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STATE OF WYOMING
SS.
COUNTY OF LINCOLN
COMES NOW, Linda A. Miller, whose address is P.O. Box 3230, Alpine, Wyoming
83128, being duly sworn on oath according to law, does hereby make the following
statement of facts and affirms:
1. That she is the owner of Lots 401 -410 as depicted on the plat titled, "FINAL PLAT
PALIS PARK FOURTH ADDITION TO THE TOWN OF ALPINE WITHIN
NW1/4SE1/4 SECTION 29 T37N RI 18W WITHIN THE INCORPORATED LIMITS
OF THE TOWN OF ALPINE, LINCOLN COUNTY, WYOMING dated 25
October 2000, as revised.
2. She has reviewed said plat.
3. She has read and understands the provisions of the Certificate of Owner thereon and
the implications thereof.
4. That this affidavit is signed in the stead of and has the sane effect as if the original
mylar of said addition had been signed.
DATED this c-a. day of L .%rIbC<2000.
nda A. Miller
The f• otng instrument was acknowledged before my by Linda A. Miller, this
day ofd 2000.
Witness my hand and official seal.
Notary Public
My commission expires: 8 04.
307 885 9809;
AFFIDAVIT
Dec -1 -00 1:09PM;
Page 2/2
d
Recorded r 1.�:'� at rr.:�l.',�.'�M
in Book 4- Page Pa e 1 Kemmerer, WY
Jeanne Wagner, Clerk