A. U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT

B. TYPE OF LOAN

1.___ FHA     2.___FmHA   3.___Conventional
4 ___VA        5.___Conventional Insured		 6. File Number
7. Loan Number 8. Mortgage Insurance Case Number

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.

D. NAME AND ADDRESS OF BORROWER:
 

E. NAME AND ADDRESS OF SELLER:
Name
Address
City, State Zip

F. NAME AND ADDRESS OF LENDER

G. PROPERTY LOCATION:
Address
City, State Zip

 

H. SETTLEMENT AGENT:

PLACE OF SETTLEMENT:


 

I. SETTLEMENT DATE:
Settlement Date

 

J. SUMMARY OF BORROWER’S TRANSACTION

K. SUMMARY OF SELLER’S TRANSACTION

100. GROSS AMOUNT DUE FROM BORROWER:

400. GROSS AMOUNT DUE TO SELLER:

101. Contract sales price


401. Contract sales price Input Value

Sales Price

102. Personal property


402. Personal property


103. Settlement charges to borrower (line 1400)


403.


104.


404.


105.


405.


Adjustments for items paid by seller in advance

Adjustments for items paid by seller in advance

106. City/town taxes to


406. City/town taxes to Input 20 Char. City Name
(Input City Taxes) Paid thru (Input Date)
If Input Date is beyond Settlement Date Adjust by Daily Rate. Total City Tax/365=Daily Rate
Calculate Only if (Paid Thru Date is Beyond Settlement Date)

 Input Default 0
Calculated From Total City Tax

107. County taxes to


407. County taxes to Input 20 Char.  County Name
Input County Taxes Paid thru Input Date
If Input Date is beyond Settlement Date  Adjust by Daily Rate. Total County Tax/365=Daily Rate
Calculate Only if (Paid Thru Date is Beyond Settlement Date)

 put Default 0
Calculated From Total County Tax

108. Assessments to


408. HOA Assessments to Input 20 Char. HOA Name
Input HOA Paid thru Input Date
If Input Date is beyond Settlement Date Adjust by Daily Rate. Total HOA Assessment/365=Daily Rate
Calculate Only if (Paid Thru Date is Beyond Settlement Date)

 Input Default 0
Calculated From Total HOA Assessments

109. Condo Fees to


409. Condo Fees to Input 20 Char.
Condo Name
Input Condo Paid thru Input Date
If Input Date is beyond Settlement Date Adjust by Daily Rate. Total Condo Fee/365=Daily Rate Calculate Only if (Paid Thru Date is Beyond Settlement Date)

 Input Default 0
Calculated From Total Condo Fee

110.


410.


111.


411.


112.


412.


120. GROSS AMOUNT DUE FROM BORROWER


420. GROSS AMOUNT DUE TO SELLER

Total of Lines 401-420

200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER:

500. REDUCTIONS IN AMOUNT DUE TO SELLER:

201. Deposit of earnest money


501. Excess deposit (see instructions)


202. Principal amount of new loan(s)


502. Settlement charges to seller (line 1400)

From Line 1400

203. Existing loan(s) taken subject to


503. Existing loan(s) taken subject to Input Assumed Lender Name
 

 Input Loan Amt. Default 0
Loan Assumed

204.


504. Payoff of first mortgage loan
Input 1st Lender Name
1st Loan Amt+Daily Rate to End of Current Month
2nd Loan Amt*Loan Rate/365=Daily Rate

 Input Loan Amt.
Default 0
1st Loan Payoff

205.


505. Payoff of second mortgage loan
Input 2nd Lender Name
2nd Loan Amt+Daily Rate to End of Current Month
2nd Loan Amt*Loan Rate/365=Daily Rate

 Input Loan Amt.
Default 0
2nd Loan Payoff

206.


506.


207.


507.


208.


508.


209.


509.


Adjustments for items unpaid by seller

Adjustments for items unpaid by seller

210. City/town taxes to


510. City/town taxes to Input 20 Char.
Name
Input City Total Annual Taxes Paid thru Input Date
If Input Date is Before  Settlement Date Adjust by Daily Rate. Total City Tax/365=Daily Rate
Calculate Only if (Paid Thru Date is Before Settlement Date)

 Input Default 0

Calculated From Total City Tax

211. County taxes to


511. County taxes to Input 20 Char.
Name
Input County Total Annual Taxes Paid thru Input Date
If Input Date is before Settlement Date Adjust by Daily Rate. Total County Tax/365=Daily Rate
Calculate Only if (Paid Thru Date is Before Settlement Date)

 Input Default 0

Calculated From Total County Tax

212. Assessments to


512. Assessments to Input 20 Char. HOA Name
Input Annual HOA Assessment Paid thru Input Date
If Input Date is before Settlement Date Adjust by Daily Rate. Total HOA Assessment/365=Daily Rate
Calculate Only if (Paid Thru Date is Before Settlement Date)

 Input Default 0

Calculated From Total HOA Assessment

213. Condo Fees to


513. Condo Fee to Input 20 Char.
Condo Name
Input Annual Condo Fee Paid thru Input Date
If Input Date is before Settlement Date Adjust by Daily Rate. Total Condo Fee/365=Daily Rate
Calculate Only if (Paid Thru Date is Before Settlement Date)

 Input Default 0

Calculated From Total Condo Fee

214.


514.


215.


515. Purchasers Closing Cost Credit

 Input Default 0
Purchaser Closing Cost

216.


516. Input 20 Char. Name of Other Charges

 Input Default 0

217.


517. Payoff/Courier Fee

 Input Default 50

218.


518.


219.


519.


220. TOTAL PAID BY/FOR BORROWER


520. TOTAL REDUCTION AMOUNT DUE SELLER

Total of Lines 501-520

300.CASH AT SETTLEMENT FROM/TO BORROWER

600. CASH AT SETTLEMENT TO/FROM SELLER

301. Gross amount due from borrower (line 120)


601. Gross amount due to seller (line 420)

From Line 420

302. Less amounts paid by/for borrower(line 220)


602. Less reductions in amount due seller (line 520)

From Line 520

303. CASH FROM BORROWER


603. CASH TO SELLER

Line 601-Line 602

 

L. SETTLEMENT CHARGES

700. TOTAL SALES/BROKER’S COMMISSION based on price
Division of Commission (line 700) as follows: (Listing%)+(Selling%) $ (Listing%)+(Selling%)*(Sales Price)
701. Input Listing% $ (Listing%)*(Sales Price)  to  Listing Company
702. Input Selling% $ (Listing%)*(Sales Price) to Selling Company

PAID FROM BORROWER’S FUNDS AT SETTLEMENT

PAID FROM SELLER’S FUNDS AT SETTLEMENT

703. Total Commission Paid
Listing%+Selling%*Sales Price
704.

800. ITEMS PAYABLE IN CONNECTION WITH LOAN

801. Loan Origination Fee  %



802. Loan Discount   %



803. Appraisal Fee


804. Credit Report



805. Lender’s Inspection Fee


806. Underwriting Fee

807. Tax Service Fee

808.

809.



810.



811.



900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE

901. Interest from to  @$   per day for



902. Mortgage Insurance Premium



903. Hazard Insurance Premium $




1000. RESERVES DEPOSITED WITH LENDER



1001. Hazard Insurance months @ $  per month



1002. Mortgage Insurance months @ $  per month



1003. City property taxes  months @ $  per month



1004. County property taxes months  @ $  per month



1005. Annual assessments months @ $ per month



1006. months @ $ per month



1007. months @ $ per month



1008. Aggregate Adjustment months @ $ per month



1100. TITLE CHARGES



1101. Settlement or closing fee
Input Fee Default 250

1102. Abstract or title search



1103. Title examination

1104. Title insurance binder



1105. Document preparation (Deed)
Input Fee Default 195

1106. Notary fees

1107. Attorney’s fees

(includes above items No:                      )


1108. Title Insurance to



(includes above items No:                      )

1109. Lender’s coverage $

1110. Owner’s coverage $

1111. R-5 Compliance Fee
Input Fee Default 45

1112. Release Processing
Input Fee Default 100

1113.



1200. GOVERNMENT RECORDING AND TRANSFER CHARGES

1201. Recording fees:

 Deed $ Mortgage $ Releases $

1202. City/county tax/stamps:

 Deed $ Mortgage$

1203. State tax/stamps:

 Deed $ Mortgage $

1204. Grantors Tax
Sales Price*.001

1205.



1300. ADDITIONAL SETTLEMENT CHARGES



1301. Survey

1302. Pest inspection Input Pest Inspector
Input Fee Default 35

1303. HOA Management Transfer Fee

1304. Other Fees Input Name of Other Fee
Input Fee Default 0

1305.



1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section K)


Total of Lines 703-1305
Total of This Column Carries to Line 502