T-234A (Rev 6-2006)
Certificate of Permanent Location for a Manufactured Home (Title Not Required)
This certificate is presented for filing and recording in the real estate records pursuant to §8-2-183.1 of the O.C.G.A.
A certificate of title is not required to be issued when using this form, if the home was sold on or after July 1, 2006.
The certificate of origin is required to be attached to this form when filed with the Clerk of Superior Court.
1. Mail certified copy to:
(Name and mailing address)
T
.
HIS SPACE IS FOR RECORDING INFORMATION ONLY
2. Debtor’s Name and Mailing Address: (Last name first if an individual)
3. Debtor’s Name and Mailing Address:
(Last name first if an individual)
4. Lien Holder/Secured Party’s Name and Mailing Address:
(Last name first if an individual)
5. Lien Holder/Secured Party’s Name and Mailing Address:
(Last name first if an individual)
6. This Certificate of Permanent Location covers the following collateral:
VIN: ____________________________________________________________
7. Description of real estate to which this home has been permanently affixed:
The deed to said real estate is located on page number ________ in deed book number ________ in the real
estate records maintained by the Clerk of the Superior Court of _____________________________County.
8. Name of the Record Owner(s) of Said Real Estate:
(Must include at least one debtor listed above.)
9. County (ies) in which this Certificate of Permanent Location is filed:
10. Signature(s)
____________________________________________________
__________________________________________________
Debtor
Date
Debtor
Date
____________________________________________________
__________________________________________________
Lien Holder/Secured Party
Date
Lien Holder/Secured Party
Date
I hereby certify that this is a true and accurate copy of this Certificate of Permanent Location as recorded in
the records of the Clerk of Superior Court of ____________________________ County. This ______ day
(County Name)
(Day)
of __________________, ________
(Month)
(Year)
Page ________ of _______________.
___________________________________________
(Deputy) Clerk of Superior Court)
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