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Nevada Manufactured/Mobile Home Conversion Affidavit Form

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Nevada Manufactured/Mobile Home Conversion Affidavit Form
Nevada Manufactured/Mobile Home Conversion Affidavit Form
MH Conv-Rev 06/03
Page 1 of 2
ASSESSOR'S PARCEL #____________________________
COUNTY OF _____________________
AFFIDAVIT
CONVERSION OF MANUFACTURED/MOBILE HOME
TO REAL PROPERTY
NRS 361.244
PART I - TO BE COMPLETED BY APPLICANT
MANUFACTURED/MOBILE HOME INFORMATION
1. Owner/Buyer name___________________________________________________________________________
2. Owner of land (if leased) ______________________________________________________________________
3. Physical location of manufactured/mobile home____________________________________________________
4. Manufactured/mobile home description: Manufacturer____________________Model______________________
Model Year____________Serial #_____________________________Length____________Width___________
5. New lienholder:
Name________________________________________________________________________________________
Address_______________________________________________________________________________________
_______________________________________________________________________________________
PART II - LAND OWNER SIGNATURE (If real property is leased in accordance with NRS 361.244.1.B)
As the owner of the real property listed at _______________________________________________, I,
___________________________________ consent to the conversion of the above described manufactured home
from personal property to real property.
___________________________________________ ___________________________________________
SIGNATURE-OWNER/BUYER DATE SIGNATURE-OWNER/BUYER DATE
___________________________________________ ___________________________________________
PRINT NAME DATE PRINT NAME DATE
On ______________________, 20____, before me the undersigned, a Notary Public, in and for the State of
Nevada, County of _______________________ personally appeared _________________________________,
________________________________ who acknowledged that __he__ executed the affidavit.
__________________________________________ Notary Public
Nevada Manufactured/Mobile Home Conversion Affidavit Form
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