US Department of Housing and Urban Development Settlement Statement

A. U.S. Department of Housing & Urban Development SETTLEMENT STATEMENT
	B. TYPE OF LOAN
	1. FHA 2. FmHA 3. CONV. UNINS. 4. VA 5. CONV.INS.
	6. FILE NUMBER:	7. LOAN NUMBER:
	8. MORTGAGE INS 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 "[POC]" 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:	I. SETTLEMENT DATE:
	PLACE OF SETTLEMENT

J. SUMMARY OF BORROWER'S TRANSACTION
100. GROSS AMOUNT DUE FROM BORROWER:
101. Contract Sales Price
102. Personal Property
103. Settlement Charges to Borrower (Line 1400) 403.
104.
105.
Adjustments For Items Paid By Seller in advance
106. City/Town Taxes to
107. County Taxes to
108. Assessments to
109.
110.
111.
112.
120. GROSS AMOUNT DUE FROM BORROWER
200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER:
201. Deposit or earnest money
202. Principal Amount of New Loan(s)
203. Existing loan(s) taken subject to
204.
205.
206.
207.
208.
209.
Adjustments For Items Unpaid By Seller
210. City/Town Taxes to
211. County Taxes to
212. Assessments to
213.
214.
215.
216.
217.
218.
219.
220. TOTAL PAID BY/FOR BORROWER
300. CASH SETTLEMENT FROM/TO BORROWER:
301. Gross Amount Due From Borrower (Line 120)
302. Less Amount Paid By/For Borrower (Line 220)	()
303. CASH (FROM) (TO) BORROWER

K. SUMMARY OF SELLER'S TRANSACTION
400. GROSS AMOUNT DUE TO SELLER:
401. Contract Sales Price
402. Personal Property

404.
405.
Adjustments For Items Paid By Seller in advance
406. City/Town Taxes to
407. County Taxes to
408. Assessments to
409.
410.
411.
412.
420. GROSS AMOUNT DUE TO SELLER
500. REDUCTIONS IN AMOUNT DUE TO SELLER:
501. Excess Deposit (See Instructions)
502. Settlement Charges to Seller (Line 400)
503. Existing loan(s) taken subject to
504. Payoff First Mortgage
505. Payoff Second Mortgage
506.
507.
508.
509.
Adjustments For Items Unpaid By Seller
510. City/Town Taxes to
511. County Taxes to
512. Assessments to
513.
514.
515.
516.
517.
518.
519.
520. TOTAL REDUCTION AMOUNT DUE SELLER
600. CASH SETTLEMENT TO/FROM SELLER:
401. Gross Amount Due From Borrower (Line 420)
402. Less Amount Paid By/For Borrower (Line 520)	()
603. CASH (TO) (FROM) SELLER

The undersigned hereby acknowledge receipt of a completed copy of pages 1&2 of this statement & any attachments referred to herein

, Borrower Date

L. SETTLEMENT CHARGES
700. TOTAL COMMISSION Based on Price $ @ %	PAID FROM BORROWER'S FUNDS AT SETTLEMENT	PAID FROM SELLER'S FUNDS AT SETTLEMENT
701. $ to
701. $ to
703. Commission Paid at Settlement
704.
800. ITEMS PAYABLE IN CONNECTION WITH LOAN
801. Loan Origination Fee % to
802. Loan Discount % to
803. Appraisal to
804. Credit Report to
805. Lender's Inspection Fee to
806. Mortgage Ins. App. Fee to
807. Assumption Fee to
808.
809.
810.
811.
900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE
901. Interest From to @ %/day ( days %)
902. Mortgage Insurnace Premium for months to
903. Hazard Insurance Premium for years to
904.
905.
1000. RESERVES DEPOSITED WITH LENDER
1001. Hazard Insurance @ $ per
1002. Mortgage Insurance @ $ per
1003. City/Town Taxes @ $ per
1004. County Taxes @ $ per
1005. Assessments @ $ per
1006. @ $ per
1007. @ $ per
1008. @ $ per
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 item numbers: )
1108. Title Insurance to
(includes above item numbers: )
1109. Lender's Coverage to
1110. Owner's Coverage to
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. Mortgage Tax ;
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)

By signing page 1 of this statement, the signatories acknowledge receipt of a completed copy of page 2 of this two page statement.

, Settlement Agent

MISC NY: US DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT