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RECEIVED 5/12/2008 at 4:38 PM
RECEIVING # 938951
BOOK: 694 PAGE: 415
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
0004:15
LSI - FNIS
Recording Department
700 Cherrington Parkway
Coraopolis, PA 15108
MANUFACTURED HOME
AFFIDA VIT OF AFFIXATION
0175907906
BEFORE ME, the undersigned notary public, on this day personally appeared
ELIZABETH C SPOMER
known to me to be the person(s) whose name(s) is/are subscribed below (each a "Homeowner"), and
who, being by me first duly sworn, did each on his or her oath state as follows:
}. Homeowner owns the manufactured home ("Home") described as follows:
USED
New/Used
2001
Year
OAKWOOD HOMES
Manufacturer's Name
NA/02 662F
Model Name / Model No.
68 X 27
Length / Width
GWOR23N25610
Serial No, 1
GWOR23N25610
Serial No, 2
Serial No.3
Serial No, 4
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.
4. The Home is or will be located at the following "Property Address":
549 FOREST CIRCLE, ALPINE, WY 83128
(property AddreSS)
5. The legal description of the real property where the Home is or will be permanently affixed ("Land")
IS:
See Attached Leeal Description
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.
(Page 1 of 4) EC228A REV. 02/02/07
00041.6
0175907906
7. The Home Is 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 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-existence of security
interests in it.
12. 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 endorsed 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 certificate of origin.
_ The 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. The Affidavit executed by Homeowner(s) pursuant to applicable state law.
(Page 2 of 4) EC228C Rev. 02/02/07
00041.7
0175907906
IN WI1NESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the
Rresence of the undersigned witnesses on this 26 day of A-fv'\ ,
1ßa.-1 .
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ELIZABETH C POMER -Borrower KATH MER
-Borrower
Witness
STATE OF
COUNTY OF
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Witness
'2~ 'À.f1V\ \
On the day of 'r' . in the year Zøèß before
me,_ the u~dersf~, ed, a Notary Public in and (or said State, personal1y a '. r-r
2A.bd~, v VI".ct ~--D, ¿>',I\.' ':' , / ,/.:.."J 1... n 1t.µ\
personal1y known to me or proved to me on the basis of s tisfactoryevidence 0 be the indivi ual(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' . idual(s), or the person on behalf of which the individual(s) acted, executed the
instrument.
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Magda Esposito. Notary Public
Moon Twp., Allegheny County
My Commission ExpIres Oct. 4, 2009
Member, Pennsylvania Association of Notaries
Notary Sipn.a e
tvl(~ C\, 0:~~\
Notary Printed ame
Notary Public; State of ~,¡A.:
Qualified ~ t.he Cou~ty of t:.~Vui.ft..t..f
My COmI11lSSI0n expires ' _ 0
(Page 3 of 4)
EC228E Rev. 02/02/07
00041.8
EXHIBIT A
0175907906
PROPERTY DESCRIPTION
The 1eg~ll description or the Property Address ("Land") is typed below or please see attached
legal description:
(Page 4 of 4) EC2281 REv. 02/02/07