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Home My WebLink About975911218644 Record and Return 1 by Mail 11 by Pickup to: FINAL DOCS N0012 -01B 6200 PARK AVENUE DES MOINES, IA 50321 This Instrument Prepared By: STAN LOBYAN Preparer's Name 9780 S MERIDIAN BLVD, 3RD FL Preparer's Address 1 t..m.....sL_ .1_::. r..::.::.liitfn ✓,'.:.::u: 's.. "ti M"Fn! }GTY:Yi.> >ti: }Y", ENGLEWOOD, CO 801125910 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: C it NMFL 7111 (MAFIA) Rev 2/4/2008 975911 4/14/2014 2:11 PM LINCOLN COUNTY FEES: $24.00 PAGE 1 OF 5 BOOK: 830 PAGE: 479 AFFIDAVIT JEANNE WAGNER, LINCOLN COUNTY CLERK IIIIIIIHIIIIII IIIIII 1IIIII II IIIIIIIIIIIIII III 1111111111111 MANUFACTURED HOME AFFIDAVIT OF AFFIXATION IIII 02 CLINTON T NIELSON TOREY A BARTLETT (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 1986 GUERDON HOMES New /Used Year Manufacturer's Name 5213A 5213A NA NA 060 x027 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. 4. The Home is or will be located at the following "Property Address 26 LITTLE CANYON ROAD, DIAMONDVILLE, LINCOLN, WY 83116 Street or Route, City, County, State Zip Code 5. The legal description of the Property Address "Land is: $EE ATTACHED EXHIBIT "A" THIS IS A PURCHASE MONEY SECURITY INSTRUMENT. TAX STATEMENTS SHOULD BE SENT T0: 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 Initial: r- �!V' 1 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: [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. 1 The Horne 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 1 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 Initial: I NMFL 7 (MAHA) Rev 2/4/2008 mWW111� .SiPGltiiu ?'!'k�2R4:Tic:�.l_ Homeowner 2 (SEAL) TOREY BARTLETT Homeowner #3 (SEAL) Homeowner #4 (SEAL) STATE OF v p� COUNTY O .�L ✓I.t�v^' Page 4 NMFL 7111 (MAHA) Rev 2/4/2008 IN WITNESS WHEREOF, Homeowner(s) has executed this Affidavit in my presence and in the pre ence of the undersigned witnesses on this /1 day of Homeowner #1 (SEAL) l Witness CLINTON T NIE]SSON Witness Witness Witness ss. algenewaranattram aazeg On the 1/ day of in the year b for mr� _e, the undersigned, a N otary Public for said State, personally ppeared personally known to me or proved to me on the bats s 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(iesl, 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. y Signature Nota�f'y Printed Name Notary Public, State of ak) p Qualified in the County of L/ 1X-41---' a My Commission expires: cs .A. JILL H. LA SON NOTARY PUBLIC State. of County of :';.,pi Wyoming Lincoln ;h 6, 0 A, My C -r•n a xl,v ..)1inn 20 2'015 4i4. i Y 4 y. n •"'4 T+' J 'm'W' A 01 '"e p`40- 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 PROPERTY DESCRIPTION The legal description of the Property Address "Land is typed below or please see attached legal description: SEE ATTACHED EXHIBIT "A" Parcel Sixty -Five (65) of thei1942 Replat of the Town of Diamondville, Lincoln County, Wyoming, as described on the official plat thereof. Page 4 Initial: 7743 k3 NMFL 7110 (MALA) Rev 2/4/2008