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RECEIVED LINCOLN COUNTY CLERK AFFIDAV ~1, RSUANT TO 03 0~T 23 W.S. 34-11-101 (Facts affecting title to real est,~.p_,~Nf~E WAGNER and NOTICE OF TRUST OR REPRESENTATIVE CAPACITY OF GRANTEE MADE PRUSUANT TO W.S. 34-2-123 STATE OF VVYOMING COUNTY OF LINCOLN SS. Deon F. Heiner and Quinn R. Heiner, of Thayne, Lincoln CoUnty, Wyoming, upon their oaths depose and state as follows: 1. By a Patent of the United States of America, Patent Number 49-2003~0024 ("the Patent"), dated August 11,2003, the United States of America conveyed the following described real property located in Lincoln County, Wyoming, to Deon F: Heiner and Cheryl V. Heiner, Trustee, in trust for Deon F. Heiner and Cheryl V. Heiner, Beneficiaries under the Deon F. Heiner and Cheryl V. Heiner Family Revocable Trust, and Quinn R. Heiner and Carolyn S. Heiner, Trustee, in trust for Quinn R. Heiner and Carolyn S. Heiner, Beneficiaries under the Quinn R. Heiner and Carolyn S. Heiner Family Revocable Trust ("the property"): Sixth Principal Meridian, Lincoln County, Wyoming T. 33 N., R. 118 W., sec. 7, E1/2SE1/4; sec. 8, Sl/2; sec. 9, Sl/2SWl/4. 2. The Patent was recorded in the office of the Lincoln County Clerk on August 14, 2003, in Book 531 PR, page 022, Recorder's Number 892495. 3. The persons making this affidavit and statement are trustees and beneficiaries of the trusts named as grantees in the Patent. 4. Carolyn S. Heiner became deceased on ~)//. // issuance of the Patent. ,200o'L, prior t© the 300 5. The information required by W.S. 34-2-122 that should have been set forth in the Patent is the correct information as to the grantees, their trusts, and resultant representative capacity stated as follows: Deon F. Heiner and Cheryl V. Heiner, Trustee, in trust for Deon F. Heiner and Cheryl V. Heiner, Beneficiaries under the Deon F. Heiner and Cheryl V. Heiner Family Revocable Trust dated May 16, 1997, and Quinn R. Heiner, Trustee, in trust for Quinn R. Heiner, Beneficiary under the Quinn R. Heiner and Carolyn S. Heiner Family Revocable Trust dated May 16, 1997. 6. As stated above, the Patent contained incorrect information that may affect title to the property. Affiants as grantees in the Patent have knowledge of the facts and are competent to testify concerning them in open court and make this affidavit to correct the information set forth in the Patent. 7. The facts stated in this affidavit may affect title to the property consisting of lands located in LinColn County, Wyoming, as more particularly described above. DATED this 8th day of October, 2003. Quinn R. Heiner this Subscribed, verified and sworn to before me by Deon F. Heiner and Quinn R. Heiner !._~. day of ~ r_.J¢'-O~ 6¢--.. , 2003. Witness my hand and official seal. County of ~ State of ~ My Commission Expires: · NOTARY PUBLIC 2