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60021 (04)
Record :and Return to:
WELlS FARGO BANK, NA.
FINAL DOCUMENTS X9999-01M
1000 BLUE GENTIAN ROAD
EAGAN, MN 55121-1663
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RECEIVED 2/3/2006 Bt221 PM
RECEIVING:# 915749
BOOK: 611 PAGE: 494
JEANNE WAGNER
.LINCOLN COUNTY CLERK, KE~MERER, WY
MANUFACTURED HOME
AFFIDAVIT OF AFFIXATION
0149943615
BEFORE ME, the undersjgned notary public, on this day personally .appeared
(type the name(s) of.aach Homeowner signing this Affidavit):
known 10 JTIe to be the person(s) whose name(s) islare subscribed below (e.ach.a "Homeowner"), .and
who, being by JTIe :first duly swam, did œcb on his or her oath state .as follows:
1. Homeowner owns the JTI.anUfactured home ("Home") described.as follows:
.."d
USED
New/Used
2000
Year
RADCO/N/A
Model Name / Model No.
"It
-'
GW0R23 N25509A
Serial No.1
GW0R23 N25509B
Serial No.2
OAKWOOD HOMES
Manufacturer's Name
67X27
.1enghtl Width
Serial No.3
Serial No.4
2. The Home w.as built in compliance with the federal Manufactured Home construction .and Safety
Standards Act.
3. If the Homeo~ is thefust reiail buyer of the Home, Homeowner is in receipt of (i) the
:manufacturer's warr.anty for the Home, (ii) the consumer Manual for the Home, (ill) the lnsulation
Disclosure for the Home,..and (iv) the fonnaldehyde health notice.
4. The Home is or will be located .at the following ''Property Address":
249 DOUBLE fAGlE RANCH ROAD,IHA YNE, WY B3127
(Property Address)
5. The legal description of the real property where the Home is or will be permanently affixed ("Land")
.IS:
See Attached Le~al Description
6. The Homeowner is the owner of the Land or, llnot the owner of the land, is inpossesion ofllie
real property pursuant 10 .a lease in recordable form, .and the consent of the lessor is .attached to this
Affidavit.
(Page 1 of£)£C2.28A m:V.12/22/D5
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0149943615
7. The Home Is anchored to the Land by attachment to a permanent foundation,
constructrd in accordance with applicable state and local building codes and manufactures's specifications
in a manner sufficient to validate any applicable manufacturer's warranty, and permanently connected to
appropriate resindential utilities (e.g., water, gas, electricity, sewer) ("permanently affixed"). The
Homeowner intends that the Home be an inm10veable fixture and a permanent improvement to the
Land.
8. The Home shall be assessed and taxed as an improvement to the Land
9. Homeowner agrees that as of today, or if the Home is not yet located at the Property Address, upon
the delivery of the Home to the Property Address:
(a) All permits required by governmental authorities have been obtained;
(b) The foundation system for the Home was designed by an engineer to meet the soil conditions of
Property Address. All foundations are constructed in accordance with applicable state and local building
codes, and manufacturer's specifications in a manner sufficient to validate any applicable manufacturer's
warranty.
(c) The wheels, axles, towbar or hitch were removed when the Home was, or will be, placed on the
Property Address;
(d) The Home is (i) permanently affixed to a foundation, (ii) has the characteristic of site-built housing,
and (iii) is part of the Land; and '
(e) The Home is permanently connected to a septic tank or sewage system and other utilities such as
electricity, water and natural gas.
10. If the Homeowner is the owner of the Land, any conveyance or financing of the Home and the
Land shall be a single transaction under applicable state law.
11. Other than those disclosed in this Affidavit, the Homeowner is not aware of (i) any other claim, lien
or encumbrance affecting the Home, (ii) any facts or information known to the applicant that could
reasonably affect the validity of the title of the Home or the existence or non-exixtence of security
interests in it.
12. A release of lien from each of the lien holders identified in paragraph 11 of this Affidavit _ has
been shall be delivered to the commissioner of motor vehicles.
13. A homeowner shall initial only one of the following, as it applies to title to the Home:
~ The Home is not covered by a certificate of title. The original manufacturer's certificate of origin,
duly endosed to the Homeowner, is attached to this affidavit.
~ The Home is not covered by a certificate of title. After diligent search and inquiry, the Homeowner
is unable to produce the original manufacturer's certifi~te of ori in.
~ The certificate of title to the Home ~shall be xx eliminated as required by applicable
~ The Home shall be covered by a certificate of title.
14. The Homeowner designates the following person to record this Manufactured Home Affidavit of
Affixation and upon its recording it shall be returned by the recording officer in the real property records
where the home is to be located to same:
Name:
Address:
15. The Affidavit executed by Homeowner(s) pursuant to applicable state law.
(Page 2 of 5) EC228C Rev. 12/22/05
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0149943615
IN WI1NESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the
prese of the under sin 'tness s on this ~Ð~ day of ,7àAA. vCt..v( .,
-Borrower ~(¡ /ttLw -Borrower
Witness
Witness
STATE OF ~DM~£-'S
COUNTY OF ~¡j
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On the· 3D~ day of JÓ---\- UOV-~ in the year "2JX)ç, before
me the undersi ed, a Notary Public in and for said State, personally appeared
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personally known to me or proved to me on the oasis of satisfactory evidence to be the individual(s)
whose name(s) is~subscribed to the within instrument and acknowledged to me that he/she/~
executed the same in his/her/.!heir-capacity(ies), and that by hislherltb.cir..J¡ignature(s) on the instrument,
the individual(s), or the person on behalf of which the individual(s) acted, executed the instrument.
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Notary Printed Name
Notary Public; State of LU'10iM (&1 5
Qualified in the County of Li h C-o[ V'I
My commission expires tD {'r;;; ('2-1)0/
(Page 3 of 5)
EC228E Rev. 12/22/05
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::,00497
0149943615
Lender's Statement of Intent:
The undersigned ('Lender") intends that the Home be an immoveable fixture and a pennanent
improvement to the Land.
WELLS FARGO BANK. NA
Lender
By, ~e Wg~~
STATE 0 F \. \ ~I lO-\lY\,Út\ ex- )
~.J..A l^ V ) sS.:
COUNTY OF \.oc:.Al'J;'7 , )
day of 1="eJo in the year dOO l.p
tar Public in and for said State, personally appeared
1"6
personally Known to me or proved to me on the basis of satisfactory evidence to be the individual(s)
whose name(s) is(are) subscribed to the within instrument and acknowledged to me that helshelthey
executed the same in his/her/their capacity(ies), and that by his/her/their signature(s) On the instrument
the individual(s), or the person on behalf of which the individua1(s) acted, executed the instrument.
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N~~I~~ l-aY'tL
Notary Public; State of aéM
Qualified ~ t?e Cou!lty of' ,~
My commlSSlOn expJres _ __
before
Official Seal:
JACKLYNN LA~cè'. NOTARY,PU~lJc
COUNTYOF e' ., ·...SJAT.EO.F
TETON· wYOMING
MV CO~MISSldNE)ÇPlR~S 9-28-08'
A 1TENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on
the Property described herein and is to be filed for record in the records where conveyances of real
estate are recorded. (Page 4 of 5)
EC228G Rev, 12/22/05
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~OC498
EXHIBIT A
0149943615
PROPERTY DESCRIPTION
.. f h P t Address ("Land") is typed below or please see attached
The legal descnptlOn 0 t e roper y .
legal description:
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LEGAL DESCRIPTION
A portion or the SE1/4 or Section 26, T34N, Rl19W, 6th P.M., located South rrom
the Town of Thayne, Lincoln County, Wyoming being more particularly described
as follows:
BEGINNING at a point in the North line Or that certain parcel Or land described
in Exhibit "A" or Warranty Deed recorded in Book 365 P.R., Page 459, Lincoln
County, Wyoming, said point being 776.87 feet N89°53'2QuE.from the Northwest
corner of said parcel of land; thence running N89°53'20"E, along said North line
394.05 reet; more or less, to the ~ortheast corner Or saidparcel¡ thence S30
11'37"E, along an Easterly line of said parcel, 325.07 feet¡ thence West 412.16
feet; thence North 323.80 feet to the Point of Beginning.
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(Page 5 of 5) EC2281 REv. 12/20/05