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MANUFACTURED HOME AFFIDAVIT OF AFFIXATION
Record and Return 0 by Mail 0 by Pickup to:
RECEIVED 1/3/2007 at 3:55 PM
RECEIVING # 925792
BOOK: 645 PAGE: 377
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Wells Fargo Bank, N.A.-Construction Lending
2701 Wells Fargo Way, MAC# X9999-01T
Minneapolis, Minnesota 55467
'1,
This Instrument Prepared By:
Wells Fargo Bank, N.A.
2799 Wells Fargo Way, MAC#X9901-08T
Minneapolis, Minnesota 55467
Loan Number: 0067847921
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described
herein and is to be filed for record in the records where conveyances of real estate are recorded.
Page 1 of 5
c:I Marc J. LKset An rights reserved
Rev, 8/22/2005
TODD W. CLARK and PATRICIA LYNN CLARK 0925792
000378
being duly sworn, on his or her oath state as follows:
1. Homeowner owns the manufactured home ("Home") described as follows:
New 2006
New/Used Year
KIT Homebuilders
Manufacturer's Name
Cedar Canyon
Model Name or Model No.
64x26
Length/Width
206KID1302A
Serial No.
206KID1302B
Serial No.
Serial No.
Serial No.
2. The Home was built in compliance with the federal Manufactured Home Construction and Safety Standards Act.
3. If the Homeowner is the first retail buyer of the Home, Homeowner is in receipt of (i) the manufacturer's warranty
for the Home, (ii) the Consumer Manual for the Home, (Iii) the Insulation Disclosure for the Home, and (Iv) the
formaldehyde health notice for the Home.
4. The Home is or will be located at the following "Property Address":
LOT 2 REDTOP SUBDIVISION
Street or Route
SMOOT
City
LINCOLN
County
WYOMING
State
83126
Zip Code
5. The legal description of the Property Address ("Land") is typed below or please see attached legal description:
SEE EXHIBIT "An ATTACHED HERETO AND MADE A PART HEREOF FOR ALL PURPOSES
6. The Homeowner is the owner of the Land or, if not the owner of the Land, is in possession of the real property
pursuant to a lease in recordable form, and the consent of the lessor is attached to this Affidavit.
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described
herein and is to be filed for record in the records where conveyances of real estate are recorded.
Page 2 of 5
tD Marc J. LWset All rights reserved
Rev. 8/1912005
09Z5792
000379
7. The Home 0 is 0 shall be anchored to the Land by attachment to a permanent foundation, 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, and permanently connected to appropriate residential utilities
(e.g., water, gas, electricity, sewer) ("Permanently Affixed"). The Homeowner intends that the Home be an
immoveable 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 govemmental authorities have been obtained;
(b) The foundation system for the Home was designed by an engineer to meet the soil conditions of the Land. 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, placed on the Property Address; and
(d) The Home is (i) Permanently Affixed to a foundation, (ii) has the characteristics of site-built housing, and (iii) is
part of the Land.
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 Homeowner that could reasonably affect the validity of
the title of the Home or the existence or non-existence of security interests in it.
12. A Homeowner shall initial only one of the following, as it applies to title to the Home:
[r.lnKlng AgAnt· plAAKA rAfAr tn thA MAnllfAr.tllrAd HnmA And I And ~lIpplAmAntAI ClnKing
InKtnu~tlnnK fnr cnmplAtlnn inKtructinnK)'
L-J The Home is not covered by a certificate of title. The original manufacturer's certificate of origin, duly
endorsed to the Homeowner, is attached to this Affidavit, or previously was recorded in the real property
records of the jurisdiction where the Home is to be located.
L-J 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 certificate of origin.
L-J The manufacturer's certificate of origin and/or certificate of title to the Home 0 shall be 0 has been
eliminated as required by applicable law.
L-J The Home shall be covered by a certificate of title.
13. This Affidavit is executed by Homeowner(s) pursuant to applicable state law.
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described
herein and is to be filed for record in the records where conveyances of real estate are recorded.
Page 3 of 5
@ Marc J. LKset All rights reserved
Rev. 8/1912005
0925792
0003g0
IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the presence of the
undÐ<Slgned witnesses on this ;:¡ .5 ~ day of T.::é . 200 t.
---7~ tV c~A
TO'bD W. CLARK
(SEAL)
Witness
~{('j}'~ ~(I 0~('Å-~
PATRICIA LYNN CLA ~. - Witness
(SEAL)
Witness
(SEAL)
Witness
STATE OF
¿Jy~
~
. ) ss.:
COUNTY OF
~
On the ;),£ - day of
me, the undersigned, a Notary Public in and for sa'
PATRICIA LYNN CLARK, HUSBAND AND WIF
in the year ::LOOt. before
TODD W. CLARK and
, 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 he/she/they 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
individual(s) acted, executed the instrument.
~(¡¿ AI ~
Notary Signature
(;'¿O"'<?/~ ~. Æ:l YÆÁ?S'
Notary Printed Name
Official Seal:
Notary Public; State of
Qualified in the County of
My commission expires:
W~C7YYU/)?Q
~~,¿ß.¿"Y)
9 -/5 -(J7
g~: ~ BYE.RS. NOTARY PUBLIC
LIncoln . State of
My C Wyoming
ommrssron EXPires Sept. 15, 2007
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described
herein and is to be filed for record in the records where conveyances of real estate are recorded.
Page 4 of 5
c> Marc J. Lllset All rights reserved
Rev. 8/1912005
O~~~'i'92
Lender's Statement of Intent:
000381
The undersigned ("Lender") intends that the Home be an immoveable fixture and a permanent
improvement to the Land.
WELLS FARGO BANK. N.A.
Lender
By:
Authorized Signature
STATE OF
) ss.:
COUNTY OF
On the ;ZS ~ day of
me, the undersigned, a Notary Public in and for said S
LYNN CLARK. HUSBAND AND WIFE
in the year 2. 0 0 éø before
e, personally appeared TODD W. CLARK and PATRICIA
, 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 he/she/they 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
individual(s) acted, executed the instrument.
~ /0/ /).IfO/:>/) /
Notary Signature' ~
Q¿O,RI!:J k. ßY£~S
Notary Printed Name
Notary Public; State of
Qualified in the County of
My commission expires:
~
9 - /5 - 07
Official Seal:
GLORIA K BYERS· NOTARY PUBLIC
County of & State of
Un caIn W Wyoming
My CommlssTon Expires Sepl15, 2001
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described
herein and is to be filed for record in the records where conveyances of real estate are recorded.
Page 5 of 5
CI Marc J, llfset All right. reserved
Rev. 8/1912005
File Number: 6010615274
EXIllBIT "A"
092579,2
LEGAL DESCRIPTION
0003Ð2
Lot 2 of Red Top Subdivision, Lincoln County, Wyoming as described on the official plat filed
on August 8, 2002 as instrument No. 883070 of the records ofthe Lincoln County Clerk
(Ð StreamLine Legal Description - Exhibit "A" @ Rev. 3/22/2006