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STATEMENT OF LIEN
STATE OF WYOMING
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COUNTY OF LINCOLN
I, Sharon L. Backus, Manager for Star Valley Ranch Association, Inc., a
Wyoming Corporation, being first duly sworn, h~reby state as follows:
1. Star Valley Ranch Association, Inc., is located at 781 Vista Drive, P.O.
Box 159 Thayne, WY 83127 and is the entity hereby seeking enforcement of this Lien.
2. That under the provisions of the Declaration of Covenants, Conditions and
Restrictions of the Star Valley Ranch Subdivision and the Association ("the Declaration)
Joshua E. Johnson owes to Star Valley Ranch Association, Inc., the amount of Five
Hundred Twenty Three Dollars and Forty-Four Cents ($523.44).
3. That the last known address of Joshua E. Johnson is P.O. Box 3617
Alpine, WY 83128.
4. That said debt is owed because of Joshua E. Johnson's obligation under
the Declaration of Covenants, Conditions and Restrictions of the Star Valley Ranch
Subdivision and the Association.
II
5. That the name of the person(s) against whom this Lien is claimed is:
Joshua E. Johnson.
6. That this Lien is for the Association Dues due and owing to Star Valley
Ranch Association, Inc. for the year of 2005.
7. That the legal description of the property benefited by the services of Star
Valley Ranch Association, Inc. is: Plat 5 Lot 17.
8. That a copy of the instrument creating the obligation is attached as
EXHIBIT A.
DATED this 1~ay of October, 2005.
RECEIVED 10/20/2005 at 10:39 AM
RECEIVING # 912977
BOOK: 601 PAGE: 868
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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Sharon Backus, Manager
Star Valley Ranch Association, Inc.
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Statement of Lien
Page 1 of2
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SUBSCRIBED AND SWORN TO, AND ACKNOWLEDGED before me by
SHARON BACKUS, who acknowledged further that she is the Manager of Star Valley
Ranch Association, Inc., and that she signed the foregoing STATEMENT OF LIEN for
and on behalf of Star Valley Ranch Association, In~'rrsuant to the authority given to
her by said Corporation's Board of Directors, this' day of October, 2005.
WITNESS my hand and official seal.
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NOTARY PUBLIC ¿(
My Commission expires: Q '5 'O~.. .l.OO';-
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SUO ELLA PETTY NOTARY PUBLIC ~\'
State of
County of Wyoming
Uncoln
My Commission Expires May 7, 2007
Statement of Lien
Page 20f2
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