(19) The affidavit of affixation required pursuant to this section shall be in substantially the following form:
THE INSTRUMENTPREPARED BY: |
INDEXING INSTRUCTIONS: |
____________________ |
____________________ |
____________________ |
____________________ |
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:
1. Homeowner(s) own(s) the manufactured home or mobile home ("home") described as follows:
____________________
Manufacturer's Name Make Model Name Model Year
____________________
Manufacturer's Serial No./VIN Length/Width New/Used
2. The home is or will be located at the following "property address":
____________________
Street City County State Zip Code
3. The legal description of the real property where the home is or will be permanently affixed ("land") is:
[insert legal description]
4. The homeowner(s) executing below is/are all the legal owner(s) of the real property to which the home has become permanently affixed.
5. The home shall be assessed and taxed as an improvement to the land.
6. Check one:
[ ] 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.
7. The home (check one):
[ ] 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:
8. Other than those disclosed in this affidavit, the homeowner is not aware of (a) any other security interest or lien affecting the home; and (b) any other facts or information that could reasonably affect the validity of the title of the home or the existence or nonexistence of security interests or lien in it.
9. A release of personal property security interest or lien from each of the lienholders identified in paragraph 7 of this affidavit, if any, is attached hereto.
10.
(a) All permits required by applicable governmental authorities have been obtained;
(b) the wheels and axles have been removed; and
(c) the home is or will be permanently connected to a septic or sewer system and other utilities such as electricity, water and/or gas.
11. The home is or shall become an immovable fixture and a permanent part of the real property.
12. All ad valorem taxes currently due and payable for the home and the land to which it is attached have been paid and a receipt for the prior year confirming the same are attached hereto.
13. The homeowner(s) hereby authorize(s) the following person(s) to file an application to retire title to the home with the tax collector of the county where the manufactured home or mobile home is located and to receive written acknowledgement from the Department of Revenue of retirement of title:
Name of Authorized Representative____________________
Mailing Address____________________Phone Number____________________
14. The homeowner(s) hereby authorize(s) the tax collector to submit the completed application on behalf of the homeowner(s) to the Department of Revenue to permanently retire title to the manufactured home or mobile home to herein described land. 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.
____________________
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: ____________________
(20) The affidavit of severance required pursuant to this section shall be in substantially the following form:
THE INSTRUMENTPREPARED BY: |
INDEXING INSTRUCTIONS: |
____________________ |
____________________ |
____________________ |
____________________ |
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:
1. Homeowner(s) own(s) the manufactured home or mobile home ("home") described as follows:
____________________
Manufacturer's Name Make Model Name Model Year
____________________
Manufacturer's Serial No./VIN Length/Width New/Used
2. The title to the home was previously retired pursuant to that certain affidavit of affixation recorded on____________________in Book____________________, Page____________________ or as Instrument____________________.
3. The homeowner(s) executing below is/are all the legal owner(s) of the real property to which the home has become permanently affixed.
4. Upon the recording hereof, the home shall no longer be assessed and taxed as an improvement to real property.
5. The home (check one):
[ ] 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:
6. Other than those disclosed in this affidavit, the homeowner is not aware of (a) any other security interest or lien affecting the home; or (b) any other facts or information that could reasonably affect the validity of the title of the home or the existence or nonexistence of security interests or lien in it.
7. Check one:
[ ] 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.
8. All ad valorem taxes due and payable for the land on which the home is located have been paid, and a paid receipt for the prior year confirming the same are attached hereto. Homeowner acknowledges that taxes for the current year, which are assessed but not yet due and payable, will be based on the status of the home and land to which it is attached as of January 1 of the current year.
9. The homeowner(s) hereby authorize(s) the following person(s) to file a certified copy of the affidavit of severance with the tax collector of the county where the manufactured home or mobile home is located and to receive the newly issued certificate of title from the Mississippi Department of Revenue:
Name of Authorized Representative____________________
Mailing Address____________________Phone Number____________________
10. The homeowner(s) hereby authorize(s) the tax collector to submit the completed application on behalf of the homeowner(s) to the Department of Revenue to sever title to the manufactured home or mobile home from herein described land and issue a new certificate of title in the name of the homeowner(s).
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.
____________________
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: ____________________
(21) The affidavit of destruction required pursuant to this section shall be in substantially the following form:
THE INSTRUMENTPREPARED BY: |
INDEXING INSTRUCTIONS: |
____________________ |
____________________ |
____________________ |
____________________ |
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:
1. Homeowner(s) own(s) the manufactured home or mobile home ("home") described as follows:
____________________
Manufacturer's Name Make Model Name Model Year
____________________
Manufacturer's Serial No./VIN Length/Width New/Used
2. The title to the home was previously retired pursuant to that certain affidavit of affixation recorded on____________________ in the official land records of in____________________County, Mississippi, in Book____________________, Page____________________ or as Instrument____________________.
3. The homeowner(s) executing below is/are all the legal owner(s) of the real property to which the home has become permanently affixed.
4. The home was destroyed or became uninhabitable on ____________________ (insert date) as a result of ____________________ (describe cause).
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.
____________________
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: ____________________