V. Cautionnement

This conveyance and transfer in payment, dation en paiement, is made in consideration of the acquittal and general and final discharge which Mr. B....… , hereby grants unto Mr. A... of a sum of... and interest accrued thereon up to this date ; which said sum is due to Mr. A... by Mr. B..... by virtue of... ete., (describe the title or cause of the debt ; if it is a hypothecary debt, stipulate the main levée).

For the execution... , ete.

Done and passed..……. , ete.