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Home My WebLink About971052RECEIVED 5/17/2013 at 3:39 PM RECEIVING 971052 BOOK: 811 PAGE: 807 3 n G ri JEANNE WAGNER 1 LINCOLN COUNTY CLERK, KEMMERER, WY MANUFACTURED HOME AFFIDAVIT OF AFFIXATION 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 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 Initial: NMFL 7111 (MAHA) Rev 2/4/2008 i i i OSO? SCOTT G. ANDERSON JENNIFER A. KOCHER— ANDERSON [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 2003 GUERDON New /Used Year Manufacturer's Name UNKNOWN UNKNOWN 053 x 027 Model Name or Model No. Length x Width GDBOID430301686AA GDBOID430301686A,9 5 1 64- 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 110 ROCK FARM COURT, ETNA, LINCOLN, WY 83118 Street or Route, City, County, State Zip Code 5. The legal description of the Property Address "Land is: SF,F, ATTACHF,r) T,FAAT, DF,SC:RTPTTON 00808 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 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. Page 2 Initial: NMFL 7111 (MAHA) Rev 2/4/2008` 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 SupplementalClosing Instructionsfor completioninstruction4: U 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. L 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. U 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 Initial: NMFL 7111 (MAHA) Rev 2/4/2008 u0809 U 0 IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the presence of. he undersigned witnesses on this day of A0/0 Homeowner #1 (SEAL) SCOTT G. ANDERSON Home/ner #2 (SEAL) JENNIFER A. KOCHER— ANDERSON Homeowner #4 (SEAL) STATE OF Al COUNTY OF On the day of before.9/44 e, the u ersl nee a Notary Public Notary Signature Notary Public, State of My Commission expires: Official Seal: County of A Lincoln Page 4 NMFL 7111 (MAHA) Rev 2/4/2008 0 If Witness Witness Homeowner #3 (SEAL) Witness Witness ss.: personally known to me or proved to me o 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. R�II D. Fenton N ota,ry public State of Wyoming Z My Commission Expires 10/11/2011 7IIIII IIIuIIIIIluuIIuIIIISI6ioncrour ,i J r' in the year and fpr said ersonally a p Notary Printed Name Qualified in the County of 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" 00811 PARCEL l: Lot 3 of ROCKY MOUNTAIN RANCHES SUBDIVISION, Lincoln County, Wyoming, as shown on the official plat thereof filed October 22, 2003, as Receiving No. 894646, in the Office of the Clerk of Lincoln County, Wyoming, as Plat No. 225 -E. PARCEL 2: TOGETHER WITH access as provided in that certain EASEMENT recorded on October 27, 2003, in Book 539 P.R., on Page 569, as Receiving No. 894726. 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 STATE OF MINNESOTA COUNTY OF DAKOTA Notary Sign- ure Sue Vue Notary printed Name Notary Public; State of: Minnesota Qualified in the County of: My commission expires: Page 5of5 ss.. (SEAL) Ra se County t 3 1 !is Witness By: Maipa Der Lo Witness Its: Vice President Loan Documentation U0812 On the day of AAA 1 in the year 26(7 before me, the Undersigned, a Notary Public in and for said State, personally appeared Maipa Der Lo, 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 instrumee, nd acknowledged to me that he /she /they executed the same in his /her /their capacity(ies), a at by his /her /their signature(s) on the instrument, the individual(s), or the person on behalf of -the individual(s) acted, executed the instrument. SUE VUE NOTARY PUBUC MINNESOTA My Commission Expires January 31, 2018