HomeMy WebLinkAbout948250RECORDING REQUESTED BY
EL DORADO COUNTY DEPARTMENT
OF CHILD SUPPORT SERVICES
COUNTY CODE: 0601700
WHEN RECORDED MAIL TO
EL DORADO COUNTY DEPARTMENT OF
CHILD SUPPORT SERVICES
3057 BRIW RD STE B
PLACERVILLE CA 95667-5321
RECEIVED 7/13/2009 at 1:51 PM
RECEIVING # 948250
BOOK: 727 PAGE: 365
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
C-106365
SPACE ABOVE THIS LINE RESERVED FOR RECORDER'S USE
DOCUMENT TITLE
NOTICE OF LIEN
ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address):
FOR RECORDER'S USE ONLY
Recording requested by and return lo:
DAVID L. BURNS, ATTORNEY
EL DORADO COUNTY
3057 BRIW RD STE B
0670490337-01
PO BOX 391
PLACERVILLE CA 95667-5321
TELEPHONE NO.: (866) 901-3212 FAX NO. (Optional): (530) 621-2022
ATTORNEY FOR = JUDGMENT CREDITOR ® ASSIGNEE OF RECORD
SUPERIOR COURT OF CALIFORNIA, COUNTY OF Wyoming/Lincoln
STREET ADDRESS:
MAILING ADDRESS: PO Drawer 510
CITY AND ZIP CODE: Kemmerer 83101
BRANCH NAME:
PETITIONER/PLANTIFF: STATE OF WYOMING, EX REL., STATE OF
CALIFORNIA
RESPONDENT/DEFENDANT: KASEY J COY
OTHER PARENT:
CASE NUMBER:
NOTICE OF LIEN
CU2007178DC
COUNTY RECORDER TRANSMITTAL STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
DCSS 0635 (08/20108) DEPARTMENT OF CHILD SUPPORT SERVICES
COMPLAINT
NOTICE OF LIEN
0®0366
TO:
Registrer of Deeds
Lincoln County Clerk, 925 Sage Ave. Suite 101, Kemmerer, WY 83101-0670
Obligor:
KASEY J COY, 01/05/1975, 564-83-2757
88 NIELD AVE, AFTON WY 83110-9774
FROM:
EL DORADO COUNTY DEPT. OF CHILD SUPPORT SERVICES
PO BOX 391, PLACERVILLE CA 95667-0391
(866) 901-3212, dcss@co.el-dorado.ca.us, (530) 621-2022
Obligee:
CHERYL A LESHER
IV-D Case 0670490337-01
This lien results from a child support order, entered on by WY in Wyoming/Lincoln tribunal
number CU2007178DC.
As of 06/04/2009 , the obligor owes unpaid support in the amount of $396.53
This judgment may be subject to interest.
Prospective amounts of child support, not paid when due, are judgments that are added to the lien
amount. This lien attaches to all non-exempt real and/or personal property of the above-named
obligor which is located or existing within the State/county of filing, including any property
specifically described below.
Specific description of property:
88 NIELD AVE, AFTON WY 83110-9774
Pagel of_3
0®036'
All aspects of this lien, including its priority and enforcement, are governed by the law of the
State where the property is located. An obligor must follow the laws and procedures of the State
where the property is located or recorded. An obligor may also contact the entity sending the
lien. This lien remains in effect until released or withdrawn by the obligee or in accordance with
the laws of the State where the property is located.
Note to Lien Recorder: Please provide the sender with a copy of the filed lien, containing
the recording information, at the address provided above.
Check either "A" or "B" below. The option that does not apply may be omitted from the form.
If "B" is checked, the form must be notarized.
A. [ ] Submitted by a IV-D agency/office on behalf of the named obligee
As an authorized agent of a State or Tribal, or subdivision of a State or Tribal, agency
responsible for implementing the child support enforcement program set forth in Title IV, Part D,
of the Federal Social Security Act (42 U.S.C. 651 et seq.), I have authority to file this child
support lien in any State, or U.S. Territory. For additional information regarding this lien,
including the pay-off amount, please contackthq, authorized agency and reference its case
number, both listed above. , , I . . ,/7 06/04/2009 4// v
Date Authorized Agent
SHERIE L MARINO
Print name, e-mail address, phone and fax number
B. [ ] Submitted by an obligee or a private (non-IV-D) attorney or entity on behalf of an
obligee
I am [ ] the obligee of the above referenced order [or]
[ ] an attorney or entity representing the above named obligee
I certify under penalty of perjury that the information contained in this notice is true and accurate
and that this lien is submitted in accordance with the laws of the State of
For additional information regarding this lien, including the pay-off amount, please contact the
obligee listed above.
Date
Signature
Print name, e-mail address, phone and fax number
Page 2 of 3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 00CY368
State of California
County of
On C 4,GQ before me, -J1UF1 E. E-RtSE N0-r PZ/ 9lA13L1C_
Date Here In ert me and Title of the Officer
personally appeared S }}F_:7&tP7 Name L, tAtR,V0
(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to
be the person, s hose names/are subscribed to the
within instrument and acknowledged to me that
he/she/they executed the same in his/her/their authorized
capacity(i , and that by his/her their signatureoron the
instrument the personigr,-or the entity upon behalf of
JULIET F. E Rem! which the personp)`~cted, executed the instrument.
COMM. 01718870 m
Net" Pubib-CdNomlo N
U.1 EL DORADO COUNTY I certify under PENALTY OF PERJURY under the laws
My Comm. Exp. Jan21,2011 of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature
Place Notary Seal Above
Sig atur of N ary Public
77
OPTIONAL -
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent remo
val and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document: _ MCE
F `-IEW l CA120 -7 1-7
C
Document Date: CCr, /Q 4I 16GI
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I Ne1.(A.0tn1 ~
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Number of Pages:
Signer(s) Other Than Named Above: _
Capacity(ies) Claimed by Signer(s)
Signer's Name:
Signer's Name:
❑ Individual
❑ Individual
❑ Corporate Officer - Title(s):
❑ Corporate Officer - Title(s):
❑ Partner - ❑ Limited ❑ General
❑ Partner - ❑ Limited ❑ General
•
El Attorney in Fact
❑ Attorney in Fact •
~
❑ Trustee
7
El Trustee Top of thumb here
7
❑ Guardian or Conservator
❑ Guardian or Conservator
❑ Other:
❑ Other:
Signer Is Representing:
Signer Is Representing:
®2007 National Notary Association- 9350 De Soto Ave., P.O. Box 2402 -Chatsworth, CA 91313-2402 - www.NationalNotaryorg Item #5907 Reorder: Call Toll-Free 1.800-876-6827