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COUNTY OF LINCOLN
COMES NOW Ryan H. Teichert and Jamie L. Teichert, husband and wife, who, being duly
sworn on oath according to law, do hereby make the following statements of facts and affirms:
1. That they are owners 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 R119W LINCOLN
COUNTY, WYOMING as revised.
2. That they have reviewed said map.
3. That they have read and understand the provisions of the Certificate of Owners thereon
and the implications thereof.
4. 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 3O day of J1JV 2009.
The foregoing instrument w s acknowledged before me by A. Ryan H. Teichert and Jamie L.
Teichert, this 30 day of (A/r 2009.
Witness my hand and official seal.
CERTIFICATE OF SIGNATURE
My commission expires: /1 g e-Z//
OO6O1
RECEIVED 12/18/2009 at 12:28 PM
RECEIVING 951185
BOOK: 738 PAGE: 601
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY