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000702
STATE OF WYOMING
STATEMENT OF LIEN
RECEIVED 11/9/2006 at 10:52 AM
RECEIVING # 924253
BOOK: 639 PAGE: 702
JEANNE WAGNER "
LINCOLN COUNTY CLERK, KEMMERER, WY
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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, hereby 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)
Katrina Bareno owes to Star Valley Ranch Association, Inc., the amount of $545.26.
3. That the last known address of Katrina Bareno is P.O. Box 3604 Alpine,
WY 83128.
4. That said debt is owed because of Katrina Bareno's obligation under the
Declaration of Covenants, Conditions and Restrictions of the Star Valley Ranch
Subdivision and the Association.
5. That the name of the person(s) against whom this Lien is claimed is:
Katrina Bareno.
6. That this Lien is for the Association Dues due and owing to Star Valley
Ranch Association, Inc. for the year of 2006.
7. That the legal description of the property benefited by the services of Star
Valley Ranch Association, Inc. is: Lot 91 in Star Valley Ranch Plat 5, Lincoln County
Wyoming.
8. That a copy of the instrument creating the obligation is attached as
EXHIBIT A.
DATED this (¡ 1"kday of November, 2006.
Sharon Backus, Mager
Star Valley Ranch Association, Inc.
Statement of Lien
Page l.of2
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000703
SUBSCRmED 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~uant to the authority givón to
her by said Corporation's Board of Directors, this' day of November, 2006.
WITNESS my hand and official seal.
State of
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NO A PUBLIC
Statement of üen
Page 2 of2
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