Form T-234 - Mobile/manufactured Home Certificate Of Permanent Location
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T-234 (Rev 8-2005)
Mobile/Manufactured Home Certificate of Permanent Location
This certificate is presented for filing and recording in the real estate records pursuant to §8-2-
181(c) of the O.C.G.A.
1. Mail certified copy to:
(Name and mailing address)
T
.
HIS SPACE IS FOR RECORDING INFORMATION ONLY
2. Debtor’s Name and Mailing Address: (Last name first if an individual)
3. Debtor’s Name and Mailing Address:
(Last name first if an individual)
4.Lien Holder/Secured Party’s Name and Mailing Address:
(Last name first if an individual)
5. Lien Holder/Secured Party’s Name and Mailing Address:
(Last name first if an individual)
6. This Certificate of Permanent Location covers the following collateral:
VIN: ____________________________________________________________ Title # _____________________________________
7. Description of real estate to which this vehicle has been permanently affixed:
The deed to said real estate is located on page number ________ in deed book number ________ in the real
estate records maintained by the Clerk of the Superior Court of _____________________________County.
8. Name of the Record Owner(s) of Said Real Estate:
(Must include at least one debtor listed above.)
9. County(ies) in which this Certificate of Permanent Location is filed:
10. Signature(s)
____________________________________________________
__________________________________________________
Debtor
Date
Debtor
Date
____________________________________________________
__________________________________________________
Lien Holder/Secured Party
Date
Lien Holder/Secured Party
Date
I hereby certify that this is a true and accurate copy of this Certificate of Permanent Location as recorded in
the records of the Clerk of Superior Court of ____________________________ County. This ______ day
(County Name)
(Day)
of __________________, ________
(Month)
(Year)
Page ________ of _______________.
___________________________________________
(Deputy)Clerk of Superior Court)
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