HomeMy WebLinkAbout963991Recording requested By: Fire Services of
Idaho, Inc.
When recorded, mail to: Space above reserved for use by Recorder's Office
Name: Fire Services of Idaho, Inc. Document Prepared by:
Address: 610 Mallard Name: John Holman
City: Chubbuck Address: 610 Mallard
State /Zip: Idaho, 83202 City /State /Zip: Chubbuck, ID 83201
Claim of Lien
State of Wyoming, County of Lincoln
I, Fire Services of Idaho, being duly sworn, state the following:
In accordance with an agreement to provide labor and /or material, I did furnish the following labor and /or
materials:
Annual Service of the Fire Extinguishers
on the following described real property located in Lincoln County, State of Wyoming, commonly known
as:
and legally described as:
Bello 's Italian Grille
46 W. Hwy 26
Alpine, WY 83128
Alpendorf subdivion
Lot 1
RECEIVED 4/6/2012 at 9:49 AM
RECEIVING 963991
BOOK: 784 PAGE: 288
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
28
which property is owned by All Seasons LLC (Larry Reinhart) whose address is PO Box 5054 Idaho
Falls, ID 83405 of a total value of $189.46 plus accruing interest, of which there remains unpaid $189.46
plus accruing interest, and I further state that I furnished the first of the items on the date of 23- Jan -12,
and the last of the items on the date of 23- Jan -12.
I hereby, under the laws of the State of Wyoming, claim a lien against the above described property in the
amount of money, stated above, which remains unpaid to me.
Name of erson Claii g Lie
On I 4. Greg Thompson, an employee of Fire Services of Idaho Inc.,
came be re me personally and, under oath, stated that he /she is the person described in the above
document and that he /she signed the above document in my presence.
Nota ry Si latu
Notary Public,
In and for the County of
My commission expires:
CERTIFICATE OF MAILING
I, certify that on this date,
I have mailed a copy of this claim of Lien by USPS certified mail, return receipt requested, in accordance
with the law, to:
Name:
Address:
Date:
Signature of Person Mailing Claim of Lien
Name of Person Mailing Claim of Lien
64(tAmocE
1(1 I 1 1e7
State of
00289