HomeMy WebLinkAbout979906This document was prepared by:
Kevin L. Hillier
After recording return to:
RoHillCo Business Solutions LLC
P.O. Box 2014
Lake Oswego, OR 97035
503 636 -0495
STATE OF WYOMING
COUNTY OF LINCOLN
statement and swears as follows:
LIEN STATEMENT
979906 12/31/2014 2:21 PM
LINCOLN COUNTY FEES: $15.00 PAGE 1OF 2
BOOK: 845 PAGE: 725 MECHANIC'S LIEN
JEANNE WAGNER, LINCOLN COUNTY CLERK
1111111111111111111110111111111111111111111111111011111111111111111111111
Pursuant to the provisions of W.S. 29 -1 -312 relating to lien statements, the undersigned hereby files this lien
1. Name and address of lien claimant: GTS Interior Supply —10819 120 Avenue NE, Kirkland WY 98033.
2. The amount claimed to be due and owing; $9,555.68, plus pre judgment interest at a rate of 9% (if applicable),
and attorneys' fees and costs incurred by lien claimant in the collection of this amount.
3. The names and addresses of the persons against whose properties the lien is tiled include:
Lynn A. and Laniece Trust P.O. Box 255, Afton WY 83110-0255.
4. An itemized list setting forth and describing the work performed or materials furnished by the lien claimant:
Building material and professional services. The amounts are due and owing from Majestic Drywall LLC for the
work performed and/or materials provided.
5. The name of the persons whom the lien claimant asserts is /are obligated to pay the debt secured by the lien:
Majestic Drywall L.LC P.O. Box 5091, Etna WY 83119.
6. The lien claimant last performed work, or furnished materials, for which the lien claimant asserts a lien on
the 26th day of September, 2014.
7. The legal description of the real properly where the lien claimant performed work or furnished materials is
described as T36 8119 S4 L 03 PT L 04 PT L 05 PT SW4NE4 PT NW4SE4 PT TOTAL 31.19 ACRES and as
further described in the document records at Lincoln County in the instrument n.umbered 2012-801-176. The situs
address is 1477 McCoy Forest Road, Alpine WY, State of Wyoming, County of Lincoln.
8. A true and accurate copy of the written contract, if available, under which the lien claimant perfonned work or
furnished materials is not in.ciuded. If the contract was oral or is too extensive, the patties to the contract and
contract terms are described above between GTS Interior Supply (Claimant) and Majestic Drywall LLC (debtor).
A copy of the written contract, if applicable, is located at the following address:
GTS Interior Supply 10819 120'x' Avenue NE, Kirkland WA 98033.
Name of lien claii ant: GTS Interior Supply.
X
By: Mich e1 D. HillierIt's Agent
Dated: December, 3b 2014
State of Oregon
SS
County of Clackamas
Signature:
The foregoing instrument was acknowledged before me by
Michael D. Hillier, Agent for GTS Interior Supply
This 7 jO day of December, 2014
Witness my hand and seal.
Notary Public, Bend Oregon
My commission expires
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