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A.
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT
STATEMENT
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B.
TYPE OF LOAN
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6.
File Number
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7.
Loan Number
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1.
o FHA
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2.
o FmHA
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3.
o CONV. UNINS.
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4.
o VA
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5.
o CONV. INS.
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8.
Mortgage Insurance Case Number
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C.
NOTE: This form is furnished to give you a statement of actual
settlement costs. Amounts paid to and by the settlement agent
are shown. Items marked "(p.o.c.)" were paid outside
the closing; they are shown here for informational purposes
and are not included in the totals.
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D.
NAME AND ADDRESS OF BORROWER:
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E.
NAME AND ADDRESS OF SELLER:
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F.
NAME AND ADDRESS OF LENDER:
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G.
PROPERTY LOCATION:
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H.
SETTLEMENT AGENT: NAME, AND ADDRESS
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PLACE
OF SETTLEMENT:
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I.
SETTLEMENT DATE:
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J.
SUMMARY OF BORROWERS TRANSACTION
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K.
SUMMARY OF SELLERS TRANSACTION
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100.
GROSS AMOUNT DUE FROM BORROWER:
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400.
GROSS AMOUNT DUE TO SELLER:
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101.
Contract sales price
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401.
Contract sales price
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102.
Personal property
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402.
Personal property
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103.
Settlement charges to borrower(line 1400)
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403.
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104.
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404.
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105.
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405.
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Adjustments
for items paid by seller in advance
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Adjustments
for items paid by seller in advance
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106.
City/town taxes to
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406.
City/town taxes to
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107.
County taxes to
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407.
County taxes to
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108.
Assessments to
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408.
Assessments to
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109.
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409.
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110.
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410.
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111.
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411.
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112.
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412.
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120.
GROSS AMOUNT DUE FROM BORROWER
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420.
GROSS AMOUNT DUE TO SELLER
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200.
AMOUNTS PAID BY OR IN BEHALF OF BORROWER:
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500.
REDUCTIONS IN AMOUNT DUE TO SELLER:
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201.
Deposit of earnest money
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501.
Excess deposit (see instructions)
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202.
Principal amount of new loan(s)
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502.
Settlement charges to seller (line 1400)
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203.
Existing loan(s) taken subject to
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503.
Existing loan(s) taken subject to
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204.
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504.
Payoff of first mortgage loan
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205.
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505.
Payoff of second mortgage loan
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206.
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506.
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207.
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507.
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208.
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508.
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209.
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509.
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Adjustments
for items unpaid by seller
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Adjustments
for items unpaid by seller
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210.
City/town taxes to
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510.
City/town taxes to
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211.
County taxes to
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511.
County taxes to
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212.
Assessments to
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512.
Assessments to
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213.
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513.
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214.
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514.
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215.
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515.
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216.
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516.
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217.
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517.
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218.
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518.
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219.
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519.
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220.
TOTAL PAID BY/FOR BORROWER
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520.
TOTAL REDUCTION AMOUNT DUE SELLER
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L.
SETTLEMENT CHARGES
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700.
TOTAL SALES/BROKERS COMMISSION based on price $ @
%=
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PAID
FROM BORROWERS FUNDS AT SETTLEMENT
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PAID
FROM SELLERS FUNDS AT SETTLEMENT
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Division
of Commission (line 700) as follows:
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701.
$ to
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702.
$ to
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703.
Commission paid at Settlement
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704.
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800.
ITEMS PAYABLE IN CONNECTION WITH LOAN
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801.
Loan Origination Fee %
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802.
Loan Discount %
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803.
Appraisal Fee to
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804.
Credit Report to
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805.
Lenders Inspection Fee
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806.
Mortgage Insurance Application Fee to
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807.
Assumption Fee
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808.
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809.
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810.
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811.
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900.
ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
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901.
Interest from to @$ /day
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902.
Mortgage Insurance Premium for months to
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903.
Hazard Insurance Premium for years to
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904.
years to
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905.
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1000.
RESERVES DEPOSITED WITH LENDER
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1001.
Hazard Insurance months @ $ per month
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1002.
Mortgage insurance months @ $ per month
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1003.
City property taxes months @ $ per month
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1004.
County property taxes months @ $ per month
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1005.
Annual assessments months @ $ per month
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1006.
months @ $ per month
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1007.
months @ $ per month
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1008.
Aggregate Adjustment months @ $ per month
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1100.
TITLE CHARGES
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1101.
Settlement or closing fee to
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1102.
Abstract or title search to
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1103.
Title examination to
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1104.
Title insurance binder to
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1105.
Document preparation to
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1106.
Notary fees to
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1107.
Attorneys fees to
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(includes
above items numbers; )
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1108.
Title Insurance to
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(includes
above items numbers; )
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1109.
Lenders coverage $
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1110.
Owners coverage $
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1111.
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1112.
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1113.
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1200.
GOVERNMENT RECORDING AND TRANSFER CHARGES
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1201.
Recording fees: Deed $ ; Mortgage $ ; Releases $
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1202.
City/county tax/stamps: Deed $ ; Mortgage $
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1203.
State tax/stamps: Deed $ ; Mortgage $
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1204.
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1205.
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1300.
ADDITIONAL SETTLEMENT CHARGES
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1301.
Survey to
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1302.
Pest inspection to
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1303.
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1304.
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1305.
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1400.
TOTAL SETTLEMENT CHARGES (enter on lines 103, Section
J and 502, Section K)
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