HomeMy WebLinkAbout966202July
Date
Place of Recording
Address 1
a(j 20 12
Name
Address 2
Tax Parcel No.
Legal Description is at page
AFTER RECORDING, RETURN TO:
AMERICAN TITLE, INC.
P.O. BOX 641010
Lot Block Plat or Section OMAHA, NE 68164 -1010
ATI# rc ,dl ac.) 14 .V c�s.N
Township Range Quarter /Quarter Section
This Instrument Prepared By:
Leanne Young WELLS FARGO BANK N.A.
Preparers Name Lender's Name
1 HOME CAMPUS, X2303 -01 P
Preparers Title Lender's Address 1
2801 4th Ave S DES MOINES, IA 50328
Preparers Address 1 Lender's Address 2
Minneapolis, Minnesota 55408 EUGENE ALBERT ROOT, TRUSTEE
Preparer's Address 2 Homeowner's Name
612- 312 -5294 1982 COUNTY RD 117
Preparer's Telephone Number Homeowner's Address 1
THAYNER, WY 83127
Preparers Signature Homeowner's Address 2
MANUFACTURED HOME AFFIDAVIT OF AFFIXATION
Homeowner, being duly sworn, on his or her oath, states as follows:
1. Homeowner owns the manufactured home "Home described as follows:
USED 1997 NASHUA
NA NCID36905AS
New /Used Year Manufacturer's Name Model Name or Model No. Manufacturer's Serial No.
00649
RECEIVED 8/15/2012 at 2:54 PM
RECEIVING 966202
BOOK: 791 PAGE: 649
JEANNE WAGNER
LINCOLN COUNTY CLERK, KEMMERER, WY
044 026
Length Width
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described herein
and is to be filed in the real estate conveyance records.
Page 1 of 4
Manufactured Home Affidavit of Affixation Rev. 01/06/09
1982 COUNTY RD 117
Street or Route
2. The Home was built in compliance with the federal Manufactured Home Construction and Safety
Standards Act.
3. if th Homeowner is the first retail buyer of the Home, Homeowner is in receipt of (i) the HUD
installation standards disclosure, (11) the manufacturer's warranty for the Home, (iii) the Consumer
Manual for the Home, (iv) the Insulation Disclosure for the Home, and (v) the formaldehyde health
notice for the Home.
4. The Home is or will be located at the following "Property Address
5. The legal description of the Property Address "Land is:
SEE ATTACHED LEGAL DESCRIPTION
THAYNE LINCOLN WY 83127
City County State Zip Code
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 X 1 is I 1 shall be anchored to the Land by attachment to a permanent
foundation, in accordance with applicable federal, state and local building codes and
manufacturer's specifications, and permanently connected to appropriate residential utilites (e.g.,
water, gas, electricity, sewer) "Permanently Affixed Homeowner intends that the Home be an
immoveable fixture and a permanent improvement to the Land.
8. The Home shall be assessed and taxed as an improvement to the Land.
9. Homeowner has obtained or shall obtained all permits and certifications required by governmental
authorities.
10. If 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, 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 validy of the title of the Home or the existence or non existence of security
interests in it.
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described herein
and is to be filed in the real estate conveyance records.
Page 2 of 4
Manufactured Home Affidavit of Affixation Rev. 01 /06 /09
00650
12. [Homeowner shall initial only one of the following, as it applies to title to the Home. Closing Agent:
please refer to the Manufactured Home and Land Supplemental Closing Instructions for
completion instructions]:
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.
Homeowner is unable to produce the original manufacturer's certificate of origin.
X 1 The manufacturer's certificate of origin and /or certificate of title to the Home [xj shall be
has been eliminated as required by applicable law.
1 The Home shall be covered by a certificate of title.
13. This Affidavit is executed by Homeowner(s) pursuant to applicable state law.
IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my prese ce and in the
presence of the undersigned witnesses on this O day of 26 ]'Z
x (Seal) (Seal)
Homeowner #1
EUGENE ALBERT ROOT, TRUSTEE
1 The Home is not covered by a certificate of title. After diligent search and inquiry, the
Printed Name
Homeowner #2
Printed Name
(Seal)
Witness
Witness
Printed Name
0065
Lc RJZ' aY161t V�
Printed Name
(Seal)
ATTENTION COUNTY CLERK This instrument covers goods that are or are to become fixtures on the Land described herein
and is to be filed in the real estate conveyance records.
Page 3 of 4
Manufactured Home Affidavit of Affixation Rev. 01/06/09
STATE OF k cy—
COUNTY OF L, d Liu
On the 6 day of in the year26
before me, the undersigned, a Notary Public in and for sa State, personally appeared
gu Fr ENE f} 8 ER g O6 r j" 'e
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
in
Notary Printed Narp
ss.:
Notary Public; State of k) t( 6 th_ (v`
Qualified in the County of Al c C3 (--/L
My commission expires: /1/p V 7 2013
Official Seal:
SHERYL MANNING NNING NOTARY PUBLI IC
County oT
Liocnin
-i nmmission Expires
State of
Wyoming
V 7 201
ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become fixtures on the Land described herein
and is to be filed in the real estate conveyance records.
Page 4 of 4
Manufactured Home Affidavit of Affixation Rev. 01/06/09
006
ASSESSORS PARCEL NUMBER:
ATI ORDER NUMBER: 201205140023
EXHIBIT "A"
006",`'
THE NORTH ONE -HALF (N112) OF THE FOLLOWING: BEGINNING AT A POINT 24 FEET SOUTH
OF THE NORTHWEST CORNER OF LOT THREE (3), BEING THE NORTHWEST QUARTER OF
THE SOUTHWEST QUARTER (NW1 /4 SW1 /4), AND RUNNING THENCE EAST 300 FEET;
THENCE SOUTH 290.4 FEET; THENCE WEST 300 FEET; THENCE NORTH 290.4 FEET, TO THE
POINT OF BEGINNING, ALL IN SECTION 7, TOWNSHIP 34 NORTH, RANGE 118 WEST OF THE
6TH P.M., LINCOLN COUNTY, WYOMING.
SUBJECT TO RESTRICTIONS, RESERVATIONS, EASEMENTS, COVENANTS, OIL, GAS OR
MINERAL RIGHTS OF RECORD, IF ANY.
3418- 07 -3 -00- 221.00
J