HomeMy WebLinkAbout952616MEDICAL SERVICES PROVIDER LIEN
COLLECTION PROFESSIONALS, INC
P.O. BOX 1340
CODY WY 82414
307 587 -4761 RECEIVED 3/22/2010 at 10:13 AM
RECEIVING 952616
BOOK: 744 PAGE: 203
CHRISTOPHER PIERCE JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
02 -25 -10
Collection Professionals, Inc., acting as agent for the clients listed below including
services rendered by the same clients, is hereby filing a lien against any real property
owned by CHRISTOPHER R PIERCE including but not limited to property owned at
1418 VISTA DR, STAR VALLEY RANCH, WY 83127.
Legal Description:
STAR VALLEY RANCH, UNIT 13, LOT 50, TOWNSHIP 35, RANGE 118, SECTION 32
Property may not be sold, traded, deeded, willed or in any way change ownership without
payment in full to be made directly to Collection Professionals, Inc. up to amounts
necessary to retire the above indebtedness in full, including additional accruing interest.
Name :Aeix.... /te;i Account Executive for Collection Professionals, Inc.
P.O. BOX 1340, CODY WY 82414. L.
Signature:
Date: //l�
State of Wyoming
County of PARK
The foregoing instrument was acknowledged before me by
Account Executive for Collection Professionals, Inc., P.O. BOX 1340, CODY WY 82414.
This day of ina./ cl. 20 0
Clients included in this lien:
CREDITOR /ACCOUNT NUMBER
ST JOHN'S HOSPITAL
20107874
ST JOHN'S HOSPITAL
20144106 -0001
ST JOHN'S HOSPITAL
30106578 -0001
ST JOHN'S HOSPITAL
30106520 -0001
ST JOHN'S HOSPITAL
30044322 -0001
ST JOHN'S HOSPITAL
30180964 -0001
A
NOTARY PUBLIC
STATE OF
WYOM
o ary Public
AMT /SVC DT INTEREST
0.00 0.00 35.00
10 -10 -02
2,379.06 1,455.10 0.00 3,834.16
09 -11 -03
310.85 21.46 0.00
06 -29 -06
596.66 275.89 0.00
06 -29 -06
645.95 329.29 0.00
04 -06 -05
347.57 20.91 0.00
12 -01 -07
FEES
LOIS L. TAYLOR
COUNTY OF
PARK
MY COMMISSION UMES
TOTAL
35.00
332.31
872.55
975.24
368.48
CONTINUED FOR: PIERCE, CHRISTOPHER ACCT# 880705
CREDITOR /ACCOUNT NUMBER AMT /SVC DT INTEREST FEES TOTAL
ST JOHNS MED CTR ER PHYSICIANS 66.00 39.43 0.00 105.43
0022424765 12 -01 -07
Additional Judgment Charges /Interest 891.97
TOTAL 4,346.09 2,142.08 35.00 7,415.14
WY -MSPL 880705
000204