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RECEIVED 7/14/2008 at 12:13 PM
RECEIVING # 940499
BOOK: 699 PAGE: 834
JEANNE WAGNER
W · fL· LINCOLN COUNTY CLERK, KEMMERER, WY
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for and in corisideration of 917" /UN~{~IVC 'N;?,~{~ ~
Dollars ($ q ~q. Oï) ) and other good and valuable consideration, to me paid, the receipt whereof is hereby
acknowledged, do hereby waive, release, remise and relinquish any and all right to claim any lien or liens for work done or material
furnished, or any kind or class of lien whatsoeyer on the following described property:
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Title owner of said property:
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Signed, sealed and dated this /0 t"f'L day of
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Signed in the presence of:
Witness
State of ~k 6
County of ~-4-;;;; ....1/(
On ~l~ ~ 0 <f; before me, ~ \0 '..cL ~_/'+~
. appeared ~ (I ~ P(lciil.e.~
personally known to me (or p d to me on the basis of satisfactory evidence) 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), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
WITNESS my hand and official seal.
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Signature
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