APPLICATION 870
User Manual: 870
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STATE OF ALASKA - DIVISION OF MOTOR VEHICLES APPLICATION for MANUFACTURED HOME APPLICATION REASON PLEASE TYPE OR PRINT (IN BLACK OR BLUE INK) 1 MANUFACTURED HOME SERIAL NUMBER (VIN) YEAR MANUFACTURER IS THE MANUFACTURED HOME ? SECONDARY VIN MAKE NEW MODEL USED Date of Purchase COLOR (PRIMARY) 2 LESSOR SUFF. STATE* DATE OF BIRTH* OR (REQUIRES EITHER SIGNATURE TO RELEASE TITLE) FULL LAST NAME SUFF. YES DRIVERS LICENSE NO.* STATE* DATE OF BIRTH* 4 5 CONTACT INFO MAILING ADDRESS OF OWNER OR LESSOR PHYSICAL ADDRESS OF OWNER OR LESSEE PREVIOUS OWNER AND MAILING ADDRESS 7 8 FEES CLASS TITLE 36 $100 NO SOCIAL SECURITY NO.* LIEN SEX EMAIL ADDRESS Taxpayer ID Number PHONE # PO BOX OR STREET ADDRESS TAX LOCATION TAX PREVIOUS STATE MISCELLANEOUS CITY / STATE / ZIP CODE STREET OR LOCATION (Physical location - no PO Box or Mail Cache addresses.) CITY / STATE / ZIP CODE NAME (Dealer / Previous Owner) TOTAL PO BOX OR STREET CITY / STATE / ZIP CODE 6 CODES LESSEE COMPANY OR TRUST NAME (If this is to appear on the title) 3 FOR DIVISION USE ONLY ORGAN DONOR? CO-OWNER OR SEX Taxpayer ID Number (REQUIRES BOTH SIGNATURES TO RELEASE TITLE) FULL MIDDLE NAME NO SOCIAL SECURITY NO.* AND FULL FIRST NAME ORGAN DONOR? YES FULL LAST NAME COMPANY OR TRUST NAME (If this is to appear on the title) OR FULL MIDDLE NAME DRIVERS LICENSE NO.* OWNER Cancel Title Cancel Manufacturers Certificate of Origin (MCO) Non-application of Alaska Statute 28.10 Severed Manufactured Home OWNERSHIP Title Only BODY STYLE HS FULL FIRST NAME PAYMENT TYPE CA CC CK NAME (Title Company, Agent, Etc.)(Parties are only notified for Cancel Title/MCO , Non-Application or Title of Severed) (Optional) ADDITIONAL NOTIFIED PARTY AND MAILING ADDRESS TO CORRECT SERIAL NUMBER (First Priority) LIEN HOLDER AND MAILING ADDRESS PO BOX OR STREET DOCUMENTS ACCEPTED CITY / STATE / ZIP CODE INCORRECT SERIAL NUMBER (VIN) SHOW CORRECT SERIAL NUMBER IN ITEM 1 ABOVE NAME (If the vehicle has been paid in full - write “NONE”) (if more than 1 lien holder, list the other lien holders in owner affidavit in priority order) PO BOX OR STREET CITY / STATE / ZIP CODE I certify under penalty of law: the above information is true and correct to the best of my knowledge. X / SIGNATURE OF OWNER (IN INK) X / SIGNATURE OF OWNER (IN INK) BATCH NO.: . / . DATE X COMPANY NAME / DATE by AUTHORIZED AGENT BATCH DATE: / DATE / . PROCESSED BY: *AK driver license number, date of birth or social security number is required for an individual. Taxpayer ID number is required for a business. [2 AAC 92.030] * Form 870 (Rev. 01/2018) ALASKA.GOV/DMV DOCUMENTATION REQUIREMENTS: Application for Manufactured Home Owner Affidavit Lien Releases MCO or Title Appraisal Surety Bond Declaration Affidavit Affixation Affidavit Severance Affidavit Title Fee Lien Fee (if applicable) Title Only Title Only (with a MCO or Prior Title) (No MCO or Prior Title) X X X X X X X Affixation Severance NonApplication X X X X X X X X X X X X X X X X X X $100 $15 $100 $15 $100 $15 X $100 $15 $100 $15 Additional Instructions: Following are answers to the most frequently asked questions about our application. Affixation is the process of legally combining a manufactured home and real property into one unit. Severance is the process of legally separating a previously Affixed a manufactured home from real property. Non-Application of AS 28.10 is Affixation but without an MCO or prior title using a surety bond. Secondary Serial Number - Some mobile homes are constructed in multiple separate units and connected when placed at a permanent location. The vehicle identification numbers (VIN) for two-unit mobile homes are generally identified by an "L" for the left unit and an "R" for the right unit or by an "A" or a "B" found in the center of the VIN. Company name - This is for ownership purposes only, not where you work. Your taxpayer ID number is required before your transaction can be processed. Ownership - Alaska allows up to four owners. The title will show all the names. If there are additional owners, enter their information in the owner affidavit. You must provide your Alaska driver license or state identification number, date of birth or social security number. If you do not, we will not be able to process your application. Physical address - Must be a physical location. Mail caches are not acceptable. If you do not have a street address, enter a mile post and highway name, or another type of physical description. Previous Owner - This is the name of the individual or business you bought the manufactured home from. Additional Notified Party - This is an optional field of the name of the individual or business you want to notify about this transaction for this manufactured home. This may be a title company, real estate agent, attorney, or financial institution. Lien holder - This is the name of the individual or business you are making payments to. If there are more than one lien holder, enter the first priority lien holder on the application and any remaining lien holders in priority order in the owner affidavit. If you do not owe anyone for the manufactured home, you must write the word “NONE” in this section. N/A may not be used on this form. Signature - If there is no change from the ownership document (title or Manufacturer’s Certificate of Origin) being submitted, only one owner must sign. If there is a change, all owners must sign. (Example: Assignment on title is made to John and Jane Doe. You want the title to read John OR Jane Doe. Both John and Jane must sign the application to make this change.) If you use a power of attorney, the correct way to sign is as follows: Jane Doe by John Doe, POA If you are titling a manufactured home owned by a business, company or trust, use the company name and authorized agent area for the signatures. NOTE: When you purchase a manufactured home, check the serial numbers (VIN) on the manufactured home against the ownership documents, before transferring the title to your name. Form 870 (Rev. 01/2018) ALASKA.GOV/DMV Owner Affidavit I swear under oath I am the owner of the manufactured home. Manufacturer Year Make Model Dimensions Manufacturer's Serial Number / VIN I certify that this manufactured home is either 8 feet or more wide, 40 or more feet long, 320 square feet or more, or the manufacturer voluntarily complies with the standards established under Title 42 of the United States Code (U.S.C.) and filed a certification required by the United States Secretary of Housing and Urban Development(HUD). I further certify the manufactured home state herein is free and clear of all liens and encumbrances and I have no known facts or information that could reasonably affect the validity of the title to the manufactured home or the existence or nonexistence of a lien or encumbrance on the manufactured home. If facts or information are known that could reasonably affect the validity of the title they are listed below, or if there are no factors write the word NONE below: Lien Holder Names Owners Printed Name Address Signature Address Subscribed and sworn to before me this ___ day of _________20__ ___________________________________ Notary Public in the State of Alaska My Commission Expires:____________________ Form 870 (Rev. 01/2018) ALASKA.GOV/DMV Declaration Affidavit (AS 28.10.267) Manufacturer Year Make Dimensions Model Manufacturer's Serial Number / VIN To comply with AS 28.10.267, I swear under oath I am an attorney authorized under AS 08.08 to practice law or am agent of a title insurance company entitled under AS 21.66 to transact a title insurance business in this state, the manufactured home stated herein is free and clear of all liens and encumbrances and I have no known facts or information that could reasonably affect the validity of the title to the manufactured home or the existence or nonexistence of a lien or encumbrance on the manufactured home. If facts or information are known that could reasonably affect the validity of the title list below or attach as a sworn addendum: Attorney / Title Agent Printed Name Signature Business Name Address Subscribed and sworn to before me this ___ day of _________20__ ___________________________________ Notary Public in the State of Alaska My Commission Expires:____________________ Form 870 (Rev. 01/2018) ALASKA.GOV/DMV Affixation Affidavit (AS 34.85.060) I certify that the manufactured home described herein: Manufacturer Year Make Dimensions Model Manufacturer's Serial Number / VIN Street address of Property Manufactured Home is Affixed To Legal Description of Property Manufactured Home is Affixed To MCO Date (if applicable) The Manufactured Home Described is: New or Used . I further certify that I am either the owner of the real property listed here or I am the Lessee in possession of the real property under a lease in recordable form that has a term that continues for at least 20 years after the date of execution of the affidavit; and the Lessor of the real property consents (attach the consent of the lessor of the real property endorsed on or attached to the affidavit and acknowledged or proved in the manner required for the conveyance to be recorded); and that the manufactured home is permanently affixed to the real property herein. The manufactured home is covered by a Manufacturer’s Certificate of Origin(MCO) OR Certificate of Title. I confirm as the owner that the Manufacturer’s Certificate of Origin or Certificate of Title will accompany this application; I am unable to provide either the Manufacturer’s Certificate of Origin or Certificate of Title, after diligent search and inquiry. (Declaration Affidavit must be completed.) I certify that the manufactured home is or is not subject to a lien or encumbrance. If the manufactured home is subject to a lien or encumbrance, the name and address of each person who holds a lien or encumbrance is listed below and shall be released or has been released (releases should be attached to application): Lien Holder Names Address Printed Name Person Designated For Filing the Certified Copy of the Affixation Affidavit Signature Address Owners Signature Signature Address Subscribed and sworn to before me this ___ day of _________20__ ___________________________________ Notary Public in the State of Alaska My Commission Expires:____________________ Form 870 (Rev. 01/2018) ALASKA.GOV/DMV Severance Affidavit (AS 34.85.120) I certify that the manufactured home described herein: Manufactured Year Make Dimensions Model Manufacturer's Serial Number / VIN Street address of Property Manufacture Home is Affixed To Legal Description of Property Manufactured Home is Affixed To Mailing Address of Owner City/State Serial Numbers of Affixation Affidavit Date Affixation Recorded Zip Code The Manufactured Home Described is: New or Used. I certify that the manufactured home state herein is free and clear of all liens and encumbrances and I have no known facts or information that could reasonably affect the validity of the title to the manufactured home or the existence or nonexistence of a lien or encumbrance on the manufactured home. If facts or information are known that could reasonably affect the validity of the title list below or attach as a sworn addendum: Printed Name Person Designated for Filing the Certified Copy of the Affixation Affidavit Signature Address Subscribed and sworn to before me this ___ day of _________20__ ___________________________________ Notary Public in the State of Alaska My Commission Expires:____________________ Form 870 (Rev. 01/2018) ALASKA.GOV/DMV STATE OF ALASKA DIVISION OF MOTOR VEHICLES MANUFACTURED HOMES SURETY BOND AND APPRAISAL This packet is designed for use by applicants who have a manufactured home and who are applying for Non-application of Alaska Statute 28.10 To apply for Confirmation of non-application of AS 28.10.264, you must: 1. Complete an Application For Manufactured Home Title(Form 870) 2. Obtain a bona fide appraisal of the current fair market value of the manufactured home: • Value must be fully justified. • Appraisal must be on a “Fair market appraised value” form (attached). • Appraisal may be obtained from a licensed dealer, insurance appraiser or a Bank. If none of these are available in your area, check with DMV for other options. • Appraisal must be dated within the last 90 days. • The applicant and the appraiser may not be the same individual or company. Appraisals that are significantly less than the fair market appraised value of the manufactured home will be rejected. 3. Secure a three (3) year non-cancelable surety bond* for one and one-half times the appraised value of the manufactured home (attached), or submit a cash bond to DMV. 4. Obtain lien releases. The Application for Manufactured Home, Affidavit of Ownership, Surety Bond, and Fair market appraised value forms, in conjunction with proper fees and taxes, are to be submitted to the nearest motor vehicle office in addition to any further titling requirements. A SURETY BOND MUST BE NON-CANCELABLE FOR A PERIOD OF THREE (3) YEARS. *A surety bond is an insurance policy purchased from an insurance company licensed to do business in Alaska, guaranteeing payment up to one and one-half times the appraised value of the manufactured home to people who have sued and won in the Alaska courts due to illegal or wrong issuance of a manufactured home title issued according to AS 28.10.264. NOTE: Cash deposits are not automatically returned. You must apply with the Division to obtain your deposit at the end of the three years. Form 870 (Rev. 01/2018) ALASKA.GOV/DMV STATE OF ALASKA DIVISION OF MOTOR VEHICLES MANUFACTURED HOME TITLE SURETY BOND 3 YEAR NON-CANCELABLE Bond Number: KNOW ALL MEN BY THESE PRESENTS: That as principal/s and , NAME OF SURETY COMPANY a company duly authorized to transact surety business in the State of Alaska, a surety, do hereby jointly and severally acknowledge ourselves to be held and bound unto the State of Alaska, Commissioner of Administration, State of Alaska, in his capacity as agent in the premises for the State of Alaska, in the sum of $ , which is one and one-half times the fair market appraised value of the manufactured home described below: SERIAL NUMBER (VIN) SECONDARY SERIAL NUMBER (VIN) HS YEAR MAKE MODEL BODY STYLE COLOR for the true payment of which we, and each of us, bind ourselves, our heirs, executors, administrators, successors or assigns, jointly and severally by these presents. THE CONDITIONS OF THE ABOVE BOND ARE SUCH that the above named principal warrants: (1) They are the true owner of the manufactured home described above; (2) There is no defect in or undisclosed security interest on the title of the manufactured home; (3) If any former owners, second parties, or subsequent purchasers of the manufactured home and their successors suffer any loss resulting from a defect in or undisclosed security on the title of the manufactured home, they may sue on the bond for a breach of its condition, but the liability of the surety may not exceed the amount of the bond. No attached documents shall modify the provisions of this bond or conditions thereto or rights of action arising under AS 28.10.264 (c). This bond shall remain in force until three years from its date except as it may be extended under the provisions of AS 28.10.264 (d). IN WITNESS WHEREOF the said surety has hereunto set his hand and seal and the said surety has caused this bond to be signed, sealed and dated this ______ day of _________, 20 . BY NOTARY OR DMV REPRESENTATIVE (AMVC & Office Number) SURETY (SEAL) MY COMMISSION EXPIRES: ATTORNEY-IN-FACT Attached hereto a valid power of attorney authorizing the attorney-in-fact to bind the surety. IN WITNESS WHEREOF the said principal has hereunto set his hand and seal and the said surety has caused this bond to be signed, sealed and dated this ______ day of _________, 20 . BY NOTARY / DMV REPRESENTATIVE (AMVC & Office Number) (SEAL) MY COMMISSION EXPIRES: Form 870 (Rev. 01/2018) PRINCIPAL PRINTED NAME AND TITLE ALASKA.GOV/DMV STATE OF ALASKA DIVISION OF MOTOR STATEMENT OF FAIR MARKET APPRAISED VALUE OF MANUFACTURED HOME SERIAL NUMBER (VIN) SECONDARY SERIAL NUMBER (VIN) HS YEAR MAKE MODEL NAME OF APPLICANT BODY STYLE COLOR ADDRESS CITY/STATE/ZIP APPRAISER / DEALER / COMPANY NAME ADDRESS CITY/STATE/ZIP I, _______________________________________________, certify as a Dealer / Appraiser that the Fair Market Appraised Value of the manufactured home shown above is $____________. This form should not serve as an offer to purchase the subject manufactured home. AUTHORIZED SIGNATURE AND TITLE Form 870 (Rev. 01/2018) DATE ALASKA.GOV/DMV
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