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Re `rd and Return by Mail to: <br />�V is Fargo Bank, N.A. <br />AL DOCS N0012 -01B <br />200 PARK AVE <br />DES MOINES, IA 50321 <br />This Instrument Prepared by: <br />Carol L Goethe <br />9780 S MERIDIAN BLVD <br />3RD FLOOR, SUITE 300 <br />ENGLEWOOD, CO 80112 -5910 <br />HCFG-00628 <br />Manufactured Home Affidavit of Affixation <br />2016111815.3.2.3509- J20160721Y <br />N <br />CO <br />ATTENTION COUNTY CLERK: This instrument covers goods that are or are to become <br />fixtures on the Land described herein and is to be filed for record in the records where <br />conveyances of real estate are recorded. <br />[type the name of each Homeowner signing this Affidavit]: <br />JOSEPH L SCHLEICHER and SHANNON M COOK, husband and wife <br />being duly sworn, on his or her oath state as follows: <br />1. Homeowner owns the manufactured home ( "Home ") described as follows: <br />New or Used: Used <br />Year: 1999 <br />Manufacturer's Name: HERRITAGE AMERICAN <br />Model Name or Model Number: COLT 686428HA2009 <br />Length x Width: 64 x 28 <br />Serial Number: HA00657ABMO <br />MANUFACTURED HOME AFFIDAVIT OF AFFIXATION <br />2236918416221 <br />Page 1 of 4 <br />