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ALAN BRANDO <br />[type the name of each Homeowner signing this Affidavit]: <br />being duly sworn, on his or her oath state as follows: <br />1. Homeowner owns the manufactured home ( "Home ") described as follows: <br />USED 1999 PATRIOT <br />New /Used Year Manufacturer's Name <br />LPP9805AINUV019 LPP9805BINUV019 <br />Serial No. Serial No. Serial No. Serial No. <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 />manufacturer's 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 />601. SATURN ST, ALDA, HALL, NE 68810 <br />Street or Route, City, County, State Zip Code <br />5. The legal description of the Property Address ( "Land ") is: <br />Hp,T,T, C AUNTY, NEBRASKA <br />THIS IS A PURCHASE MONEY SECURITY INSTRUMENT. <br />TAX STATEMENTS SHOULD BE SENT TO: WELLS FARGO HOME MORTGAGE, P.O. BOX 11758, <br />NEWARK, NJ 071014758 <br />6. The Homeowner is the owner of the Land or, if not the owner of the Land, is in possession of <br />the real property pursuant to a lease in recordable form, and the consent of the lessor is <br />attached to this Affidavit. <br />7. The Home 1 1 is [ 1 shall be anchored to the Land by attachment to a permanent <br />foundation, constructed in accordance with applicable state and local building codes and <br />manufacturer's specifications in a manner sufficient to validate any applicable manufacturer's <br />warranty, and permanently connected to appropriate residential utilities (e.g., water, gas, <br />electricity, sewer) ( "Permanently Affixed "). The Homeowner intends that the Home be an <br />immoveable fixture and a permanent improvement to the Land. <br />ATTENTION COUNTY CLERK:This instrument covers goods that are or are to become fixtures on the Land described herein <br />and is to be filed for record in the records where conveyances of real estate are recorded. <br />Page 2 Initial: <br />NMFL # 7111 (MAHA) Rev 2/4/2008 <br />Model Name or Model No. Length x Width <br />201300710 <br />NA NA 048 x 026 <br />