STATE OF SOUTH CAROLINA | ) | MANUFACTURED HOME |
) | AFFIDAVIT FOR | |
) | RETIREMENT OF TITLE | |
COUNTY OF ______________ | ) | CERTIFICATE |
Date of Manufacture: | ||
Manufacturer: | ||
Model year: | ||
Make: | ||
Width: | ||
Length: | ||
Identification Number (VIN): |
_____The above described manufactured home is not subject to a security lien.
_____The above described manufactured home is subject to a security lien and a separate affidavit, as required by law, will be filed naming the secured parties.
_____The above described manufactured home is located in a jurisdiction with locally enforced building and safety codes adopted pursuant to Title 6, Chapter 9 and attached to this form is written evidence of compliance with the applicable codes as of the date the manufactured home was permanently affixed to the above described real property. Written evidence of compliance includes, but is not limited to, a copy of a certificate of occupancy, a statement from the code enforcement office, an inspection report, or any documentation of similar effect from the local code enforcement office having the appropriate jurisdiction. Only one document should be attached to this form.
_____The above described manufactured home is not located in a jurisdiction with locally enforced building and safety codes adopted pursuant to Title 6, Chapter 9 applicable to manufactured homes.
Tax map number ________________________
Tax billing address ______________________
______The owner of the manufactured home owns or has a leasehold estate of thirty-five or more years in the real property to which the manufactured home is affixed.
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: |
Type or print name of owner |
Witness: |
Witness: |
STATE OF SOUTH CAROLINA | ) | |
COUNTY OF ________________ | ) | PROBATE |
Before me, the undersigned Notary Public, personally appeared ______________________________, who, being duly sworn, deposed and said that (s)he saw ___________________________________, sign, seal, and deliver the foregoing Affidavit and that (s)he, together with ____________________________ witnessed the execution thereof.
SWORN to before me this | |
____________ day of | |
Notary Public for _________________ (L.S.) | |
My Commission Expires: _____________ |
S.C. Code § 56-19-510