Affidavit Of Severance Of Manufactured Home {50.3.5}

AFFIDAVIT OF SEVERANCE OF MANUFACTURED HOME Minn. Stat. 168A.142 State of Minnesota, County of (Top 3 inches reserved for recording data) Minnesota Uniform Conveyancing Blanks Form 50.3.5 (2013) being first duly sworn on oath says that: 1. I am: (choose one) (insert name of Affiant) ("Affiant"), an owner of the Property described below and the Manufactured Home described below. the of a (insert type of entity) (insert title) (insert name of entity) , , under the laws of which is an owner of the Property described below and the Manufactured Home described below. 2. The manufactured home that I own ("Manufactured Home") is described as follows: Manufacturer's name: Make: Model number: Model year: Serial number: Dimensions: Manufactured Home was purchased: Other descriptive information (if any): (check one box) New Used 3. The Manufactured Home was affixed, in accordance with Minn. Stat. 273.125, subd. 8, to real property in County, Minnesota, legally described as follows ("Property"): Check here if all or part of the described real property is Registered (Torrens) Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2 Minnesota Uniform Conveyancing Blanks Form 50.3.5 4. The name(s), residence address(es), and mailing address(es) of the owner(s) of the Manufactured Home is (are) as follows: 5. (choose one) I am not aware of any facts or information that could affect the validity of the title of the Manufactured Home or the existence of a security interest in or other lien on the Manufactured Home. The following facts or information could affect the validity of the title of the Manufactured Home or evidence the existence of a security interest in or other lien on the Manufactured Home: 6. An attorney's opinion that conforms to Minn. Stat. 168A.142, subd. 2(a)(2) is attached to this Affidavit. 7. This Affidavit is executed in support of severance of the Manufactured Home from the Property in accordance with Minn. Stat. 168A.142. Affiant (signature) Signed and sworn to before me on (month/day/year) by . (insert name of person making statement) (Stamp) (signature of notarial officer) Title (and Rank): My commission expires: (month/day/year) THIS INSTRUMENT WAS DRAFTED BY: (insert name and address) NOTE: An attorney's opinion that conforms to Minn. Stat. 168A.142, subd. 2(a)(2) must be attached to this Affidavit to comply with Minn. Stat. 168A.142, subd. 2. American LegalNet, Inc. www.FormsWorkFlow.com