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Home My WebLink About930680 ~ :!; bÎI, "0 ~-:: ~'g \ 'Eo 0;>', ~~-ã' bOOO .¡¡ ~ ~ ~gê ..~ ~ ::S "'~8 ;3"0 . S ~ <Ù :.;! Q) ¡g g:E ~~ .... Q) F~ ~ <: (~ .'; 0076370626 RECEIVED 6/26/2007 at 10:56 AM RECEIVING # 930680 BOOK: 663 PAGE: 465 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY MANUFACTURED HOME AFFIDAVIT OF AFFIXATION Record and Return [] by Mail [ ] by Pickup to: WFHM FINAL"DOCS X9999-01M 1000 BLUE GENTIAN ROAD EAGAN, MN 55121 This Instrument Prepared By: DANI MULL Preparer's Name 2387 F ROAD, Preparer's Address 1 GRAND JUNCTION, CO 815050000 Preparer's Address 2 0076370626 Loan Number I { (1 ~"'"'.J'.~, 65 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 4 Initial: ~C·. ð . NMFL # 7111 (MAHA) Rev 05/07 09.:30680 r..n'fÞ,~ ~fS 'u"tJ '. ":t Ii.;) JAY P FONNESBECK CONNIE M FONNESBECK [type the name of each Homeowner signing this Affidavit]: being duly sworn, on his or her oath state as follows: 1. Homeowner owns the manufactured home (" Home") described as follows: USED 1994 CHAMPION LANCASTER New/Used Year Manufacturer's Name Model Name or Model No. 064 X 026 Length x Width 05958248374A 05958248374B Serial No. 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": 244 ELM ST, KEMMERER, LINCOLN, WY 83101 Street or Route, City, County, State Zip Code 5. The legal description of the Property Address ("Land") is: LOT 6 IN BLOCK 3 OF THE OAKLEY SUBDIVISION, LINCOLN COUNTY, WYOMING AS DESCRIBED ON THE OFFICIAL PLAT RECORDED SEPTEMBER 8, 1975 AS INSTRUMENT NO. 470179 OF THE RECORDS OF THE LINCOLN COUNTY CLERK. TAX STATEMENTS SHOULD BE SENT TO: WELLS FARGO HOME MORTGAGE, P.O. BOX 11701, NEWARK, NJ 071014701 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. 7. The Home [~ is [~ 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. 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 4 Initial: ~,d ' NMFl # 7111 (MAHA) 0930680 0',01'" q'</"".{J '. ~ t'! ¡J. ~<-~ . ... ,," ...~.~ 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 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, tow bar or hitch were removed when the Home was, or will be, 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: rClosinq and Aqent: please refer to the Manufactured Home and Land Supplemental Closinq Instructions for completion instructions]: [~ 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. [~ 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. [~ The manufacturer's certificate of origin and/or certificate of title to the Home [ ] shall be [ ] has been eliminated as required by applicable law. [~ 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. .-r-r- (). \ '.' I Page 3 of 4 Initial~ "-. \.: ã:- NMFL # 7111 (MAHA) 09306~O ~··hf}Oð.~ ~ 8 4.,!\Jl '... IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the presence of the undersigned witnesses on this 21st day of June fJ' 2007 C)~ f:.t; ~ 4- ~e ner #1 ( EAL) Witness JAY P FONNESBECK ~ . \...~'~k t' '-' '--m . . , DWnA.L UV I, ¿ . (I Homeowner #2 (SEAL) Witness CONNIE M FONNESBECK Homeowner #3 (SEAL) Witness Homeowner #4 (SEAL) Wit ness STATE OF Wyoming COUNTY OF Lincoln ) ) ss.: ) On the 21st day of June in the year 2007 before me, the undersigned, a Notary Public in and for said State, personally appeared Jay p. Fonnesbeck and Connie M. Fonnesbeck 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. ~~ Notary Signature Lori Kalan Notary Printed Name Notary Public, State of Wyoming Qualified in the County of Lincoln My Commission expires: 02/26/2011 Official Seal: ~ LORI KALAN - NOTARY PUBLIC 1 COUNTY OF STATf Of LINCOLN WYOM!Nl My Commission Expires Feb, 26, 20¡ ..~~_ LORI KALAN - NOTARY PUBLIC COUNTY OF STATE OF LINCOLN WYOMING My Commission Expires Feb, 26, 2011 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 4 NMFL # 7111 (MAHA)