Fill and Sign the 29 10 106 Form for Notice of Satisfaction of Lien 2013

Request for Entry of Notice of Satisfaction Page 1 of 1 REQUEST FOR ENTRY OF NOTICE OF SATISFACTION--INDIVIDUAL (Wyo. Stat. §29-1-303) On this the _____ day of _______________, 20______, the undersigned does hereby request that __________________________________ as lien claimant, enter a satisfaction to release any lien he or she may have relating to labor performed and/or materials furnished in connection with the following improvements _______________________________________________________________________ ______________________________________________________________________________________________________________________________________________ to property located at _______________________________________________________________________ within thirty (30) days after receiving payment for such performance of labor or furnishing of materials. In addition to any actual damages, if the lien claimant refuses or neglects to enter satisfaction within thirty (30) days after payment as provided by Wyo. Stat. §29-1- 302 and after having received this request, the lien claimant will be liable for damages of not less than one-tenth of one percent (.10%) of the original principal amount of the debt per day until such time as the lien claimant enters satisfaction. The additional damages authorized by Wyo. Stat. §29-1-303 shall not exceed one hundred dollars ($100.00) per day. __________________________________ Signature __________________________________ Type or Print Name Certificate of Delivery I, _______________________________, hereby certify that I have delivered this day a true and correct copy of the foregoing to the lien claimant, __________________________________ by: ( ) Mailing a true and correct copy of same by certified or registered U.S. mail, postage prepaid, return receipt requested to ___________________________________. So certified this the _____ day of ________________, 20______. ________________________ Signature