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SINCE 1904
RECEIVED 7/1/2008 at 4:23 PM
RECEIVING # 940238
BOOK: 699 PAGE: 6
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
Re~urn To:
COUNTRYWIDE BANK, FSB
MS SV-79 DOCUMENT PROCESSING
P.O. Box 10423
Van Nuys, CA 91410-0423
000006
Prepared By:
MARIA ELENA NICK
AFFIX A TION AFFIDAVIT MANUFACTURED HOME
61986 00019245033606008
[Escrow/Closing #] [Doc ID #]
THE STATE OF
COUNTY OF
Section:
Block:
Manufactured Home Affixation Affidavit
1 E227·XX (03/07),03(dll)
Lot:
Unit:
Page 1 of 4
1111111
· 2 3 {I 9 1 ·
1111111111.111111
· 1 924 503 3 6 0 0 0 0 0 1 E 2 2 7 .
· FROM CHL
.......····".JUN 28 2008 5: !54/ST. 6: 51 /NO'. 7--"'---""31158 P 18
000007
BEFORE ME, the undersigned
Kenneth E. KIRKPATRICK
DOC ID #: 00019245033606008
authority, on this day personally appeared
("Borrower"), known to me to be the person(s) whose name(s) is/arc 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 located
31 LARIAT CIR, ETNA, WY 83118-9718
in LINCOLN County, ("Property Address") is
permanently affixed to a foundation, is made a part of the land and will assume the
characteristics of site-built housing.
2. The manufactured home is des ibed as f¡Q1l s; I ~T'\-
o ~ (f ~f\o . ~ ;4 ~ .:;.)~ I B S 3/ 3
New se Manufacturer's Name Manufacturer', Name and Model No.
N N I D ..3 q ~"o A 8 5 y X ;l.t.o Attach Legal Description
Manufacturer's Serial No. Length/Width
3. The wheels, axles. tow bar or hitch were removed when the manufactured home was
placed and anchored on its permanent foundation, and the manufactured home waf!
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.
4. All foundations, both perimeter and piers, for the manufactured home have footings that
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 Properly Address.
5. If piers are used for the manufactured home, they have been provided.
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 required by governmental authorities have been obtained.
8. The manufactured home is permanentJy connected to appropriate residential uti]jties such
as electricity, water, sewer and natural gas.
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 Manufactured Home
Construction and Safety Standards Act.
11. The undersigned acknowledge his or her intent that the manufactured home wiIJ be an
immovable fixture, a permanent improvement to the land and a part of the real property
securing the Security Instrument.
12. The manufactured home will be assessed and taxed by the applicable taxing jurisdiction
as real estate.
Manufactured Home Affixation Affidavit
1 E227·XX (03/07).03 ,
Page 2 of 4
000008
DOC ID #: 00019245033606008
13. The borrower is the owner of the land and any conveyance or financing of the
manufactured home and the land shaH be a single real estate transaction under applicable
state law.
Borrower(s) certifies that Borrower(s) is in receipt of (a) the manufacturer's recommended
carpet maintenance program (if required by Lender), (b) any manufacturer's warranties that
are still in effect and cover the heating/cooling systems, water heater, range, etc., and (c) the
formaldehyde health notice. This affidavit is being executed pursuant to applicable state law.
Witness
Witness
~~ t, ']¡,~~A4
KENNETH E, KIRKPATRICK
PO BOX 7230, JACKSON, WY 83002
G -;<" - 0 9\
Borrower
Date
Borrower
Date
Borrower
Date
Borrower
Date
S tat e 0 f \.,..J", '>_:~.-.:;.., ""(..
County of\:.-( ')...-t:> .~" '7- cD
Subscribed ,and sworn to (or affirmed) before me on this cS day of '). \:j~1l..- lC\)~,
by \b.¿. ),1\\)\.-1).."-'-'...... '\L'i'i "-l. ~~H \ \.. ')C personally known to me or proved to
me on the basis of satisfactory evidence to be the person(s) who appeare before me.
~\:~5 SG-- \~
,....'.-.."'......
C::~S:fA CAPEeNER. NOTARY :~:
Teton Wyoming
M Commission expires Ma 19, 2012
[Acknowledgment on Following Page]
Manufactured Home Affixation Affidavit
1 E227·XX (03f07).03
Page 3 of 4
000009
DOC ID #: 00019245033606008
I LENDER ACKNOWLEDGMENT
LenÅer's Statement of Intent:
The ¡underSigned Lender intends that the manufactured home be an immovable fixture and a
perrr¡.anent improvement to the land.
LENþER: '~
BY.~", t.
Its: -t.. Â
S tat e 0 f \..A..... ~ ""-
State of lA-\-t\..V\
#'
§
§
County of \J0¿\o.e...v , (city or town),§
This instrument was acknowledged before me on b / q / og [date],
~ 'J ¡,.. \ ¡ I
by ~.£.S \ C.t\.. L- \ :JlA.r- I-a \.oJ ~ k , [name of agent],
o _--,,-1)0'115 maM.Cc-~ [title of agent] of
( Ov...."\.kV'1 IAl-- ð-e. ß{lVl. ~I FS.B' [name of entity acknowledging],
a [state and type of entity], on behalf of
[name of entity acknowledging].
"
JOEL KENNY
.1IIr1W&C......
17M 1t41.....
OCIDIN. UT.....
COIM. EXP. ".~ 0
Signature ~ ~er
£~ Î O'-LI fJ+(... ~ ,C v ~
Title of Notarial Officer
My commission expires: 7/Z.5.>//D
":,--.,
Manufactured Home Affixation Affidavit
1 E227-XX (03/07),03
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