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Recording Requested By
QUITCLAIM DEED
STATE OF
1
J
5 Q i e
WOLCOTTS FORMS INC.
SINCE 1893
(Name of grantor(0)
the undersigned grantor(s), fora luable consideration, receipt of which is hereby acknowledged, do hereby remise, release,
convey and forever quitclaim to i( v s S e /14 j Ni i 7'
(Name of grantee(s))
the following escribed real property City R ty L. 1 C o, N State of L Y
g p perly In the Ci of da /Je y 12a.,, un of
I r S i X 7 -e e (14) 1 era
iv ;T,Jo./
Assessor's.parcet No.
Executed on in the City of
COUNTY OF t it I r)
Q120 before me, M(1 n! r{\l(,t.,n 7 Notary
On
Public, personally appeared attrYl 5 V (C•Q_
who proved to me on the basis of satisfactory evidence to be the person(s) whose
name(s) is/are subscribed to the within instrument and acknowledged to me that
he /she/they executed the same in his /her /their authorized capacity(ies), :and that by
hislher /their signature(s) on the instrument the person(s) or the upon behalf of
which the-person(s) acted;' executed the instrument.
I. certify under Penalty of Perjury under the laws of the State that the
foregoing paragraph is true arid correct.
WITNESS my han ftd official seal.
JENNIFER BRYANT
Notary Public
Lincoln County
Wyoming
Myl`.A9nrnh isslorl: EOM))
Signs
It tAX'STIVATTO:
Wolcotis Forms, our metiers and agents make no representations or warranty. excess or Implied, es.to
the fitness of this fomr for any specific Use or purpose If you have: any Russtlon it Is. always best to
consult a. qualifed attorney before using this or any legal documeht. 62007 Wotc oT1 FORMS.: INC.
977563 7/17/2014 4:21 PM
LINCOLN COUNTY FEES: $12.00 PAGE
BOOK: 836 PAGE: 288 DEED, QCD
JEANNE WAGNER, LINCOLN COUNTY CLERK
11111111141101 11111111111111III 1111111111 H ll111111111111111111II IIII IIII
Space above this line for recorder's use
DOCUMENTARY TRANSFER TAX S
0 computed on full value of property conveyed, or
O computed on full value less liens and
encumbrances remaining at time of sale.
Autograph of Declarant or Agent Determining Tax Firm Name
CAPACITY CLAIMED BY' SIGNER(S)
a Individuals)
0 Corporate
Officer(s)
A Partners) ha Limited ['General
cl Attorney in Fact
0 Trustee
0 Guardian/Conservator
RIGHT THUMBPRINT' Si ner #1
RIGHT THUMBPRINT Signer #2