Your Name/Name
Address
Postal Code/ City
Destination
Address
Postal Code/ City
Done
[your city], on [specify date].
Object :Release of Debt
Madam, Sir,
I, the undersigned [last name, first name], born [date of birth], residing [place of birth], have received;u the sum of [sum in words] euros or [sum in figures] euros régl;s by [means of payment], from [name, préname], born [date of birth]; [place of birth] and residing [state your address].
This sum is the loan I made to him on [date], repaid in full this day.
This release therefore cancels the IOU previously issued on [date] à [place of signature].
[date and signature]