Your City LLC
disclaims any liability arising out of the use or misuse of this
form. It is supplied for informational purposes only.
| 1. [ ] FHA 2.[ ] FmHA 3.
[ ] Conv. Unins.
4. [ ] VA 5. [ ] Conv. Ins. |
6. File Number: |
7. Loan Number: |
8. Mortgage Insurance Case Number:
|
| C. Note: This
form is furnished to give you a statement of actual settlemant
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 & Address of Borrower |
E. Name & Address of Seller |
F. Name & Address of Lender
|
| G. Property Location |
H. Settlement Agent: |
|
| Place of Settlement: |
I. Settelment 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 |
100,000.00 |
401. Contract sales price |
100,000.00 |
| 102. Personal Property |
|
402. Personal Property |
|
| 103. Settlement charges to borrower
(line 1400) |
3,104.98 |
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 |
0.00 |
406. City/town taxes |
to |
0.00 |
| 107. County taxes |
to |
0.00 |
407. County taxes |
to |
0.00 |
| 108. Assessments |
to |
0.00 |
408. Assessments |
to |
0.00 |
| 109. |
|
409. |
|
| 110. |
|
410. |
|
| 111. |
|
411. |
|
| 112. |
|
412. |
|
| 120. Gross Amount Due
From Borrower |
103,104.98 |
420. Gross Amount Due
To Seller |
100,000.00 |
| 200.
Amounts Paid By Or In Behalf Of Borrower |
500.
Reductions In Amount Due To Seller |
| 201. Deposit or earnest money |
100.00 |
501. Excess deposit (see instructions) |
|
| 202. Principal amount of new loan(s) |
102,000.00 |
502. Settlement charges to seller
(line 1400) |
10,566.50 |
| 203. Existing loan(s) taken subject
to |
|
503. Existing loan(s) taken subject
to |
|
| 204. Application fee |
350.00 |
504. Payoff of first mortgage
loan |
80,634.72 |
| 205. |
|
505. Payoff of second mortgage
loan |
0.00 |
| 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 |
364.53 |
510. City/town taxes |
to |
364.53 |
| 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 |
102,814.53 |
520. Total Reduction Amount
Due Seller |
91,565.75 |
| 300.
Cash At Settlement From/To Borrower |
600.
Total Reduction Amount Due Seller |
| 301. Gross amount due from borrower (line
120) |
103,104.98 |
601. Gross amount due to seller (line 420) |
100,000.00 |
| 302. Less amounts paid by/for borrower (line
220) |
(102,814.53) |
602. Less reductions in amount due seller
(line 520) |
(91,565.75) |
| 303. Cash [X] From [ ] To Borrower |
290.45 |
603. Cash [ ] To [X] From Seller |
8,434.25 |
| L.
Settlement Charges |
| 700.
Total Sales/Broker's Commision based on price $100,000.00 |
@ 6.00 % |
=$6,000.00 |
Paid
From Borrowe'rs Funds at Settlement |
Paid
From Seller's Funds at Settlement |
| Division of Commission (line 700)
as follows: |
| 701. $3,000.00 |
to Buyer's realty |
| 702. $3,000.00 |
to Seller's realty |
| 703. Commision paid at Settlement |
|
6,000.00 |
| 704. |
|
|
| 800.
Items Payable In Connection With Loan |
| 801. Loan origination fee |
1.00 % with ABC bank |
|
1,020.00 |
| 802. Loan discount |
% |
|
300.00 |
| 803. Appraisal fee |
to |
|
40.00 |
| 804. Credit report |
to |
|
60.00 |
| 805. Lender's inspection fee |
|
0.00 |
| 806. Mortgage insurance application
fee |
|
0.00 |
| 807. Assumption fee |
|
0.00 |
| 808. Flood certification fee |
|
25.00 |
| 809.Tax service fee |
|
76.00 |
| 810. |
|
|
| 811. |
|
|
| 900.
Items Required By Lender To Be Paid In Advance |
| 901. Interest from (date) |
to (date) |
@$$22.356 |
/day for 6 days |
134.14 |
|
| 902. Mortgage insurance premium
for |
months to |
0.00 |
|
| 903. Hazard insurance premium
for |
years to |
409.00 |
|
| 904.Flood insurance premium |
0.00 |
|
| 905.VA funding fee to Dept. of
Veterans Affairs |
2,000.00 |
|
| 1000.
Reserves Deposited With Lender |
| 1001. Hazard insurance |
2 months @ $34.08 |
per month |
68.16 |
|
| 1002. Mortgage insurance |
months @ $ |
per month |
0.00 |
|
| 1003. City property taxes |
months @ $ |
per month |
0.00 |
|
| 1004. County property taxes |
9 months @ $63.00 |
per month |
567.00 |
|
| 1005. Annual assessments |
months @ $ |
per month |
|
|
| 1006. Aggragate adjustment |
(73.32) |
|
| 1007. |
|
|
| 1008. |
|
|
| 1100.
Title Charges |
| 1101. Settlement or closing fee |
to |
|
75.00 |
| 1102. Abstract or title search |
to |
|
|
| 1103. Title examination |
to |
|
175.00 |
| 1104. Title insurance binder |
to |
|
|
| 1105. Document proparation |
to |
|
100.00 |
| 1106. Notary fees |
to |
|
|
| 1107. Attorney's fees |
to |
|
|
| includes above items numbered: |
|
|
| 1108. Title insurance |
to |
|
278.50 |
| includes above items numbered: |
|
|
| 1109. Lender's coverage |
$ |
|
|
| 1110. Owner's coverage |
$ |
|
|
| 1111. Express fee |
|
15.00 |
| 1112. |
|
|
| 1113. |
|
|
| 1200.
Government Recording and Transfer Charges |
| 1201. Recording fees:Deed $8.00 |
Mortgage $20.00 |
Releases $4.00 |
|
32.00 |
| 1202. City/county tax/stamps:
Deed $ |
Mortgage $ |
|
|
| 1203. State tax/stamps: Deed $371.00 |
Mortgage $116.00 |
|
487.00 |
| 1204. Record power of attorney
to Register of Deeds |
|
8.00 |
| 1205. |
|
|
|
| |