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HCFG-00628 Manufactured Home Affidavit of Affixation JS � i 201607953 HA00657ABMO 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 ": 14375 S ALDA RD, WOOD RIVER, NE 68883 5. The legal description of the Property Address ( "Land ") is: LEGAL DESCRIPTION ATTACHED HERETO AS EXHIBIT "A" AND MADE A PART HEREOF 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. 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, tow bar 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]: 2236918416221 2016111815.3.2.3509-J20160721Y Page 2 of 4