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COUNTY OF LINCOLN
COMES NOW LaVonne M. Wathen, who, being duly sworn on oath according to law, does
hereby makes the following statements of facts and affirms:
1. That she is an owner of part of the lands depicted on the map titled, "COKEVILLE
THIRD ADDITION TO THE TOWN OF COKEVILLE IDENTICAL WITH LOT 10
OF BLOCK 9 LOTS 3, 4 AND 5 OF BLOCK 19 LOTS 1, 2 AND 3 OF BLOCK 20
AND FOURTH STREET BETWEEN BLOCKS 19 AND 20 OF THE ORIGINAL
TOWNSITE OF COKEVILLE WITHIN TRACT 90 T24N RI19W LINCOLN
COUNTY, WYOMING as revised.
5. That she has reviewed said map.
6. That she has read and understand the provisions of the Certificate of Owners thereon and
the implications thereof.
7. That this affidavit is signed in the stead of and has the same effect as if the original mylar
of said map had been signed.
DATED this day of '72 6 2009.
aVonne M. Wathen
CERTIFICATE OF SIGNATURE
The foregoing instrument was acknowledged before me by LaVonne M. Wathen, this a Y -day
of 72 2009.
Witness my hand and official seal.
NaDene Dana NOTARY PUBLIC
County of
Lincoln
State of
Wyoming
My Commission Expires May 20, 2013
My commission expires: r/ Cty old D /3
&-fix—
otar Public
000597
RECEIVED 12/18/2009 at 12:24 PM
RECEIVING 951181
BOOK: 738 PAGE: 597
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY