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Home My WebLink About9686850102472586 Record and Return by Mail by Pickup to: WFHM FINAL DOCS X2599 -024 405 SW 5TH STREET DES MOINES, IA 50309 -4600 This Instrument Prepared By: JANICE.SWANBERG®WELLSFARGO.COM Preparer's Name 2701 WELLS FARGO WAY, X9901 -115 Preparer's Address 1 MINNEAPOLIS, MN 554670000 Preparer's Address 2 0102472586 Loan Number MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 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: NMFL 7111 (MAHA) Rev 2/4/2008 003 RECEIVED 12/26/2012 at 3:29 PM RECEIVING 968685 BOOK: 801 PAGE: 322 JEANNE WAGNER LINCOLN COUNTY CLERK, KEMMERER, WY SHAR PERRY BEN PERRY [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 1993 FLEETWOOD HOMES OF IDAHO BROOKFIELD 5523B New /Used Year Manufacturer's Name IDFLPO4A16147BF IDFLPO4B16147BF 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. 4. The Home is or will be located at the following "Property Address 391 BELLVIEW RD, SMOOT, LINCOLN, WY 83126 Street or Route, City, County, State Zip Code 5. The legal description of the Property Address "Land is: SEE ATTACHED LEGAL DESCRIPTION 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 is 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 0 t) 052 x 027 Model Name or Model No. Length x Width 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. 0 0 3 n 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. 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: [Closing and Agent: please refer to the Manufactured Home and Land Supplemental Closing Instructions for completion instructions]: 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. 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 of 5 Initial: 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 /2i/ meowner #1 (SEAL) SHAR PERRY Homeowner #2 (SEAL) BEN PERRY STATE OFD` \v,� Witness Witness Homeowner #3 (SEAL) Witness Homeowner #4 (SEAL) Witness ss.: COUNTY OF L`�c \■1\ On the 2 day of in the year 7- before me, t undersigned, a Notar Public i and for said State, personally appeared 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. Page 4 of 5 NMFL 7111 (MAHA) Rev 2/4/2008 Ssa Notary Signature Notary Public, State of Owti My Commission expires: S I c l 1 Official Seal: ',MELISSA CAPENER NOTARY PUBLIC .ounty of State of 7 Teton r Wyoming My Commission Expires May 19, 2012 Notary Printed Name a Qualified in the County of \/N 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. EXHIBIT "A" W d d, -4 /d PARCEL A: A portion of the Northwest Quarter of the Southeast Quarter (NW 1 /4 SE 1 /4) of Section 31, Township 31 North, Range 118 West, 6 t1i P.M., Northwest from Smooth, Lincoln County, Wyoming and more particularly described as follows: BEGINNING at a point in the East line of said NW 1 /4 SE 1/4, said point being 644.87 feet, North 00 °15'07" West, from a B.L.M. type Monument set marking the Southeast corner of said NW 1 /4 SE 1/4; Thence South 89 °49'01" West, 380.00 feet; Thence North 00 °15'07" West, 231.50 feet; Thence North 89 °49'01" East, 380.00 feet; Thence South 00°15'07" East, 231.50 feet, to the Point of Beginning. PARCEL B: A portion of the Northwest Quarter of the Southeast Quarter (NW 1 /4 SE 1 /4) of Section 31, Township 31 North, Range 118 West, 6111 P.M., Northwest from Smooth, Lincoln County, Wyoming and more particularly described as follows: BEGINNING at a point in the East line of said NW 1 /4 SE 1 /4, said point being 413.37 feet, North 00°15'07" West, from a B.L.M. type Monument set marking the Southeast corner of said NW 1 /4 SE 1 /4; Thence South 89 °49'01" West, 380.00 feet; Thence North 00 °15'07" West, 231.50 feet; Thence North 89 °49'01" East, 380.00 feet; Thence South 00°15'07" East, 231.50 feet, to the Point of Beginning.