Home Buying / Selling

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

6. File Number 7. Loan Number

1. o FHA 2. o FmHA

3. o CONV. UNINS. 4. o VA 5. o CONV. INS. 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: F. NAME AND ADDRESS OF LENDER:
G. PROPERTY LOCATION: H. SETTLEMENT AGENT: NAME, AND ADDRESS

PLACE OF SETTLEMENT: I. 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
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
107. County taxes to

407. County taxes to
108. Assessments to

408. Assessments to
109.

409.
110.

410.
111.

411.
112.

412.
120. GROSS AMOUNT DUE FROM BORROWER

420. GROSS AMOUNT DUE TO SELLER
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)
203. Existing loan(s) taken subject to

503. Existing loan(s) taken subject to
204.

504. Payoff of first mortgage loan
205.

505. Payoff of second mortgage loan
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
211. County taxes to

511. County taxes to
212. Assessments to

512. Assessments to
213.

513.
214.

514.
215.

515.
216.

516.
217.

517.
218.

518.
219.

519.
220. TOTAL PAID BY/FOR BORROWER

520. TOTAL REDUCTION AMOUNT DUE SELLER
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)
302. Less amounts paid by/for borrower(line 220)

602. Less reductions in amount due seller (line 520)
303. CASH (_ FROM) (_ TO) BORROWER

603. CASH (o TO) (o FROM) SELLER

L. SETTLEMENT CHARGES
700. TOTAL SALES/BROKER’S COMMISSION based on price $ @ %= PAID FROM BORROWER’S FUNDS AT SETTLEMENT PAID FROM SELLER’S FUNDS AT SETTLEMENT
Division of Commission (line 700) as follows:
701. $ to

702. $ to

703. Commission paid at Settlement

704.

800. ITEMS PAYABLE IN CONNECTION WITH LOAN

801. Loan Origination Fee %

802. Loan Discount %

803. Appraisal Fee to

804. Credit Report to

805. Lender’s Inspection Fee

806. Mortgage Insurance Application Fee to

807. Assumption Fee

808.

809.

810.

811.

900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest from to @$ /day

902. Mortgage Insurance Premium for months to

903. Hazard Insurance Premium for years to

904. years to

905.

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 to

1102. Abstract or title search to

1103. Title examination to

1104. Title insurance binder to

1105. Document preparation to

1106. Notary fees to

1107. Attorney’s fees to

(includes above items numbers; )

1108. Title Insurance to

(includes above items numbers; )

1109. Lender’s coverage $

1110. Owner’s coverage $

1111.

1112.

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.

1205.

1300. ADDITIONAL SETTLEMENT CHARGES

1301. Survey to

1302. Pest inspection to

1303.

1304.

1305.

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

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Home Buying / Selling

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