29-10-106. Form for notice of satisfaction of lien.

(a) The form for notice of satisfaction of a lien shall be filed with the county clerk's office in the county where the property against which the lien was filed is located, sent to the record owner and shall be completed in substantially the following form:

Note to lien claimant: This form, if filled out correctly and filed with the county clerk's office within the time period specified in W.S. 29-1-314 constitutes prima facie evidence that you have fulfilled your obligation to file a notice of satisfaction of the lien required by W.S. 29-1-313 and 29-1-314. If you have any questions regarding how to fill out this form or whether it has been filled out properly, you should consult an attorney.

STATE OF _____________ )

) ss.

COUNTY OF _____________ )

NOTICE OF SATISFACTION OF LIEN

Pursuant to the provisions of W.S. 29-1-313, the undersigned hereby files its notice of satisfaction of lien statement and hereby releases its lien(s), filed with the Clerk of __________________ County on the ______ day of ______________, 20___, commencing at Page ______ of Book _______.

Dated this ______ day of ______________, 20___.

Name of lien claimant: ______________________________

By: ____________________________________

Signature: ______________________________

Title: _______________________________

Note to Notarial Officer: If the lien claimant is a legal entity formed under Title 17 of the Wyoming Statutes or other applicable law, use the first jurat. If the lien claimant is an individual or sole proprietor, use the second jurat.

(Alternative 1:)

STATE OF __________________ )

) ss.

COUNTY OF __________________ )

On this _____ day of ______________, 20___, subscribed and sworn to before me personally appeared ______________________________ (name of signatory), to me personally known, who has read the foregoing Notice of Satisfaction of Lien and knows the contents thereof and the facts are true to the best of his/her knowledge, and being by me duly sworn, did state that he/she is the ______________________________ (title, position or type of authority granted by lien claimant) of ______________________________ (lien claimant) and that this Notice of Satisfaction of Lien was signed and sealed on behalf of the lien claimant by authority granted to the signatory by the lien claimant.

Witness my hand and official seal.

______________________________

Notarial officer

My Commission Expires:

Seal:

(Alternative 2:)

STATE OF __________________ )

) ss.

COUNTY OF __________________ )

On this _____ day of ______________, 20___, subscribed and sworn to before me personally appeared ______________________________ (name of signatory), to me personally known, who has read the foregoing Notice of Satisfaction of Lien and knows the contents thereof and the facts are true to the best of his/her knowledge, and being by me duly sworn, did state that the Notice of Satisfaction of Lien to be the free act and deed of the lien claimant.

Witness my hand and official seal.

______________________________

Notarial officer

My Commission Expires:

Seal: