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NEIGHBORHOOD HOUSING SERVICES INC OMB No. 2502-0265 B Tvee _of Loan 1. - FHA 2. _ FmHA 3, - Conv, Unrns. 6. Rle Number 7. Loan Number 8. Mortgage Insurance Caee No.1II 4. VA 5. Conv, Ins. \ - - 10950303 '-~ 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 information pUrposes and are not Included In the tOtall D. Name and Address of Borrower E. Name and Address of Seller F. Name and Address of Lender CLFJ\mATER NEIGHBORHooo CITY OF CLFJ\mATER, F'IDRIDA HOUSING SERVICES, mCXlRroRATED 608 North Garden Avenue P.O. Box 4748 Clearwater, FL 34615 Clearwater, FL 34618-4748 . G. Property Location H. Settlement Agent , 1872 Spr~ Avenue BANKERs T.1.T ~ Clearwater, FL 34615 Place of Settlement I. Settlement Lot 34, SUNSEr POINI' Date 1525 SO. BELCHER mAD 11/08/95 CLEARwATER. FL. 34624 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 Drlce 12.000.00 401. Contract sales Drlce 12~000.00 102. Personal DrQDertv 402. Personal DrQDertv 103. Settlement charaes to borrower lIine 1400l 90.00 403, 104 404. 105, W. Ered Pettv 291. 92 405. Adlustments for items Daid by seller In advance Adlustments for Items Dald by' seller In adyanee 106, Cltvhown taxes to 406. Cltvhown taxes to 107. County taxes to 407. County taxes to 108. Assessments to 408. Assessments to 109. 409 110. 410, 111. 411. 112. 412. 120 GROSS AMOUNT DUE FROM BORROWER 12 381. 92 420. GROSS AMOUNT DUE TO SELLER 1., nnn.OO 200. Amounts Paid Bv or In Behalf of Borrower 500. Reductions In Amount Due To Seller 201, Decoslt or earnest money 501. Excess DeDoslt (see Instructions) 202, PrlnclDal amount of new loan(s) 502. Settlement charaes to seller nine 1400) 315.00 203. Ex/stlna loan(s) taken sublect to 503, Exlstlna loan(s) taken sublect to 204, 504. Pavoff of first mortaaae loan 205 505. Pavoff of second mortaaae loan 208 506, 207. 507. 208. 508, 209. 509, Adfustments for items unDaid by seller Adiustments for Items unDald by seller 210, Cftvltown taxes to 510, Citvhown taxes to 211. County taxes 01/01 to 11/07 247.95 511, County taxes 01/01 to 11/07 247.95 212, 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 247.95 520, TOTAL REDUCTION AMOUNT DUE SELLER 562.95 300. Cash At SAttlAmAnt From or To Borrower 600 Csulh- At Settlement To or From Seller 301. Gross amount due from borrower (line 120l 12.381.92 601 Gross amount due to seller nine 420\ 1., nnn IVI 302. Less amounts oald bvlfor borrower (line 220\ 247.95 602. Less reduction amount due seller ft/ne 520\ ~Q~ 303. CASH ERCM BORROWER 12.133.97 603. CASH 'IO SELLER ]1 437.05 A. SETTLEMENT STATEMIN,r . u.s. Department of HouLg and Urban Development lINE H VE CAREFUllY REVIEWED THE HUD-1 SElTLEMENT STATEMENT AND TO THE BEST OF MY KNOWlEDGE AND BEUEF IT IS A TRUE AND ACCURATE STATEMENT OF A CEJPTS~N URSEMENT MADE ON MYjOUR ACCOUNT OR BY ME/US IN THIS TRANSACTION. I FURTHER CERTIFY THAT '/WE HAVE RECEIVED A COPY o TH 1 sm STATEM ~~ .. e.. ~op .~~~ ,~w ~.~~JW . C1. lieller tluyer /tlorrower lieller - / 1 . RESPA, HB 4305.2 - REV. HUD-1 (3/86) l7')007-0() -Lj2 '-'I U.S. DEPARTMENT 'F HOUSING AND URBAN DEVELOPMENT SE-rrLEMENT STATEMENT PAGE 2 ~ L SElTLEMENT CHARGES: FILE NO..,: 10950303 PAID FROM PAID FROM 700. TOTAL SALES/BROKER'S COMMISSION based on price $ @ . BORROWER'S SELLER'S Division of commission (line 700) as follows: FUNDS AT FUNDS AT 701. $ to SETTLEMENT SElTLEMEN" 702. $ to 703. Commission paid at Settlement 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee % 802. Loan Discount % 803. AoDralsal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806. Mta. Ins. AoDlicatJon Fee to 807. Assumption Fee to 808. 809. 810. 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from to @$ /dav 902. Mortgage Insurance Premium for to 903. Hazard Insurance Premium for yrs to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER FOR 1001. Hazard Insurance mo,@$ /mo. 1002. Mortaage Insurance mO.@$ /mo. 1003. City Property Taxes mo,@$ /mo. 1004. County Property Taxes mo.@$ /mo. 1005. Annual Assessments mO.@$ /mo. 1006. mO.@$ /mo. 1007. mO.@$ /mo. 1008. mo.@$ /mo. 1100. TITLE CHARGES 1101. Settlement or closing fee to BANKERS TITLE 40.001 1102. Abstract or title search to ram Research 75 00 1103. TItle examination to BANKERS TITLE 25.00 1104. TItle Insurance binder to 1105. Document Preparation to 1106. Notary Fees to 1107. Attorney's fees to (Includes above items No: ) 11 08. TItle Insurance to Old Renublic Title Co. 175.00 (Includes above items No: ) 1109. Lender's coverage $ - 1110. Owner's coverage $ 100.00 - 175.00 1111. 1112. 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording Fees: Deed $ 6 . 00; Mortgaae $ ; Releases $ 6 00 1202. City/county tax/stamps: Deed $ ; Mortgage $ 1203. State Tax/stamps: Deed $ 84.00; Mortgage $ ALl,nn 1204. 1205. 1300. ADDITIONAL SElTLEMENT CHARGES 1301. Survey to 1302. Pest Inspection to 1303. 1304. 1305. 1400. TOTA!-SEI NT CHARGES (enter on lines 103 and 502, SectIons J and K) an nn "2'~ nn ~' ~""ENT WHICH I ItA'" """""" IS A l1ItJE AND ACCIJRAlE A<XXllJNT CIF THIS T1IANSACl1ON. FU~ER CERnFY ~ A' :~ CAUSED V~ DSBURSED;' #"7 ~STAlE.ENT :~ uale ( Settlemeijf ent wAR~ls a crime to knowingly make false state s to the United States on this or any other similar form. PenaJtles upon conlllctlon can Include a tine and Imprtso ent. For details see: Tltle 18 U.S. Code Se on 1001 and Section 1010. / / RESPA, HB 4305.2 - REV. HUe-1 (3/86)