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Home My WebLink About96520420 Date Place of Recording Record and return to: Wells Fargo Home Mortgage Attn: Travis Barrick 2701 Wells Fargo Way MAC: X9998 -01L Minneapolis, MN 55467 RECEIVED 6/20/2012 at 9:13 AM RECEIVING 965204 BOOK: 788 PAGE: 100 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY MANUFACTURED HOME AFFIDAVIT OF AFFIXATION Instrument Prepared By: Travis Barrick Loan Servicing Specialist 2701 Wells Fargo Way Minneapolis, MN 55467 651 605 -4594 Preparer's Signature Homeowner /Borrower Name(s): Charles I Fischer Borrower #1 Page 1 of 5 Legal Description: Tax Parcel Number: Legal Description at Page 2. Lot Township Range Terri E Fischer Borrower #2 Borrower #3 Borrower #4 Block Plat or Section Quarter Quarter Section ATTENTION COUNTY CLERK: This instrument covers good that 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. 00 1.00 Charles 1 Fischer Terri E Fischer [type the name of each Homeowner signing this Affidavit] being duly sworn, on his or her oath state as follows: 1. Homeowner owns the manufactured home "Home described as follows: Used 1998 Guerden Homes New Used Year Manufacturer's Name IDA 174326 Serial Number 209 Moose Manor Lane Street or Route Page 2of5 A2 -4762 Model Name or Number Serial Number Serial Number Serial Number 4. The Home is or will be located at the following "Property Address 8. The Home shall be assessed and taxed as an improvement to the Land. x Length Width 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 for the Home. Fairview Lincoln WY 83119 City County State Zip Code 5. The legal description of the Property Address "Land is typed below or please see attached legal description: Lot 5 of Moose Manor Estates Subdivision, Lincoln County, Wyoming as described on the official plat thereof. 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 is fl 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 t hat the Home be an immoveable fixture and a permanent improvement to the Land. 00101 9. Homeowner agrees that as of today, or if the Home is not yet located athe 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 stat 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, placed on the Property Address; and (d) The Home is (k) Permanently Affixed to a foundation, (ii) has the characteristics of sit -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 on 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 the title to the Home: [Closing Agent: please refer to the Manufactured Home and Land Supplemental Closing Instructions for completion instructions] Page 3 of 5 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. 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 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. 00102 IN WITNESS WHEREOF, Homeowner(s) has executed this Af=fidavit in my presence and the pres nce of the undersigned witnesses on this 3 day of 'V 20 Borrower #1 Charles I Fischer P Borrower #2 Terri E Fischer Borrower #3 Borrower #4 Charles I Fischer and Terri E Fischer Official Seal: Page 4 of 5 (SEAL) (SEAL) (SEAL) Witness Witness Witness Witness )103 STATE OF(A) (TIM' r ss.: CO UNTY OF Ltne:01 On the 711 day of f UaLt. in the year ac_) 2 before me, the ned a Notary in and for sai State, appeared y personally pp eared personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s)Aare) subscribed to the within instrument and acknowledged to me that his /they executed the same in hjd /hyF /their capacity(ies), and that by hjs' /tr /their signature(s) on the instrument, the individual(s), or the person on behalf of which the individual(s) acted, executed the instrument. Not ry Signature je (40 Notary Printed Name Notary Public; State of DM- Qualified in the County of I ►'1C'}l r My commission expires: 7 D 7 S TERRECE SI000WAY County of Lincoln M Commission NOTARY PUBLIC State of Wyoming fires Ju 27, 2015 Lender's Statement of Intent: The undersigned "Lender intends that the Home be an immoveable fixture and a permanent improvement to the Land. Wells Fargo Bank, N.A. Lender By: An Its: Vice Morgan sident Loan Docutientatio STATE OF MINNESOTA ss.: COUNTY OF DAKOTA Notary printed Name On the 1 day of in the year .0 1 before me, the Undersigned, a Notary Public in and for said State, personally appeared Angela M. Morgan, Vice President Loan Documentation, Wells Fargo Bank, N.A., personally known to me or proved to me on the 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(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. Notary Signature Cheryl L. Lynn Notary Public; State of: Minnesota Qualified in the County of: Offr My commission expires: 1— 31 —ac,1s Page 5 of 5 CHERYL L. LYNN NOTARY PUBLIC MINNESOTA My 1�•,�;..' Commission Expires Jan. 31, 2015 r tt 41A- W itn i s ,�%l;ll f C Oadfr 11� 1 tit. �1`1�i Witness Latx.hG 00104 Exhibit A PROPERTY DESCRIPTION The legal description of the Property Address "Land is typed below: Lot 5 of Moose Manor Estates Subdivision, Lincoln County, Wyoming as described on the official plat thereof. Page 5 of 5 05