Manufactured Home Lien Affidavit - County Of Beaufort
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1STATE OF SOUTH CAROLINA
)
)
MANUFACTURED HOME
COUNTY OF BEAUFORT
)
LIEN AFFIDAVIT
1) Name of Owner(s)___________________________________________________________________________
2) Description of Manufactured Home:
Date of Manufacture: ____________
Manufacturer: ________________________________________
Model Year: _____________ Make: ____________________________________________________
Width: ____________ Length: ___________________
Identification Number (VIN): __________________________________
3) The above described manufactured home is subject to a security lien and all secured parties with mailing
addresses are listed below:
_____________________________________________________________________________
4) Full legal description of new property to which manufactured home is to be affixed using metes and bounds or
reference to recorded plat by book and page. (A separate sheet identified as "Exhibit A" may be attached.)
5) Derivation:
This being the identical or a portion of property conveyed or leased to the owner by deed or lease from
_____________________________________________________________________
and recorded on _____________ in Book _________ at Page ______________.
Tax Map number: ________ ____ ___________ ____________ ____________
Tax Billing Address: ____________________________________________________
____________________________________________________
6) Name of owner of real property if different from owner of manufactured home:
__________________________________________________________________
7) The owner of the manufactured home affidavit was recorded on ___________________ in Book ____________
at Page _____________ in the county of Beaufort.
The owner certifies that the above information provided by the owner is true and correct to the best information and
belief of the owner.
DATE: ______________________
____________________________________________
Signature of Owner
___________________________________________
Owner's Typed/Printed Name
Witness: ________________________________________
Witness: ________________________________________
STATE OF SOUTH CAROLINA
)
COUNTY OF BEAUFORT
)
PROBATE
Before me, the undersigned Notary Public, personally appeared ______________________________________
who, being duly sworn, deposed and said that he/she saw ______________________________________________
sign, seal and deliver the foregoing affidavit and that he/she, together with _________________________________
witnessed the execution thereof.
Sworn to before me this _________ day of _______________, 20__
Notary Public for _____________________________(LS)
My Commission Expires: ______________________
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