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� • <br />Brian Baker <br />Tonya Baker <br />(type the name of each Homeowner signing this A�davit] <br />being duly sworn, on his or her oath state as follows: <br />20120'7�0� <br />1. Homeowner owns the manufactured home ("Home") described as follows: <br />Used <br />New / Used <br />FS204400 <br />Serial Number <br />1997 Dutch JJ1PH 27 x 45 <br />Year Manufacturer's Name Model Name or Number Length / Width <br />FS204400 <br />Serial Number Serial Number Serial Number <br />2. The Home was built in compliance with the federal Manufactured Home Construction and <br />Safety Standards Act. <br />3. If the Homeowner is the first retail buyer of the Home, Homeowner is in receipt of (i) the <br />manufacturers warranty for the Home, (ii) the Consumer Manual for the Home, (iii) the <br />Insulation Disclosure for the Home, and (iv) the formaldehyde health notice for the Home. <br />4. The Home is or will be located at the following "Property Address": <br />1119 East 6�' Street Grand Island Hall NE 68801 <br />Street or Route City County State Zip Code <br />5. The legal description of the Property Address ("Land") is typed below or please see attached <br />legal description: <br />FRACTIONAL LOT 1 AND THE EASTERLY 12 FEET OF LOT 2, BLOCK 16, JOHN W. LAMBERT'S ADDITION <br />AND ITS COMPLIMENT, FRACTIONAL LOT 1 AND THE EASTERLY 13.2 FEET OF FRACTIONAL LOT 2, BLOCK <br />7, EVANS ADDITION, CITY OF GRAND ISLAND, HALL COUNTY, NEBRASKA. <br />6. The Homeowner is the owner of the Land or, if not the owner of the Land, is in possession of the <br />real property pursuant to a lease in recordable form, and the consent of the lessor is attached to <br />this Affidavit. <br />7. The Home ❑ is � shall be anchored to the Land by attachment to a permanent foundation, <br />constructed in accordance with applicable state and local building codes and manufacturer's <br />specifications in a manner sufficient to validate any applicable manufacturer's warranty, and <br />permanently connected to appropriate residential utilities (e.g., water, gas, electricity, sewer) <br />("Permanently Affixed"). The Homeowner intends t hat the Home be an immoveable fixture <br />and a permanent improvement to the Land. <br />8. The Home shall be assessed and taxed as an improvement to the Land. <br />Page 2 of 5 <br />