Settlement Statement - U.S. Department of Housing and Urban Development
A. Settlement Statement U.S. Department of Housing OMB Approval No. 2502-0265
and Urban Development
B. Type of Loan
1. FHA 2. FmHA 3. Conv. Unins.
4. VA 5. Conv. Ins.
6. File Number:
7. Loan Number:
8. Mortgage Insurance Case Number:
D. Name & Address of Borrower:
(name(s))
(street address)
(street address)
(city, state zip)
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.
G. Property Location:F. Name & Address of
Lender:E. Name & Address of Seller:
(street address)
(street address)
(city, state zip)
(name(s))
(street address)
(street address)
(city, state zip)
(name(s))
(street address)
(street address)
(city, state zip)
H. Settlement Agent:
(name(s))
Place of Settlement:
(name(s))
(street address)
(street address)
(city, state zip)
I. Settlement Date:
K. Summary of Seller’s Transaction
100. Gross Amount Due From Borrower 400. Gross Amount Due to Seller
$0.00402. Personal Property$0.00101. Contract Sales Price $0.00 401. Contract
Sales Price
103. Settlement Charges to Borrower (line 1400)$0.00
102. Personal Property
$0.00 403. $0.00
104. $0.00
404.
$0.00
105. $0.00 405. $0.00
Adjustments for items paid by seller in advance
Adjustments for
items paid by seller
in advance
106. City/ town taxes to
$0.00
107. County taxes to 406. City/ town taxes
to $0.00
$0.00
407. County taxes
to
$0.00
108. Assessments to
$0.00
109. 408. Assessments to $0.00
$0.00
409. $0.00
110. $0.00 410. $0.00
111. $0.00 411. $0.00
112. $0.00 412. $0.00
120. Gross Amount Due From Borrower $0.00 420. Gross Amount Due to Seller $0.00
200. Amounts Paid By Or On Behalf of Borrower 500. Reductions in
Amount Due to
Seller
201. Deposit or earnest money $0.00 501. Excess deposit (see instructions) $0.00
202. Principal amount of new loan(s) $0.00 502. Settlement charges to seller (line 1400)
$0.00
203. Existing loan(s) taken subject to
$0.00
204. 503. Existing loan(s) taken subject to$0.00 $0.00 504. Payoff of first mortgage lien $0.00
205.
$0.00
505. Payoff of
second mortgage lien
$0.00
206. $0.00 506. $0.00
508. $0.00207. $0.00 507. $0.00
209. $0.00
208.
$0.00 509. $0.00
Adjustments for items unpaid by seller
Adjustments for items unpaid by seller
210. City/town taxes to $0.00 510. City/town taxes to $0.00
211. County taxes to $0.00
511. County taxes
to
$0.00
513. $0.00212. Assessments to $0.00 512. Assessments to $0.00
214. $0.00
213.
$0.00
215. 514. $0.00 $0.00 515. $0.00
216. $0.00 516. $0.00
217. $0.00 517. $0.00
218. $0.00 518.
$0.00
219. $0.00 519. $0.00
220. Total Paid By/For Borrower
$0.00
520. Total
Reduction Amount
$0.00
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