HomeMy WebLinkAbout9479136010917 93 6 rec dc4l by
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/alliance Title and Escro"r`
as a cOurtcsy
RECEIVED 6/22/2009 at 3:10 PM
RECEIVING # 947913
BOOK: 725 PAGE: 881
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
CqGiAsl
MANUFACTURED HOME AFFIDAVIT OF AFFIXATION
Record and Return [ ] by Mail [ ] by Pickup to:
WFHM FINAL pOCS X2599-024
405 SW 5TH STREET
DES MOINES IA 50309-4600
This Instrument Prepared By,
CLOSER I OMAHA
Preparer's Name
1919 DOUGLAS,
Preparer's Address 1
OMAHA., NE 681010000
Preparer's Address 2
0102258308
Loan Number
ATTENTION COUNTY CLEWThis 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 Inidal'712-~~
NMFL # 7111 (MAHA) Rev 21412008
11 V 882
TIMOTHY MASTRUD
CYNTHIA MASTRUD
[type the name of each Homeowner signing this Affidavlt]
being duly sworn, on his or her oath state as follows:
1. Homeowner owns the manufactured home ("Home") described as follows:
USED 1997 ATLANTIC HOMES 8579 056 x 027
New/Used Year Manufacturer's Name Model Name or Model No Length x Width
47978668579A 479786685798
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 (1) the
manufacturer's warranty for the Home, (ii) the Consumer Manual for the Horne, (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
2003 DEL RIO DRIVE, KEMMERER, UINTA, WY 83101
Street or Route, City, County, State Zip Code
5. The legal description of the Property Address ("Land") is:
LOT 14-L-3 OF ROLLING HILLS 1ST ADDITION TO THE TOWN OF KEMMERER, LINCOLN
COUNTY, WYOMING AS DESCRIBED ON THE OFFICIAL PLAT FITTED ON FEBRUARY 25, 1985
AS INSTRUMENT NO. 650749 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 U is f 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 5 Initial
NMFL 9 7111 (MAHA) Rev 2/4/2008
00V883
8. The Home shall be assessed and taxed as an improvement to the Land,
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, towbar 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, (il) 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:
fClosinaand Agent: please refer to the Manufactured Home and Land SupplementalClosing
Instructionsfor completioninstructioni:
I 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
[_J The Home is not covered by a certificate of title. After diligent search and inquiry, the
Homeowner is unable to produce the odglnal manufacturer's certificate of origin.
U 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 desorlbed herein
and Is to be filed for record in the records where conveyanoes of real estate are recorded
Page 3 of 5 Initial; Zi-c1M
NMFL # 7111 (MAHA) Rev 2/4/2008
000884
IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the
presence of a undersigned witnesses on tthis~ % h7 day of
Homeowner #1 (SEAL) Witness
T OTHY MASTRUD
m weer #2 (SEAL) Witness
CYNTHIA MASTRUD
Homeowner #3 (SEAL)
Witness
Homeowner #4 (SEAL)
Witness
STATE OF r i!~ )
~ ss.:
COUNTY OF f~!irCC~ s1 )
On the day of iwf-r _ in the year
before me, the undersigned, a Uotary Public its and fQrsaid State, Tersoylally appeared
personally kft6 to me or proved to me on4h 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(les), 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.
r.
Notary Signature Notary Printed Name
Notary Public, State of i
77 14-~
My Commission expires:
Official Seal:
My COM(IJI5S10Qualified in the County of _
LORI KALAL9
COUNTY OF 410
,.'0-
OF
LINCOLN G
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
NMFL # 7111 (MAHA) Rev 214/2008