MOBILE/MANUFACTURED HOUSING AFFIDAVIT AND INDEMNITY
File No. ________________________
STATE OF WISCONSIN )
) SS
_____________COUNTY )
The undersigned, being first duly sworn on oath, deposes and states as follows:
A. That it is my intention to make the mobile or manufactured home located on the premises a permanent fixture attached to the land and part of the real estate. That the ownership of the land and the mobile or manufactured home shall remain in the same party at all times.
B. That the wheels and axles of the mobile or manufactured home have been removed.
C. That the mobile or manufactured home has been permanently connected to water and sewer/septic systems.
D. The mobile or manufactured home will be taxed as part of the real estate and not as personal property.
E. The Motor Vehicle Registration for the mobile home with the Wisconsin Department of Transportation or that the Certificate of Title with the Wisconsin Department of Commerce for the manufactured home (if any) has been properly canceled or surrendered, or has been delivered to the Title Company for cancellation or surrender.
F. Any lien or security interest in the title registration has been fully paid and released
I agree to indemnify and hold the Title Company harmless from and against any and all loss or damage caused by my misrepresentations, inaccuracies and/or omissions in the above information, plus any cost, expense or liability, including attorneys' fees, arising from the enforcement of this indemnification.
Dated this _______________day of _________________ , 20___.
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(signature)
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(signature)
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(print name)
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(print name)
STATE OF WISCONSIN )
) SS
_____________COUNTY )
Personally came before me this _________ day of _________ 20_____ , the above named
___________________________________________, to me known to be the person(s) who executed the foregoing instrument swore to the contents thereof, and did acknowledge the same.
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(signatue) Notary Public, State of Wiscounsin
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(print name)
My Commission Expires _________________________________
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