HomeMy WebLinkAbout899540When Recorded Return to:
Espy Law Office, P.C
Hansen Building
2515 Warren Avenue, Suite 501
Cheyenne, WY 82001
RECEIVED
LINCOLN BOUNTY CLERK
RELEASE OF VERIFIED LIEN STATEM~'NT~.,_,.~ ,~ ..... PF ,,.'~" ~'~. (~t',?E R'"I '
Claimant, State of Wyoming, Depa~ment of Health, Office of Medicaid located at
2300 Capito~ Avenue, Room 147, Cheyenne, Wyoming 82002, hereby releases the
VERIFIED LIEN STATEMENT FOR LIEN FOR MEDICAL ASSISTANCE which was
recorded on September 5, 2003, in Book 533, Page 649, as Document No. 893148 on
prope~y owned by Konst~nce Merchant and affecting the lands described as:
Lot 6 of Block 57 in the Second Addition to the Town of Kemmerer, Lincoln
County, Wyoming as described on the official plat thereof. 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 Konstance Merchant has an interest.
IN WITNESS WHEREOF, I do hereunder set my hand this /d~ day of May,
2004.
~.S. ta~Wyom i ng, ~
By: Debbie Paiz
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 / ~?~.a. day of May, 2004.
My Commission expires:
WITNESS my hand and official seal.
Notary Public
1