APPLICATION 870

User Manual: 870

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Form 870 (Rev. 01/2018) ALASKA.GOV/DMV
STATE OF ALASKA - DIVISION OF MOTOR VEHICLES
APPLICATION for MANUFACTURED HOME
PLEASE TYPE OR PRINT (IN BLACK OR BLUE INK)
APPLICATION REASON
1
MANUFACTURED
HOME
SERIAL NUMBER (VIN)
YEAR
Title Only
Cancel Title
Cancel Manufacturers
Certificate of Origin (MCO)
Non-application of Alaska
Statute 28.10
Severed Manufactured
Home
MODEL
IS THE
MANUFACTURED
HOME ?
NEW
USED
Date of Purchase
COLOR (PRIMARY)
SECONDARY VIN
BODY STYLE
HS
2
OWNERSHIP
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME SUFF.
ORGAN DONOR?
YES NO
OWNER
STATE*
DATE OF BIRTH*
SOCIAL SECURITY NO.*
SEX
FOR DIVISION USE ONLY
OR
LESSOR
COMPANY OR TRUST NAME (If this is to appear on the title)
Taxpayer ID Number
CODES
FEES
AND (REQUIRES
BOTH SIGNATURES TO RELEASE TITLE)
OR (REQUIRES EITHER SIGNATURE TO RELEASE TITLE)
CLASS
36
TITLE
$100
CO-OWNER
FULL FIRST NAME FULL MIDDLE NAME FULL LAST NAME SUFF.
ORGAN DONOR?
YES NO
OR
LESSEE
STATE*
DATE OF BIRTH*
SOCIAL SECURITY NO.*
SEX
LIEN
COMPANY OR TRUST NAME (If this is to appear on the title)
Taxpayer ID Number
3
CONTACT INFO
EMAIL ADDRESS
PHONE #
MAILING
ADDRESS
OF
PO BOX OR STREET ADDRESS
TAX LOCATION
TAX
OWNER
OR
LESSOR
CITY / STATE / ZIP CODE
4
PHYSICAL
ADDRESS
OF
STREET OR LOCATION (Physical location - no PO Box or Mail Cache addresses.)
PREVIOUS STATE
MISCELLANEOUS
OWNER
OR
LESSEE
CITY / STATE / ZIP CODE
5
PREVIOUS
OWNER
NAME (Dealer / Previous Owner)
TOTAL
AND
MAILING
ADDRESS
PO BOX OR STREET
CITY / STATE / ZIP CODE
PAYMENT TYPE
CA CC CK
6
(Optional)
ADDITIONAL
NAME (Title Company, Agent, Etc.)(Parties are only notified for Cancel Title/MCO , Non-Application or Title of Severed)
NOTIFIED
PARTY
AND
PO BOX OR STREET
DOCUMENTS ACCEPTED
MAILING
ADDRESS
CITY / STATE / ZIP CODE
7
TO CORRECT
SERIAL NUMBER
INCORRECT SERIAL NUMBER (VIN)
SHOW CORRECT SERIAL
NUMBER IN ITEM 1 ABOVE
8
(First Priority)
LIEN HOLDER
AND
MAILING
ADDRESS
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) DATE
X / / .
SIGNATURE OF OWNER (IN INK) DATE
by X / / .
COMPANY NAME AUTHORIZED AGENT DATE
BATCH NO.:
BATCH 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:
Title Only
(with a MCO or
Prior Title)
Title Only
(No MCO or Prior Title)
Affixation
Severance
Non-
Application
Application for Manufactured Home
X
X
X
X
X
Owner Affidavit
X
X
X
X
X
Lien Releases
X
X
X
X
X
MCO or Title
X
X
Appraisal
X
X
Surety Bond
X
X
Declaration Affidavit
X
X
Affixation Affidavit
X
X
Severance Affidavit
X
Title Fee
$100
$100
$100
$100
$100
Lien Fee (if applicable)
$15
$15
$15
$15
$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
Make
Model
Year
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
Address
Owners Printed Name
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
Make
Model
Year
Dimensions
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
Make
Model
Year
Dimensions
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
Make
Model
Year
Dimensions
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
Zip Code
Serial Numbers of Affixation Affidavit
Date Affixation
Recorded
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)
(SEAL)
SURETY
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)
PRINCIPAL
MY COMMISSION EXPIRES:
PRINTED NAME AND TITLE
Form 870 (Rev. 01/2018) 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
BODY STYLE
COLOR
NAME OF APPLICANT
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
DATE

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