C.
NOTE: This form s
furnished to give you a statement of actual settlement costs. Amounts paid to and by the
settlement agent are shown. Item
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:
TIN:
F.
NAME AND ADDRESS OF LENDER:
G.
PROPERTY
LOCATION:
H.
SETTLEMENT AGENT: Sitelink
Title LLC
PLACE OF
SETTLEMENT: PHONE:
TIN:
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.
10.
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 or 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 REDUCTIONS
IN 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 amt. due
Seller (line 520)
(.................)
303. CASH (FROM)(TO) BORROWER:
603.
CASH (FROM)(TO) SELLER:
I.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 formos.
to
903.
Hazard insurance premium foryrs. to
904.
Flood insurance premium foryrs. 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
