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Recording Requested By
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And when recorded mail to:
RECEIVED 1/20/2006 at 10:56 AM
RECEIVING # 915363
BOOK: 610 PAGE: 181
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
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WOLCOTTS FORMS INC. WWW.WOLCOTTSFORMS.COM (BOO) 42J.2220
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QUITCLAIM DEED
residing at
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Name 01 granlor(s))
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release, convey and forever quit claim to
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the undersigned grantor(s), for a valuable consideration, receipt of which is hereby acknowledged, do hereby remise,
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1 (Na'me 01 granlee(s))
Av~" He,sfe.'( ",4
residing at
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all interest in the following described real property situated in the County of
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State of
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Assessor's parcel No.
AUTOGRAPH
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AUTOGRAPH
Mail Tax Statement to: L.ou· S,e.. 'U¡ e.d ,,-,<:...,~
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DOCUMENTARY TRANSFER TAX $ 0
o computed on lull value of property conveyed, or
o computed on full value less liens and
encumbrances remaining al time of sale.
Wolcotts Forms, our resellers and agents make no representations or
warranty, express or implied, as to the fitness of this form for any
specific use or purpose. If you have any question, it is always best to
consult a qUalifie~:~;~m~;n,:Ú?tefore using this or any legal document. U!~~¡~¡¡@}
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CLASS 03
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REV. 1-04
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STATE OFCtlh -br () 'ð.
COUNTY OF -S::t0 ~ f'ð...rà\ (\0
}ss.
On this j.fz.... da of ~u.ax L in the year~before me,
r- f"" , a Notary Public, duly
com. missio d and qUalif~d in above said County and State,
personally appeared ,.l€.f\ tV\ð.. v/)
o personally known to me or Já proved tó me on this basis of
satisfactory evidence consisting of an identifying document ~
o tkfJ oath of to be the
person{.d) whose name(.s1' is/¢ subscribed to the within instrument
and acknowledged to me that)l(¡/she/tJ:K(y executed the same in
~/her/tþéfr authorized capacity~), and that by þi1;/herttkéir
signatureffl on the instrument the person~ or the entity upon
behalf of which the personJ.8' acted, executed the same.
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¡ (ti, TmÝ . BARRETT <:
..... comm.# 1454714
( )... . . NOTARY PUBliC· CALIfORNIA m
1 ~ Son Bernoldlno County ...
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WITNESS my hand and official s~
~.' .l{--~ .
AUTOGRAPH
Seal
Corporate or partnership
STATE OF
}ss
COUNTY OF
On this _ day of in the year _. before me,
, a Notary Public, duly
commissioned and qualified in above said County and State,
personally appeared
o personally known to me or 0 proved to me on this basis of
satisfactory evidence consisting of an identifying document or
o the oath of to be the
person(s) whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in
his/her/their authorized capacity(ies), as
and that by his/her/their signature(s) on the instrument on behalf of
,a
organized under the laws of
'executed the same.
WITNESS my hand and official seal.
Seal
AUTOGRAPH
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