HomeMy WebLinkAbout972672Recording 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 Heather Warner
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:
Service and repairs on paint booth fire system
on the following described real property located in Lincoln county, State of Wyoming, commonly known
as:
and legally described as:
RECEIVED 8/15/2013 at 10:22 AM
RECEIVING 972672
BOOK: 818 PAGE: 21
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Salt River Auto Body
93 CMR
Thayne WY 83127
CMR subdivision
3 filing
L 19
which property is owned by Christopher Rachael Wolfley whose address is 2725 County road 122
Thayne, WY 83127, of a total value of $385.15 plus accruing interest, of which there remains unpaid
$385.15 plus accruing interest, and I further state that I furnished the first of the items on the date of 05-
July- 2013, and the last of the items on the date of 05 -July- 2013.
I hereby, under the laws of the State of Idaho, claim a lien against the above described property in the
amount of money, stated above, which remains unpaid to me.
Vv
Signature of Person Claiming Li' n�
e
Rw1+hk' V ai any
Name of Person Claiming Lien
Address of person claiming lien:
610 Mallard, Chubbuck, Idaho 83202
On /lug 9' Go /3 Heather Warner, an employee of Fire Services of Idaho Inc.,
came befre 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.
fr-ft Lr'ne
Notary Signature
Notary Public,
In and for the County of i &p1 f7QLJ
My commission expires: a /(Q /Z C.)/
State of L L h.
Seal
0022