Manufactured Home Relocation Trust Fund Homeowner Certification: Homeowner Relocating to Another Community
I,      , the undersigned to hereby certify that:
1.	I am the owner of the manufactured home, which is my primary residence, located at      , for which compensation is being requested from the Minnesota Manufactured Home Relocation Trust Fund.
2.	I was living in the manufactured home community prior to receiving the Park Closure Notice.
3.	The manufactured home has not been relocated to another lot within the park, or to another manufactured housing community, at the Park Owner’s expense.
4.	I did not give any notice that I am leaving the park before the Park Closure Notice was mailed.
5.	I have not abandoned the manufactured home.
6.	No eviction action is pending against me for failure to pay the lot rental and no writ of recovery has been issued by a district court.
7.	The manufactured housing park is not being closed because of a taking or eminent domain action of a unit of government or public utility. 
8.	The lot rental for the manufactured home is current.
9.	The $15 annual fee due to the Minnesota Manufactured Home Relocation Trust Fund has been paid each year it was due.
10.	A statement from the county in which the manufactured home is located verifying that the personal property taxes have been paid and are current through the current year has been delivered to the neutral third party.

	     	
Signature								Date