HomeMy WebLinkAbout892885 RECEIVED
LINCOLN COUNTY CLERK
When Recorded Relurn Io:
892885
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Espy Law O[fice, P.C. 6 3 0
Nansen Building
2515 Warren Avenue, Suite 501
Cheyenne, WY 82001
RELEASE OF VERIFIED LIEN STATEMENT
Claimant, State of Wyoming, Department of Health, Office of Medicaid located at
2300 Capitol Avenue, Room 147, Cheyenne, Wyoming 82002, hereby releases the
VERIFIED LIEN STATEMENT FOR LIEN FOR MEDICAL ASSISTANCE which was
recorded on May 16, 2002, in Book 489, Page 569 as Document No. 881023 on property
owned by Louis J. Bazzanella, Jr. and affecting the lands described as:
The Lots Numbered 1 and 2, of the Block Numbered 19 in the First Addition
to the TOwn of Kemmerer, Lincoln County, Wyoming, together with all
improvements thereon.
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 Louis J. Bazzanella Jr. has an interest.
IN WITNESS WHEREOF, ldo hereunder set my hand this ¢¢'-z/~ day of August,
2003.
Sta~Wyoming, ~
By:' Debbie Paiz ~ J "-......
Its: Recovery Manager .____~
STATE OF WYOMING )
) SS.
COUNTy OF LARAMIE )
The foregoing Release of Verified Lien Statement was subscribed and sworn to
before me by Debbie Paiz this 6¢ day of August, 2003.
My Commission expires:
WITNESS my hand and official seal.
Notary Public