A. Settlement Statement U.S. Department of Housing OMB
Approval No. 2502-0265
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B. Type of Loan
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1. FHA
2. FmHA
3. Conv. Unins.
4. VA 5. Conv. Ins.
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6. File Number:
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7. Loan Number:
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8. Mortgage Insurance Case
Number:
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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.
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D. Name & Address of
Borrower:
(name(s))
(street address)
(street address)
(city, state zip)
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E. Name & Address of
Seller:
(name(s))
(street address)
(street address)
(city, state zip)
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F. Name & Address of
Lender:
(name(s))
(street address)
(street address)
(city, state zip)
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G. Property Location:
(street address)
(street address)
(city, state zip)
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H. Settlement Agent:
(name(s))
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Place of Settlement:
(name(s))
(street address)
(street address)
(city, state zip)
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I. Settlement Date:
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J. Summary of Borrower’s Transaction
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K. Summary of Seller’s Transaction
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100. Gross Amount Due From Borrower
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400. Gross Amount Due to Seller
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101. Contract Sales Price
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$0.00
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401. Contract Sales Price
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$0.00
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102. Personal Property
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$0.00
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402. Personal Property
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$0.00
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103. Settlement Charges to
Borrower (line 1400)
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$0.00
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403.
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$0.00
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104.
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$0.00
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404.
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$0.00
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105.
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$0.00
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405.
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$0.00
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Adjustments for items paid by seller in advance
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Adjustments for items paid by seller in advance
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106. City/ town taxes to
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$0.00
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406. City/ town taxes to
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$0.00
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107. County taxes to
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$0.00
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407. County taxes to
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$0.00
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108. Assessments to
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$0.00
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408. Assessments to
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$0.00
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109.
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$0.00
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409.
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$0.00
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110.
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$0.00
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410.
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$0.00
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111.
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$0.00
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411.
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$0.00
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112.
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$0.00
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412.
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$0.00
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120. Gross Amount Due From Borrower
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$0.00
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420. Gross Amount Due to Seller
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$0.00
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200. Amounts Paid By Or On Behalf of Borrower
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500. Reductions in Amount Due to Seller
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201. Deposit or earnest
money
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$0.00
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501. Excess deposit (see
instructions)
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$0.00
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202. Principal amount of
new loan(s)
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$0.00
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502. Settlement charges to
seller (line 1400)
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$0.00
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203. Existing loan(s)
taken subject to
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$0.00
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503. Existing loan(s)
taken subject to
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$0.00
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204.
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$0.00
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504. Payoff of first
mortgage lien
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$0.00
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205.
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$0.00
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505. Payoff of second mortgage
lien
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$0.00
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206.
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$0.00
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506.
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$0.00
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207.
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$0.00
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507.
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$0.00
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208.
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$0.00
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508.
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$0.00
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209.
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$0.00
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509.
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$0.00
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Adjustments for items unpaid by seller
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Adjustments for items unpaid by seller
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210. City/town taxes to
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$0.00
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510. City/town taxes to
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$0.00
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211. County taxes to
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$0.00
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511. County taxes to
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$0.00
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212. Assessments to
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$0.00
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512. Assessments to
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$0.00
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213.
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$0.00
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513.
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$0.00
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214.
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$0.00
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514.
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$0.00
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215.
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$0.00
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515.
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$0.00
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216.
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$0.00
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516.
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$0.00
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217.
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$0.00
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517.
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$0.00
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218.
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$0.00
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518.
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$0.00
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219.
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$0.00
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519.
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$0.00
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220. Total Paid By/For Borrower
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$0.00
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520. Total Reduction Amount Due Seller
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$0.00
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300. Cash At Settlement
Due From/ To Buyer
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600. Cash at Settlement to/ From Seller
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301. Gross Amount due from
borrower (line 120)
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$0.00
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601. Gross amount due to
seller (line 420)
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$0.00
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302. Less amounts paid by/
for borrower (line 220)
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($0.00)
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602. Less reductions in
amt. Due seller (line 520)
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($0.00)
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303. Cash From To Borrower
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$0.00
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603. Cash To From Seller
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$0.00
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Section 5 of the Real Estate Settlement
Procedures Act (RESPA) requires the following: • HUD must develop a Special
Information Booklet to help persons borrowing money to finance the purchase
of residential real estate to better understand the nature and costs of real
estate settlement services; • Each
lender must provide the booklet to all applicants from whom it receives of
for whom it prepares a written application to borrow money to finance the
purchase of residential real estate; •
Lenders must prepare and distribute with the Booklet a Good Faith Estimate of
the settlement costs that the borrower is likely to incur in connection with
the settlement. These disclosures are
mandatory.
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Section 4(a) of RESPA mandates that HUD develop
and prescribe this standard form to be used at the time of loan settlement to
provide full disclosure of all charges imposed upon the borrower and
seller. These are third party
disclosures that are designed to provide the borrower with the pertinent
information during the settlement process in order to be a better shopper.
The Public Reporting Burden for this collection
of information is estimated to average one hour per response, including the
time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection
of information.
This agency may not collect this information, and
you are not required to complete this form, unless it displays a currently
valid OMB control number.
The information requested does not lend itself to
confidentiality.
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L. Settlement Charges
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700. Total Sales / Brokers
Commission based on price $0.00 @ 0.00% = $0.00
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Paid From Borrowers Funds
at Settlement
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Paid From Seller’s
Funds at Settlement
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Division of Commission (line
700) as follows:
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701.
to
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702.
to
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703.
Commission paid to at settlement
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$0.00
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$0.00
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704.
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$0.00
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$0.00
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800. Items Payable in
Connection With Loan
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801.
Loan Origination Fee 0.00%
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$0.00
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802.
Loan Discount 0.00%
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$0.00
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803.
Appraisal Fee to
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$0.00
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$0.00
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804.
Credit Report to
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$0.00
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$0.00
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805.
Lender’s Inspection Fee
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$0.00
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$0.00
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806.
Mortgage Insurance Application Fee to
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$0.00
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$0.00
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807.
Assumption Fee
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$0.00
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$0.00
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808.
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$0.00
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$0.00
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809.
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$0.00
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$0.00
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810.
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$0.00
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$0.00
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811.
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$0.00
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$0.00
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900. Items Required By
Lender To Be Paid In Advance
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901.
Interest from to @ /day ( days)
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$0.00
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$0.00
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902.
Mortgage Insurance Premium for months to
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$0.00
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$0.00
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903.
Hazard Insurance Premium for years to
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$0.00
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$0.00
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904.
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$0.00
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$0.00
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905.
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$0.00
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$0.00
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1000. Reserves Deposited
With Lender
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1001.
Hazard insurance 0 months @ $0.00 per month
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$0.00
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1002.
Mortgage insurance 0 months @ $0.00 per month
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$0.00
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1003. City property taxes 0 months @ $0.00 per month
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$0.00
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1004.
County property taxes 0 months @ $0.00 per month
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$0.00
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1005.
Annual assessments 0 months @ $0.00 per month
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$0.00
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1006.
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$0.00
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$0.00
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1007.
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$0.00
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$0.00
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1008.
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$0.00
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$0.00
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1100. Title Charges
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1101.
Settlement or closing fee
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$0.00
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$0.00
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1102.
Abstract or title search
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$0.00
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$0.00
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1103.
Title examination
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$0.00
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$0.00
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1104.
Title insurance binder
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$0.00
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$0.00
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1105.
Document preparation
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$0.00
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$0.00
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1106.
Notary fees
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$0.00
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$0.00
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1107.
Attorney’s fees
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$0.00
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$0.00
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(includes above item numbers )
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1108.
Title insurance
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$0.00
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$0.00
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(includes above item numbers )
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1109.
Lender’s coverage
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$0.00
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$0.00
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1110.
Owner’s coverage
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$0.00
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$0.00
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1111.
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$0.00
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$0.00
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1112.
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$0.00
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$0.00
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1113.
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$0.00
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$0.00
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1200. Government Recording
and Transfer Charges
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1201.
Recording fees: Deed
$0.00; Mortgage $0.00; Releases $0.00
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$0.00
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1202. City/ County tax/ stamps: Deed $0.00; Mortgage $0.00
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$0.00
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1203.
State tax/stamps: Deed
$0.00; Mortgage $0.00
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$0.00
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1204.
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$0.00
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$0.00
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1205.
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$0.00
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$0.00
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1300. Additional
Settlement Charges
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1301.
Survey
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$0.00
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$0.00
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1302.
Pest Inspection
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$0.00
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$0.00
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1303.
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$0.00
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$0.00
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1304.
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$0.00
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$0.00
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1305.
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$0.00
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$0.00
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1400. Total Settlement
Charges (enter on lines 103, Section J and 502, Section K)
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$0.00
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$0.00
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The Undersigned
Acknowledges Receipt of this Disclosure Statement and Agrees to the
Correctness Thereof.
______________________________________ ______________________________________
______________________________________ ______________________________________
Buyer or Agent Seller or Agent
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Previous
editions are obsolete
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Page 2 of 2
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form HUD-1 (3/86)
ref Handbook 4305.2
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