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ALAN BRANDO [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 1999 PATRIOT New /Used Year Manufacturer's Name LPP9805AINUV019 LPP9805BINUV019 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 ": 601. SATURN ST, ALDA, HALL, NE 68810 Street or Route, City, County, State Zip Code 5. The legal description of the Property Address ( "Land ") is: Hp,T,T, C AUNTY, NEBRASKA THIS IS A PURCHASE MONEY SECURITY INSTRUMENT. TAX STATEMENTS SHOULD BE SENT TO: WELLS FARGO HOME MORTGAGE, P.O. BOX 11758, NEWARK, NJ 071014758 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 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 Model Name or Model No. Length x Width 201300710 NA NA 048 x 026