HomeMy WebLinkAbout976450Note to Clerk: Please Do Not put recording Information Above this Line.
Claimant, State of Wyoming, Department of Health, Division of Healthcare Financing
located at 6101 Yellowstone Road, Suite 210, Cheyenne, Wyoming 82002, hereby
releases the VERIFIED LIEN STATEMENT FOR LIEN FOR MEDICAL ASSISTANCE
which was recorded on May 2, 2011, at Book 766, Page 133, as Document No. 959122 on
property owned by Trudy Merritt and affecting the lands described as:
2014.
Beginning at a point which is East along the Quarter Section line 1001.76
feet and South 7 °25' East, 38.56 feet from the center of Section 23, Township 34
North, Range 119 West, 6 P.M., Lincoln County, Wyoming, and running thence
West 121.67 feet; thence South 7 °25' East 100.46 feet; thence North 82 °35' East,
120.65 feet; thence North 7 °25' West 84.75 feet to the point of beginning, together
with all improvements situate thereon and all easements and appurtenances
belonging thereto.
The above described lien is fully released as to the above described real property,
but Claimant expressly retains and reserves the right to satisfy the remaining debt due and
owing Claimant from any and all other available assets.
Notwithstanding any other provision in this Release of Verified Lien Statement,
Claimant is not releasing or waiving any rights it has or may have to satisfy the remaining
unpaid debt from any and all other assets, including past, present, and future assets,
owned by or in which the Estate of Trudy Merritt has an interest.
IN WITNESS WHEREOF, I do hereunder set my hand this
STATE OF WYOMING
COUNTY OF LARAMIE
ss:
This Release of Verified Lien Statement consisting of t pages was subscribed,
sworn to and acknowledged before me on this 14 day of April, 2014 by Sheila
McInerney as TPL Estate Recovery Specialist of the Wyoming Department of Health,
Division of Healthcare Financing.
WITNESS my hand and official seal.
My Commission expires: \L. Vv\VL r"2,4)%5
976450 5/2/2014 9:04 AM
LINCOLN COUNTY FEES: $12.00 PAGE 1 OF 1
BOOK: 831 PAGE: 411 LIEN RELEASE ON LAND
JEANNE WAGNER, LINCOLN COUNTY CLERK.
1I IIIIIII IIIIIIII IIIIII1
RELEASE OF VERIFIED LIEN STATEMENT
1111111
State of Wyoming,
Department of Health
Notary Public
day of April,
By: Sheila Mclnern.ey
TPL Estate Recovery Specialist
MY COMMISSION EXPIRES MAR. 16, 2015