 9. (optional - if plaintiffs have special damages set forth the allegations here ) WHEREFORE, pray judgment against as follows: 1. A penalty of $ 500.00 in favor of and, and $500.00 in favor of and as prescribed by N.C.G.S. 45-36.3(b); and 2. (optional) - Damages in the sum of $ in favor of and. 3. That the Trustee be directed and authorized by the Court to cancel the Deed of Trust, or, alternatively, that the Court enter a Judgment to be recorded in the Office of the Register of Deeds for County, N.C. canceling the Deed of Trust of Public Record. 4. Recovery of the costs, including reasonable attorney s fees, required by plaintiffs to prosecute this action; and 5. Such other and further relief as the Court may deem just and proper. This the day of,. and LLP By: Attorneys for

Motion for default: MOTION AND AFFIDAVIT FOR ENTRY OF DEFAULT, by counsel and pursuant to Rule 55(a) of the North Carolina Rules of Civil Procedure, move that default be entered in this action against _, on plaintiffs claim, and in support of this motion makes the following affidavit: NORTH CAROLINA COUNTY SS: _, being duly sworn, deposes and says that: 1. A complaint was filed in this action by Plaintiff seeking affirmative relief on ; 2. A summons and a copy of the complaint were served upon by serving its registered ( optional - authorized) agent via certified mail, return receipt requested, on ; 3. Personal jurisdiction of the defendant was acquired by service of process in the manner described above; ( optional - because is without a place of business or registered agent in the State of North Carolina, but subjected itself to the jurisdiction if the courts of North Carolina through the purchase or mortgage indebtedness secured by property located in County, North Carolina; 4. No answer, other responsive pleading to the complaint, or extension of time to file an answer or any responsive pleading has been filed, requested by or granted to or by the ; 5. The time within which an answer or other responsive pleading may be filed has expired. 6. Affiant has expended hours in the prosecution of this action and customarily charges $ per hour for similar matters. This the day of,.

Judgment: JUDGMENT THIS MATTER COMING on for Hearing before the undersigned Judge of the District Court of County on Plaintiff s Motion for Hearing; and It appears to the Court that default was previously entered in this matter on or about the day of, by the Clerk of Superior Court of County, and that the matter is properly before the Court. Based thereon the Court makes the following Findings of Facts, enters its Conclusions of Law and its Judgment based thereon: FINDINGS OF FACT: 1. This Court has personal and subject matter jurisdiction, the is not suffering under any disability and this matter is properly before the Court. 2. This is an action brought by against to enforce the requirements of N.C.G.S. 45-36.3 which requires that the holder of an indebtedness secured by a Deed of Trust cancel or make provisions for cancellation of its Deed of Trust in a timely manner not more than 60 days after satisfaction plus 30 days after notice pursuant to the statute. 3. satisfied the secured indebtedness and was notified of its obligation to cancel or provide for cancellation of the Deed of Trust. 4. failed to do so within 60 days as provided by Statute. 5. After 60 days had elapsed without complying with the Statute, by and through their attorney provided the 30 day notice required by the Statute and failed and neglected to comply with the provisions of the Statute. 6. filed a complaint against in this matter on the day of, and was properly served as required by law. failed to answer or respond and Default was entered by the Clerk of Superior Court of County on or about the day of,.

7. ( optional - were damaged in the sum of $ ) 8. are entitled to attorney s fees and $ is a reasonable amount. BASED UPON THE FOREGOING FINDINGS OF FACT THE COURT MAKES THE FOLLOWING CONCLUSIONS OF LAW: CONCLUSIONS OF LAW: 1. are entitled to recover of the for its failure to comply with the requirements of N.C.G.S. 45-36.3. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED THAT: 1. and recover of the a civil penalty in the amount of $ 500.00. 2. and recover of the a civil penalty in the amount of $ 500.00. 3. ( optional - and recover of the damages in the amount of $. 4. recover of the reasonable attorney s fees required to prosecute their claim in the amount of $. 5. That the Trustee is directed and authorized by the Court to cancel the Deed of Trust, or, alternatively, that this Judgment may be recorded in the Office of the Register of Deeds for County, N.C. for the purpose of canceling the Deed of Trust of Public Record. 6. That the costs of this action be taxed against the. This the day of,. Judge Presiding