When an application for retirement is filed with the Department of Revenue within sixty (60) days of recording the related affidavit of affixation in the official records of the chancery clerk in the county, or in the judicial district in counties having more than one (1) such district, in which the real property is located and the application is thereafter accepted by the department, the requirements of this section shall be deemed satisfied as of the date the affidavit of affixation is recorded.
THE INSTRUMENTPREPARED BY: |
INDEXING INSTRUCTIONS: |
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AFFIDAVIT OF AFFIXATION
(MANUFACTURED HOME OR MOBILE HOME)
STATE OF____________________
COUNTY OF____________________
Before me, the undersigned notary public in and for said county and state, appeared [type the name and address of each homeowner signing this affidavit], known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed below (each a "homeowner"), and who, being by me first duly sworn, did each by personal oath state as follows:
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Manufacturer's Name Make Model Name Model Year
____________________
Manufacturer's Serial No./VIN Length/Width New/Used
____________________
Street City County State Zip Code
[insert legal description]
[ ] The home is currently covered by a certificate of title and the homeowner shall surrender the original title to a designated agent on behalf of the Department of Revenue;
[ ] The home is currently covered by a manufacturer's certificate of origin and the homeowner shall submit the original certificate of origin to a designated agent on behalf of the Department of Revenue; or
[ ] The home is not covered by a certificate of title and the owner of the manufactured home, after diligent search and inquiry, is unable to produce the original manufacturer's certificate of origin for the home, and a bill of sale, paid tax receipts showing assessment in the name of the owner for a period of not less than ten (10) years, an installment contract reflecting the serial number or VIN of manufactured home or mobile home, or other due proof of ownership in a form acceptable to the Department of Revenue is attached hereto.
[ ] is not subject to any security interest or lein; or
[ ] is subject to the following security interests or liens:
____________________
Lienholder #1 Original Principal Amount Secured
____________________
Address:
____________________
Lienholder #2 Original Principal Amount Secured
____________________
Address:
Name of Authorized Representative____________________
Mailing Address____________________Phone Number____________________
Further, affiant(s) sayeth naught.
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Signature of Homeowner #1
____________________
Printed Name Address City State Zip Code
____________________
Signature of Homeowner #2 (If more than one homeowner):
____________________
Printed Name Address City State Zip Code
Sworn to and subscribed before me this the ____________________ day of ____________________, 20____________________.
Notary Public
____________________
My Commission Expires: ____________________
THE INSTRUMENTPREPARED BY: |
INDEXING INSTRUCTIONS: |
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AFFIDAVIT OF SEVERENCE
(MANUFACTURED HOME OR MOBILE HOME)
STATE OF____________________
COUNTY OF____________________
Before me, the undersigned notary public in and for said county and state, appeared [type the name and address of each homeowner signing this affidavit], known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed below (each a "homeowner"), and who, being by me first duly sworn, did each by personal oath state as follows:
____________________
Manufacturer's Name Make Model Name Model Year
____________________
Manufacturer's Serial No./VIN Length/Width New/Used
[ ] is not subject to any security interest or lein; or
[ ] is subject to the following security interests or liens:
____________________
Lienholder #1 Original Principal Amount Secured
____________________
Address:
____________________
Lienholder #2 Original Principal Amount Secured
____________________
Address:
[ ] A release of the real property security interest or lien from each of the lienholders identified in paragraph 6 of this affidavit, if any, is attached hereto; or
[ ] A statement from each of the lienholders identified in paragraph 6 of this affidavit is attached hereto authorizing the lienholder's security interest or lien to be recorded on the face of the certificate of title and, if more than one lienholder, the order of priority of the same.
Name of Authorized Representative____________________
Mailing Address____________________Phone Number____________________
This affidavit is executed by homeowner(s) pursuant to applicable state law and shall be recorded in the official land records in the county in which the home is located.
Further, affiant(s) sayeth naught.
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Signature of Homeowner #1
____________________
Printed Name Address City State Zip Code
____________________
Signature of Homeowner #2 (If more than one homeowner):
____________________
Printed Name Address City State Zip Code
Sworn to and subscribed before me this the ____________________ day of ____________________, 20____________________.
Notary Public
____________________
My Commission Expires: ____________________
THE INSTRUMENTPREPARED BY: |
INDEXING INSTRUCTIONS: |
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AFFIDAVIT OF DESTRUCTION
(MANUFACTURED HOME OR MOBILE HOME)
STATE OF____________________
COUNTY OF____________________
Before me, the undersigned notary public in and for said county and state, appeared [type the name and address of each homeowner signing this affidavit], known to me (or satisfactorily proven) to be the person(s) whose name(s) is/are subscribed below (each a "homeowner"), and who, being by me first duly sworn, did each by personal oath state as follows:
____________________
Manufacturer's Name Make Model Name Model Year
____________________
Manufacturer's Serial No./VIN Length/Width New/Used
This affidavit is executed by homeowner(s) pursuant to applicable state law and shall be recorded in the official land records in the county, or in the judicial district in counties having more than one (1) such district, in which the home is located.
Further, affiant(s) sayeth naught.
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Signature of Homeowner #1
____________________
Printed Name Address City State Zip Code
____________________
Signature of Homeowner #2 (If more than one homeowner):
____________________
Printed Name Address City State Zip Code
Sworn to and subscribed before me this the ____________________ day of ____________________, 20____________________.
Notary Public
____________________
My Commission Expires: ____________________
Miss. Code § 63-21-30