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6010715712
When Recorded Return to:
E & S Legal Services, LLC
Post Offièe Box 3029
Cheyenne, VVY 82003
RELEASE OF VERIFIED LIEN STATEMENT
Claimant, State of Wyoming, Department of Health, Office of Medicaid located at 6101
Yellowstone Road, Suite 210, Cheyenne, Wyoming 82002, hereby releases the VERIFIED LIEN
STATEMENT FOR LIEN FOR MEDICAL ASSISTANCE which was recorded on 5/16/2005, in Book
585, Page 358, as Document No. 908423 on property owned by Nelda Schwab and affecting the
lands described as:
County of Lincoln, State of Wyoming
Beginning at the point which is 5 rods South of the Northwest corner
of Lot Number 2, Block Number 26, of the Afton Townsite Survey and
running thence South 3 rods; thence East 8 rods; thence North 3
rods; thence West 8 rods to the place of beginning. Containing 24
square rods of land.
000408
The above described lien is fully released as to the above-described real property, but
Claimant expressly retains and reserves. the right to satisfy the remaining debt due and owing
Claimant from any and all other available assets.
Notwithstanding any other provision in this Release of Verified Lien Statement, Claimant is
not releasing or waiving any rights it has or may have to satisfy the remaining unpaid debt from any
and all other assets, including past, present, and future assets, owned by or in which the Estate of
Nelda Schwab has an interest.
IN WITNESS WHEREOF, I do hereunder set my hand this
RECEIVED 8/20/2007 at 4:56 PM
RECEIVING # 932311
BOOK: 669 PAGE: 408
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
8-fb day of MONTH, 2007.
STATE OF WYOMING )
) ss.
COUNTY OF LARAMIE )
The foregoing instrument was acknowledged before me by Sheila Mcinerney this ~ay
of August, 2007.
By: Sheila Mclnerne
Its: Recovery Manager
WITNESS my hand and official seal.
~:~ ,?-. OoJt¡~
No Pub ic
My Commission expires: ~, s· ø
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