HomeMy WebLinkAbout939141
RECEIVED 5/20/2008 at 11 :36 AM
RECEIVING # 939141
BOOK: 695 PAGE: 62
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
000062
Retum To:
AFFIXATION AFFIDAVIT
MANUFACTURED HOME
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Prepared By:
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THE STATE OF lo'-(
COUNTY OF L):V\.1<...O(...N
· Affixation Affidavit Manufactured Home
1E221-US (05/04)(d) Page 1 of 5
000063
BEFORE ME, the undersigned authority, on this day personally appeared ,
.5Æ.AN Aße.. ~I11S AAJ,D <:.. ~1i.RRJ:: G-Ol'LD
("Borrower"), known to me to be the perncn(s) whose narne(s) is/are subscribed below, and who, being
by me first duly sworn, did each on his or her oath state as follows:
1) The manufactured home located on the following described property locatedlP3 ðQ./IW Cv,.c..£.. B;¡,.Jr.. s
in G./"\ c.o'" County, r'Property Address") is
permanently affixed to a foundation, is made a part of the land and will assume the characteristics
of site~built hQusing,
2) The manUfactu. red hom~ described as follows:
lÁ.~ ~""¿ð~
New/Used Manufacturer's Name
(l. M./ (l.. () ('IS c.o 1.. no'1í'tR-(S .:J, ~ ~ ("1_
Manufacturer's Serial No. LengthlWidth
3) The wheels, axles, towbar or hitch were removed when the manufactured home was placed and
anchored on its permanent foundation, and the manufactured home was oonstructed in accordance
wIth applicable state and local building codes and manufacturer's specifications in a manner
sufficient to validate any applicable manufacturer's warranty,
4) All foundations, both perimeter and piers, for the manufactured home have footings thet are located
below the frost line and the foundation system for the manufactured home was designed by an
engineer to meet the soil conditions of the Property Address.
5) If piers are used for the manufactured home, they are placed where the home manufacturer
recommends.
6) If state law so requires, anchors for the manufactured home have been provided.
7) The foundation system of the manufactured home meets applicable state Installation requirements
and all permits re!: uired by govemmentalauthorities have been obtained.
6) The manufactured home is permanently connected to appropriate residential utilities such as
electricity, water, sewer and nsturs! gSB.
9) The financing transaction Is intended to create a first lien in favor of Lender. No other lien or
financing affects the manufactured home, other than those disclosed In writing to Lender,
10) The manufactured home was built In compliance with the federal Manufaotured Home Con$truction
and Safety Standards Act
11) The undersigned acknowledge his or her Intent that the manufactured home will be an immovsble
fixture, a permanent improvement to the land and a part of the real property securing the Security
Instrument.
~ ~ -...-e. ôltÁ-
Manufacturer's Name and Model No.
Attach Legal Description
· Affixation Affidavit Manufactured Home
1E227~US (05/04)
Page 2 of 5
)
000064
12) The manufactured home will be assessed and taxed by the applicable taxing jurisdiction as real
estate.
13) ¡he borrower is the owner of the land and any conveyance or financing of the manLlfactured home
and the land shall be a single real estate transaction under applic:eble state law.
Borrower(s) certifies that Borrower(s) is in receipt of manufacturer's recommended maintenance program
regarding the carpet and manufacturer's warrantie$ covering the heating/cooling systems. hot water heater,
range, etc,; and the formaldehyde health notice. This affidavit is being executed pursuant to applicable
SK':h-fr\. C; ~
Witness
Witness
¿~{L~~
CN1.~~~
51¥ç~
(Borrower)
(Date)
5/2JO'ð
( orrower)
(Date)
(Borrower)
(Date)
(Borrower)
(Date)
(Acknowledgment on Following Pages]
· Affixation Affidavit Manllf'actured Home
1E227-US (05/04)
Page 3 of 5
000065
BORRO~RACKNOWLEDGMENT
Stateof wëf\~\~ ~
County of 0.c'o\ otk § Àr\.r\ n
This Instltlmeni:ià. acknowledged before me on '~1 I \~¿ ,?,- dC:O~
by :>tÑ-l A'8Ir.AM~ AHa ~Hf.AA.r £;...,,"0 .
(Seal)
l ~.~~6~~
Signature of Nðofficer
C·().O
Title of Notarial Officer
STACY SAUNDERS - NOTARY PUBLIC
COUNTY OF ~TATE OF, \
~U61 "'rrE " NYOMING
t,) be,
MCommisslon Expiros ~anuary 1'1, 20'11
My commission expires:
dø.;\'\u.~ n, ¿;lOt \
()
. AffIXation Affidavit Manufactured Home
1E227-US (05/04)
Page 4 of 5
000066
Ma~ 05 2008 9:37AM
Wind River Tobacco Co.
307-733-3899
o. 10
LeNDERACKN~DGMENT
LAmd."e 8taœm.nt of Intent:
Tn. und./'IIlgned Lender ¡ntencfe that the manufactured home bè an immovab'e fixture and a permanent
Improvement t:llhe Jand,
LENDfFl.; . ~ _ ~
By~ -WU()..,Cf 'Ln\Jol11i
QrS mqr
Statem Wù'tl~ð- ~
County of ~ ~
Thl$ Il'1Strument WÐ$ acknowledged before me Ort
by 1ð~ Dw~
Tis:
U'1 ÍJ. 1~
[d8te],
(name of agent],
[title of .agent] of
[name of entity ackncw\edglng).
a
[state and type of entity], on behalf of
(name of entity acknowledg!ngJ.
COUNTY OF
LARAMIE
STATE OF
WYOMING
~c4u1ß.- JW1 0Jvo
Slgnaturé of Notarial Officer
~AÁ. /JP.~.I:~+
Title of Notarial Officer
My commissIon eJeplres.:
(Seal)
MICHELLE M. SAlJ.S ~ NOtARY PUBLIC .
My Commission Expires April 20, 2011
· AffbcaUon Affidavit Manufactured Home
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