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Home My WebLink About967971o C.: (i N U N. r,• od X c iz co a�0 a E 159238- ATEC 4101 WISEMAN BLVD BLDG 108 SAN ANTONIO, TX 78251 -4200 This Instrument Prepared By: GLEN POMEROY Preparer's Name 9780 S MERIDIAN BLVD, 2ND FL Preparer's Address 1 ENGLEWOOD, CO 801125910 Preparer's Address 2 Page 1 Initial: C,6 NMFL 7111 (MAHA) Rev 2/4/2008 MANUFACTURED HOME AFFIDAVIT OF AFFIXATION Record and Return by Mail by Pickup to: FINAL DOCS T7408 -01F 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. 1 1 0027 RECEIVED 11/15/2012 at 3:59 PM RECEIVING 967971 BOOK: 798 PAGE: 274 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY 10 CLINTON R BAIRD [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 2001 ATLANTIC HOMES New /Used Year Manufacturer's Name 470135203573A 470135203573B 4. The Home is or will be located at the following "Property Address 126 BEDFORD TURNERVILLE, BEDFORD, LINCOLN, WY 83112 Street or Route, City, County, State Zip Code Page 2 Initial: Ce7 NMFL 7111 (MAHA) Rev 2/4/2008 NA NA 076 x 031 Model Name or Model No. Length x Width 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 (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. 5. The legal description of the Property Address "Land is: SRR LEGAT, DFSCRTPTTON ATTACHF,r) HF,RRTO ANT) MADR A PART THERF,OF 0027 TAX STATEMENTS SHOULD BE SENT TO WELLS FARGO HOME MORTGAGE, P.O. BOX 11758, NEWARK, NJ 071014758 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 1 1 is 1 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. 8. The Home shall be assessed and taxed as an improvement to the Land. 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 SupplementalClosinq Instructionsfor completioninstruction: 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. U 0 2 7 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 3 Initial: cf, NMFL 7111 (MAHA) Rev 2/4 /2008 IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the presence of the undersigned witnesses on this day of `cv p 0.3-4 a., LU k l7 X /7_, /3 Homeowner #1 (SEAL) CLINTON R BAIRD Homeow \)i STATE OF \.)0 l∎�C► ovary Signature Notary Public, State of Wei <W t flt\ My Commission expires: 0,;> Official Seal: EL)/ Page 4 NMFL 7111 (MAHA) Rev 2/4 /2008 Witness Homeowner #2 (SEAL) Witness Homeowner #3 (SEAL) Witness Witness ss.: COUNTY OF x\c >�v\:> On the day of )cw in the year r r before me, the undersigned, a Notary Public in and for said State, personally appeared Clinton R. Baird and Stacy L. Baird 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. County of Lincoln 0027 Notary Printed Name Qualified in the County of c .„4 y LISA M. SPAULDING NOTARY PUBLIC State of Wyoming My Commission Expires July 18, 2015 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. 159238 EXHIBIT "A" A portion of the Northeast Quarter of the Northeast Quarter of Section 32, Township 34 North, Range 118, West of the 6th P.M., Lincoln County, Wyoming being more particularly described as follows: Beginning at a pint in the East line of said Section 32, said point being 661.86 feet South from the Northeast corner of said Section 32; thence South, along said East line, 246.14 feet; thence West 353.13 feet; thence North 247.02 feet to a point in the South line of the North Half of the North Half of the Northeast Quarter; thence South 89 °51'24" East, along last said South line, 353.31 feet to the point of beginning 002 9 The land referred to in this document is situated in the state of Wyoming, County of Lincoln, and is described as follows: