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Home My WebLink About9480206010917708 0099426421 ~7 T cq O O .S L . wy ca c~ C7 v RECEIVED 6/29/2009 at 3:06 PM RECEIVING # 948020 BOOK: 726 PAGE: 424 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY ~,isa42~ MANUFACTURED HOME AFFIDAVIT OF AFFIXATION Record and Return [ ] by Mail [ ] by Pickup to: WHIM FINAL DOCS X2599-024 405 SW 5TH STET DES MOINES, IA 50309-4600 This Instrument Prepared By KRISTY PACHECO Preparer's Name 2387 F ROAD, Preparer's Address 1 GRAND JUNCTION, CO 815050000 Preparer's Address 2 0099426421 Loan Number 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 5 Initial a ~~-g NMFL # 7111 (MAHA) Rev 21412008 JAY P FONNESBECK CONNIE M FONNESBECK [type the name of each Homeowner signing this Affldavit] being duly sworn, on his or her oath state as follows: G425 1. Homeowner owns the manufactured home ("Home") described as follows: USED 1994 CHAMPION LANCASTER 064 x026 New/Used Year Manufacturer's Name Model Name or Model No. Length x width 05958248374A 08958248374B Serial No Serlal No Serial No Serial No. 2. The Horne 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 Home, (iii) the Insulation Disclosure for the Home, and (iv) the formaldehyde health notice for the Home. 4. The Horne is or will be located at the following "Properly 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 OAKLEY SUBDIVISION, LINCOLN COUNTY, WYOMING AS DESCRIBED ON THE OFFICIAL PLAT FILED ON 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 L___] IS L__] 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 # 7111 (MAHA) Rev 2/4/2008 81 The Home shall be assessed and taxed as an improvement to the Land, 6426 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, 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, (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; [Closingand Agent: please refer to the Manufactured Home and Land SupplementalClosing Instructionsfor co.mpletioninstructlon3: 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, U 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. 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. [-I 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:Thls Instrument covers goods that are or are to become fixtures on the Land described herein and is to be tlled.for record in the records where conveyances of real estate are recorded Page 3 of 5 Initlal. ~E 0.;z_ NMFL # 7111 (MAHA) Rev 214/2008 P.- VV427 IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the presence of the undersigned witnesses on this day of eow er #1 (S L) Witness JAY P 1<ONNESBECK l wY~m. 4 1-M F)')1M➢~1 d~A 1D~ r Homeowner #2 (SEAL) Witness CONNIE M FONNESBECK Homeowner #3 (SEAL) Witness Homeowner #4 (SEAL) Witness STATE OF ilY i 1 1' ) ss.: COUNTY OF I Y ) On the `Ly day of in the year before me, the ~an~d si red a Notary Public i' a d or said State-, pe orally appeared lfh(- 6w personally know try to me or proved to me on the basis of s~ t(sfarctory Ti dance t~be th 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. No ry Signature Notary Public, State of My Commission expires: LA, Official Seal: Notary Printed Name Qualified in the County of L' [m~y urtney L. Eisenbarth - Notary Public .r" Slate of ounty of Lincoln Nyorning Commission Expires ATTENTION COUNTY CLERK: This Instrument covers goods that are or are to become fixtures on the Lend 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 21412008