CLARK HUBBARDPrivacy Statement
Privacy Statement
SOMERS
TITLE
COMPANY
At Somers Title Company, we recognize and respect the privacy expectations of today's consumers, and meet all applicable
industry standards as well as all Federal and State laws regarding the protection of our client's Non - Public Information (NPI).
This Privacy Statement is intended to make our clients aware of how we gather, use, communicate and disclose your Non - Public
Information. The following outlines our Privacy Policy:
Information Collected
In the normal course of our business, and to provide the necessary services to our customers, we may obtain NPI directly from
our clients or through other fair and lawful means. Our client's NPI is only collected when appropriate and necessary to fulfill
our duties as your title company.
Information Retention
We will only retain our client's NPI as long as necessary for the fulfillment of our services. Once complete, all hard copies
containing NPI are either returned to our clients or shredded. State law requires that we maintain digital copies of our files for
seven years.
Information Protection
Our client's NPI is limited to authorized personnel only who need access to perform their job requirements. All hard copy
information retained on active files is secured in locked filing cabinets, in locked offices, secured by alarm systems. All digital
information is protected through encryption and secured cloud storage. Any electronic communication of our client's NPI is sent
via secured TLS encryption technology to ensure a safe and direct transmission.
Information Shared
Somers Title Company will only disclose client's NPI when given direct permission, when required by law, when necessary to
comply with Federal or State requirements, or when suspicious of fraudulent or criminal activities. One important responsibility
of our company is to record documents in the public domain. Such documents may contain client's NPI. Somers Title Company
will disclose these documents to our clients prior to recording.
Our client's Non - Public Private Information, will not be sold, exchanged, transferred, or given to any other company for any
reason other than for the express purposes stated for our services. All of our safeguards are compliant with, or exceed industry
standards and laws, as our client's trust and privacy is of the utmost importance to us.
I, Charles H. Lane, Jr., Real Estate Services Coordinator for Community Redevelopment Agency of the City of Clearwater,
Florida, hereby acknowledge receipt and understanding of the Privacy Statement and the Information and Data Privacy Policy of
Somers Title Company,
Signature Date
August 2014
Privacy Statement
Privacy Statement
SOMERS
TITLE
COMPANY
At Somers Title Company, we recognize and respect the privacy expectations of today's consumers, and meet all applicable
industry standards as well as all Federal and State laws regarding the protection of our client's Non - Public Information (NPI).
This Privacy Statement is intended to make our clients aware of how we gather, use, communicate and disclose your Non - Public
Information. The following outlines our Privacy Policy:
Information Collected
In the normal course of our business, and to provide the necessary services to our customers, we may obtain NPI directly from
our clients or through other fair and lawful means. Our client's NPI is only collected when appropriate and necessary to fulfill
our duties as your title company.
Information Retention
We will only retain our client's NPI as long as necessary for the fulfillment of our services. Once complete, all hard copies
containing NPI are either returned to our clients or shredded. State law requires that we maintain digital copies of our files for
seven years.
Information Protection
Our client's NPI is limited to authorized personnel only who need access to perform their job requirements. All hard copy
information retained on active files is secured in locked filing cabinets, in locked offices, secured by alarm systems. All digital
information is protected through encryption and secured cloud storage. Any electronic communication of our client's NPI is sent
via secured TLS encryption technology to ensure a safe and direct transmission.
Information Shared
Somers Title Company will only disclose client's NPI when given direct permission, when required by law, when necessary to
comply with Federal or State requirements, or when suspicious of fraudulent or criminal activities. One important responsibility
of our company is to record documents in the public domain. Such documents may contain client's NPI. Somers Title Company
will disclose these documents to our clients prior to recording.
Our client's Non - Public Private Information, will not be sold, exchanged, transferred, or given to any other company for any
reason other than for the express purposes stated for our services. All of our safeguards are compliant with, or exceed industry
standards and laws, as our client's trust and privacy is of the utmost importance to us.
I, Clark Hubbard, hereby acknowledge receipt and understanding of the Privacy Statement and the Information and Data Privacy
Policy of Somers Title Company,
Signature Date
August 2014
Acknowledgement as to Electronic Records
Somers Title Company strives to maintain the confidentiality and integrity of the personal
information in our possession and has instituted measures to guard against its unauthorized
access. We maintain physical, electronic and procedural safeguards in compliance with federal
standards to protect that information.
We store closing documents electronically on a remote cloud database.
Community Redevelopment Agency of the
City o Clearwater
Date
Charles H. Lane, Jr., Real Estate Services Coordinator
;(j--;
Clark Hubbard
(0 -1T15'
Date
Date
COMPLIANCE AND TAX PRORATION AGREEMENT
DATE: 10/07/2015
BUYER/BORROWER: Community Redevelopment Agency of the City of Clearwater, Florida
SELLER: Clark Hubbard
PROPERTY: Park Street, Clearwater, Florida 33755 Parcel Number 15/29/15/64890/003 /0170
We the undersigned Seller and /or Buyer/Borrowers herein acknowledge the following as conditions of the above
referenced transaction:
1. All contingencies set forth in the Contract for Sale have been complied with in full.
2. All utility bills, including but not limited to water, sewer, gas, garbage and electric are the responsibility of the
undersigned parties,pqt the closing agents. All m. ' . s regarding utilitity bills will be handled outside of closing.
f4 . L. (initial) (initial)
* * *If this transaction is a short sale, all parties understand that the third party lender(s) will NOT pay for any utilities, nor
will they allow them to be paid from the proceeds of the sale. Any utility bills, whether the final bill or delinquent bill is
the responsibility of the buyer or the seller. * ** (initial) (initial)
3. The undersigned parties will fully cooperate if adjustment for clerical errors on any or all closing documents is
necessary and will sign such additional documents as are necessary to correct such errors.
4. Calculations of payoff figures, or principal balance and escrow account balances and/or prorations, were based on
information, either obtained orally or in writing from, lender. The closing agent will not be held liable for
miscalculations as a result of errors made by the lender. If there is /are discrepancies between the figures used in
preparing the closing statements and future information provided by the lender, resulting in a demand by the lender for
additional funds, owner /seller will upon request forward said funds forthwith.
5. Consent is hereby given, pursuant to Rule 40186.008(3) to the Florida Administrative Code, to the placement of the
settlement funds for the transaction into an interest bearing account in the name of Somers Title Company. The parties
understand the interest earned or other benefits earned, if any, on such account will be the property of Somers Title
Company.
6. The proration of taxes reflected on the closing statement has been made on the basis of:
( ) Gross Tax figure for the year , in the amount of $
(X) tax figure for 2015, the year in the amount $591.52, based on information supplied to Somers Title Company by the
Pinellas County Property Assessor's office. Provided by Pinellas County Tax Collector's Office for 279 days of private
ownership. Hereafter property will be exempt.
The undersigned Owner(s) of the above referenced property herein acknowledge they ( ) have (_x ) have not, filed
for and received, homestead exemption in the amount of $25,000.00 for the current year.
We understand that Somers Title Company is relying on the statements contained herein to compute the applicable tax
proration amounts between Seller and Buyers and/or the appropriate tax amount for the lender's escrow account.
We understand that taxes for current year may increase if the property was assessed under the Save -Our Homes Cap.
The closing agent will not be liable for any discrepancies that may arise in these proration figures when the actual tax
bills for the year of closing are available, or any shortages in escrow accounts. Upon receipt of the current tax statement,
the undersigned parties will make proration adjustments between themselves outside of the closing if the total proration
difference exceeds $10.00.
Buyer(s) Seller(s)
Community Redevelopment Agency of the City of
Cl fvvat r, Florid
Charles H. Lane, Jr., Real Estate Services Coordinator
ark Hubbard
DISCLOSURE
We, the Owners/ Purchasers of that certain real property located at: Park Street, Clearwater, Florida
33755, Parcel Number 15/29/15/64890/003 /0170
Pinellas County, Florida, do hereby disclose the following facts or defects in said property.
I HEREBY CERTIFY that I have no knowledge of any facts or defects in said property which may
materially affect the value or desirability of said property, except as set forth above. I acknowledge that this
disclosure will be given to the listing broker, the selling broker, and any prospective buyer.
I HEREBY CERTIFY that as the buyer(s) I have inspected the above property and accept the same.
WITNES4
ESS
State of Florida
County of Pinellas
Community Redevelopment }icy of the City of Clearwater, Florida
1 — ]L—
Charles H. Lane, Jr. Real Estate Services Coordinator
Clark Hubbard
The foregoing instrument was acknowledged before me this 10/07/2015, by Charles H. Lane, Jr. Real Estate
Services Coordinator for Community Redevelopment Agency of the City of Clearwater, Florida, who has
produced a drivers license as identification and who did take an oath.
Seal / Expiration Date
State of Florida
County of Pinellas
Signatur
RONALD E SOMERS
NOTARY PUBLIC - STATE OF FLORIDA
COMMISSION # FF 152120
My Commission Expires November 07, 2018 I
The foregoing instrument was acknowledged before me this 10/07/2015 , by Clark Hubbard o has produced
a drivers license as identification and who did take an oath.
Seal / Expiration Date
Nitary Signat
RONALD E. SOMERS
NOTARY PUBLIC - STATE OF FLORIDA
COMMISSION # FF 152120
My Commission Expires November 07, 2018
Prepared By: Megan Bellerose
Somers Title Company
1290 Court Street
Clearwater, FL 33756
incidental to the issuance of a title insurance policy.
File Number: 1507026C
OWNER'S AFFIDAVIT
(INDIVIDUAL)
THIS IS AN AFFIDAVIT MADE UNDER OATH. THE MAKING OF A FALSE STATEMENT WILL SUBJECT THE
AFFIANT TO SEVERE CRIMINAL PENALTIES.
BEFORE ME, the undersigned authority, personally appeared Affiant,
Clark Hubbard who being by me first duly sworn on oath, disposes and says:
1. Affiant is the owner of the following described property:
Parcel Id No. 15/29/15/64890/003 /0170
Lot 17 & 18, Block 3, OVERBROOK SUBDIVISION, according to the plat thereof, as recorded in Plat Book 8, Page 23, of the
Public Records of Pinellas County, Florida.
2. Affiant is in exclusive, full, complete and undisputed possession of the above described property and any personal property
included therewith; there are no leases, options, claims, unpaid taxes, assessments or interests of any kind held thereon; title has not
been transferred; and said property is free and clear of all liens, taxes, encumbrances and claims of every kind, nature and description,
except for real property taxes for the current year, and except as shown in Title Commitment Number 1508026C.
3. There have been no improvements, alterations or repairs to the above described property for which costs thereof remain unpaid.
There are no claims for labor, material or services furnished or performed for repairing or improving the same which remain unpaid;
there are no mechanics', material men's or laborers' liens against the above described property; and no labor has been performed within
the last 90 days which has not been paid in full in regards to said premises or personal property.
4. The personal property, if any, on said property or contained in the buildings thereon, which is to be sold with the property or
premises, is free and clear of all liens, encumbrances, claims or demands whatsoever.
5. No judgments or decrees have been entered in any Court of this State or of the United States of America against Affiant which
remain unsatisfied or unpaid; there exist no funds due to the Internal Revenue Service which remain unpaid which may result in a lien
against the above described real property; and Affiant is not a nonresident alien for United States Income Tax purposes and Affiant's
Federal Income Tax Payer I.D. number (SS #) is as shown below.
6. This Affidavit is made for the purpose of inducing Community Redevelopment Agency of the City of Clearwater, Florida to
purchase the above described property, inducing to accept the mortgage loan being given to purchase the above described property
and inducing Chicago Title Insurance Company of Florida to authorize Somers Title Company hereinafter "Policy Issuing Agent ", to
issue Policies of Title Insurance insuring either the conveyance to the purchaser or the Lien of the mortgage or both.
7. Affiant agrees to indemnify and hold Policy Issuing Agent, SOMERS TITLE COMPANY and ChicagoTITLE INSURANCE
OF FLORIDA harmless of and from all loss, cost, damage and expense of every kind, including attorneys' fees, which Policy Issuing
Agent and Chicago TITLE INSURANCE OF FLORIDA shall sustain or become liable for under its policies of title insurance now to
be issued on account of or in reliance upon any statements made herein, including but not limited to, any matters that may be recorded
between the effective date of the Commitment referenced above and the time of the recording of the instruments described in said
Commitment.
8. Affiant is familiar with the nature of an oath and with the penalties as provided by the laws of the State of Florida for falsely
swearing to statements in an instrument of this nature. Affiant affirms he has read the foregoing affidavit and fully understands the
facts contained herein. For the purposes of this affidavit, the use of the word "he" is intended and understood to mean all persons
executing this affidavit be it "he ", "she" or "they ", and singular shall include plural, when indicated.
Further, Affiants sayeth naught.
State of Florida
County of Pinellas
THE FOREGOING INSTRUMENT was sworn and acknowledged before me on 10/07/2015 by:
Clark Hubbard who has produced a drivers license as identification and who did takes,: oath.
Seal / Expiration Date
Signatur
RONALD E. SOMERS
NOTARY PUBLIC - STATE OF FLORIDA
COMMISSION # FF 152120
My- Commission Expires November 07, 2018
GAP AFFIDAVIT
State of Florida
County of Pinellas
Before me, the undersigned authority, this 10/07/2015, personally appeared Clark Hubbard, who after being
duly sworn by me under oath depose(s) and say(s) of their own personal knowledge:
1. They are of legal age and have never been known by any other names, except: (If none, state
"NONE ", if yes, give names and dates known as same)
2. They are the owner(s) of the following property described property described to -wit:
Parcel Id No. 15/29/15/64890/003 /0170
Lot 17 & 18, Block 3, OVERBROOK SUBDIVISION, according to the plat thereof, as recorded in Plat Book 8,
Page 23, of the Public Records of Pinellas County, Florida.
and my /our enjoyment thereof has been peaceable and undisturbed, and my /our title to said property has never
been disputed or questioned to my /our knowledge, nor do Uwe know of any facts by reason of which the title to,
or possession of said property might be disputed or questioned, or by reason of which any claim to said property
might be asserted adversely to me /us.
3. UWe represent and warrant that I /we have examined the document(s) attached hereto as Exhibit "A ",
including, but not necessarily limited to, judgements, decrees, bankruptcies, incompetency proceedings,
divorces, change of name proceedings, Federal Tax Liens, State Tax Liens and Statements of Claim against
persons whose names arethe same as or similar to mine /ours and I am/we are not the person(s) described in such
document(s) except: (If none state "NONE ").
4. UWe represent and warrant that there are no unsatisfied or unreleased judgements, decrees, Federal or
State Tax Liens or Statements of Claim of record in the State of Florida, against me /us, except: (If none, state
"NONE ").
5. UWe represent and warrant that no proceedings in bankruptcy have ever been instituted by, or against,
me /us, and Uwe have never made an assignment for the benefit of creditors.
6. UWe represent and warrant that Uwe know of no action or proceeding relating to said property which is
now pending in any State or Federal Court in the United States nor do Uwe know of any State or Federal
Judgement or any State or Federal Lien of any kind or nature whatsoever which now constitutes a lien or charge
upon the property.
7. We were married to each other on the date indicated hereinafter and we have been continuously married
to each other, without interruption from that date to the date hereof, or if no date of marriage is filled in, that I
was at the time I became the fee simple owner of said property and have continued from that date to the date
hereof be and still am, a single person.
DATE OF MARRIAGE:
8. I/We represent and warrant that I /we have never been adjudged incompetent.
9. UWe represent and warrant that there are no other person(s), other than the undersigned, now in
possession or claiming possession of the property, except: (If none, state "NONE ").
10. I /We represent and warrant that there are no tenancies, leases or other occupancies oral or written,
affecting the property, except: (If none, state "NONE ").
11. UWe represent and warrant that there have been no notices of intentions to claim a lien, Notices to
Owner, or other cautionary notices of any kind filed or served on the undersigned regarding labor or services
performed or material furnished to the property in accordance with the Mechanic's Lien Law of the State of
Florida, except: (If none, state "NONE ").
12. I/We represent and warrant that there are no unpaid bills or claims for labor or services performed or
materials furnished or delivered during the last ninety (90) days for alterations, repair work or new construction
on the Property, except: (If none, state "NONE ").
13. I/We represent and warrant that I/we have not conveyed, transferred or encumbered the property between
and the date hereof to any persons, firm or corporation except: (if none, state "NONE ").
14. I/We represent and warrant that the property is free and clear of all liens, taxes, encumbrances and
claims of every kind, nature and description whatsoever, including, but not necessarily limited to, mortgage
liens, mechanic's, materialman's, laborers or other statutory liens, judgement liens, writs of attachment and
Federal or State income tax or intangible property tax liens, except for the mortgage lien described in Paragraph
13 above, if any, and except for real estate and personal property taxes for the year
15. This affidavit is being made for the purpose of inducing none to make a mortgage loan on the property in
the amount of $n/a and to induce SOMERS TITLE COMPANY , as Title Agent for Chicago TITLE
INSURANCE OF FLORIDA to issue a Mortgage Title Insurance Policy on the property without the possibility
of (1) unfiled mechanic's liens and materialman's liens appearing; (2) unfiled leases appearing; and (3) persons,
other than the undersigned being in or claiming possession of the property, and with the knowledge that the said
Mortgagee, Title Agent and Title Company will rely upon the statements and representations herein made in
paying out the proceeds of such first/second mortgage loan at the closing thereof and/or issuing a Mortgagee
Title Insurance Policy.
rk Hubbard
State of Florida
County of Pinellas
The foregoing instrument was sworn and acknowledged before me this 10/07/2015, by:
Clark Hubbard who has produced a drivers license as identification and who did take an oath.
Notary Seal / Expiration date
RONALD E. SOMERS
NOTARY PUBLIC • STATE OF FLORIDA
COMMISSION # FF 152120
My Commission Expires November 07, 2018
Prepared By: Megan Bellerose
RECORD & RETURN TO:
SOMERS TITLE COMPANY
1290 Court Street
Clearwater, FL 33756
(727) 441 -1088 phone
incidental to the issuance of a title insurance policy.
File Number: 1507026C
Parcel ID #: 15- 29 -15- 64890 - 003 -0170
WARRANTY DEED
(INDIVIDUAL)
This WARRANTY DEED, dated 10/07/2015 by
Clark Hubbard a /k/a Clark D. Hubbard, an unmarried man
whose post office address is:
hereinafter called the GRANTOR, to
Community Redevelopment Agency of the City of Clearwater, Florida
whose post office address is:
P.O. Box 4748, Clearwater, Fl 33758 -4748
hereinafter called the GRANTEE:
(Wherever used herein the terms "Grantor" and "Grantee" include all parties to this instrument and the heirs,
legal representatives and assigns of individuals, and the successors and assigns of corporations.)
WITNESSETH: That the GRANTOR, for and in consideration of the sum of $10.00 and other valuable
considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases,
conveys and confirms unto the GRANTEE, all that certain land situate in Pinellas County, Florida, viz:
Parcel Id No. 15/29/15/64890/003 /0170
Lot 17 & 18, Block 3, OVERBROOK SUBDIVISION, according to the plat thereof, as recorded in Plat
Book 8, Page 23, of the Public Records of Pinellas County, Florida.
SUBJECT TO covenants, conditions, restrictions, reservations, limitations, easements and agreements of record,
if any; taxes and assessments for the year 2016 and subsequent years; and to all applicable zoning ordinances
and/or restrictions and prohibitions imposed by governmental authorities, if any.
TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise
appertaining.
TO HAVE AND TO HOLD, the same in fee simple forever.
AND THE GRANTOR hereby covenants with said GRANTEE that except as above noted, the GRANTOR is
lawfully seized of said land in fee simple; that the GRANTOR has good right and lawful authority to sell and
convey said land; that the GRANTOR hereby fully warrants the title to said land and will defend the same
against the lawful claims of all persons whomsoever.
IN WITNESS WHEREOF, GRANTOR has signed and sealed these presents the date set forth above.
SIGNED IN THE PRESENCE OF THE FOLLOWING WITNESSES:
Witness Sign:
Print Name:
LC,Car-e.
Witness Sign: ,�sy
Print Name: 0,t/ /9- r
State of Florida
County of Pinellas
ark Hubbard
/0_.ta 204D
a /k/a Clark D. Hubbard
THE FOREGOING INSTRUMENT was sworn and acknowledged before me on 10/07/2015 by:
Clark Hubbard a /k/a Clark D. Hubbard who has produced a drivers license as identification.
Notary Seal /Expiration Date N
ry Signature
RONALD E. SOMERS
NOTARY PUBLIC - STATE OF FLORIDA
COMMISSION # FF 152120
My Commission Expires November 07, 2018
Pinellas County Property Appraisers's Tax Form
Parcel ID:
GRANTOR:
GRANTEE:
CONTACT:
Take:
Tax computation based on closing date of:
Taxable value of the property taken:
Special Non -Ad Valorem Assessment (if any):
Total Taxes: 773.85
Days in The Year (365/366): 365
Days In Private: 279
Prorated Taxes: 591.52
Please Send Escrow Check To:
AGENT:
Telephone #
PINELLAS COUNTY TAX COLLECTOR'S OFFICE
ATTN: DAWN SCHMERER
PO BOX 4006
SEMINOLE, FL 33775 -4006
A.
U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
SETTLEMENT STATEMENT
Somers Title Company
1290 Court Street
Clearwater, Florida 33756
(727) 441 -1088 fax: (727)449 -1359
B. TYPE OF LOAN
1. I I FHA 2. I I FMHA 3.
4.
II
VA 5.
CONV. INS.
II
CONV. UNINS.
6. File Number.
1507026C
7. Loan Number.
8. Mortgage Ins. Case No.:
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.
Community Redevelopment Agency of the City of Clearwater, Florida
D. Buyer: 112 S. Osceola Ave.
Clearwater, Florida 33756
Clark Hubbard
E. Seller: 2685 Cypress Bend Dr.
Clearwater, Florida 33761
F. Lender:
G. Property:
H. Settlement Agent:
Place of Settlement:
I. Settlement Date:
Park Street
Clearwater, Pinellas County, Florida 33755
Lot 17 & 18, Block 3, OVERBROOK SUBDIVISION, Plat Book 8, Page 23, Pinellas County, Florida
Somers Title Company
1290 Court Street, Clearwater, Florida 33756 Pinellas County
October 7, 2015
J.
Summary of Buyer's Transaction
K. Summary of Seller's Transaction
100. Gross Amount Due From Buyer:
400. Gross Amount Due To Seller:
101. Contract Sales Price
51,300.00
401. Contract Sales Price 51,300.00
102.
Personal Property
402. Personal Property
103.
Settlement Charges to Buyer (line 1400)
213.50
403.
Adjustments for Items Paid by Seller in Advance:
Adjustments for Items Paid by Seller in Advance:
106. City / Town Taxes
406. City / Town Taxes
107.
County / Parish Taxes
407. County / Parish Taxes
108.
Assessments
408. Assessments
120.
Gross Amount Due from Buyer:
51,513.50
420. Gross Amount Due to Seller: 51,300.00
200. Amounts Paid by or in Behalf of Buyer:
500. Reductions in Amount Due to Seller:
201. Deposit / Earnest Money
501. Excess Deposit (see instructions)
202.
Principal Amount of New Loan
502. Settlement Charges to Seller (Line 1400) 1,147.36
203.
Existing Loan(s)
503. Existing Loan(s)
204.
504. Payoff of First Mortgage
205.
505. Payoff of Second Mortgage
206.
506. Purchase Money Mortgage
207.
507. 2015 Real Estate Taxes to 10/7/2015 to 591.52
Pinellas County Tax Collector
Adjustments for Items Unpaid by Seller:
Adjustments for Items Unpaid by Seller:
210. City / Town Taxes
510. City / Town Taxes
211.
County / Parish Taxes
511. County / Parish Taxes
212.
Assessments
512. Assessments
220.
Total Paid by / for Buyer:
0.00
520. Total Reductions in Amount Due Seller: 1,738.88
300. Cash at Settlement from / to Buyer:
600. Cash at Settlement to / from Seller:
301. Gross Amount due from Buyer (line 120)
51,513.50
601. Gross Amount due to Seller (line 420) 51,300.00
302.
Less Amount Paid by /for Buyer (line 220)
0.00
Less Reductions Amount due Seller (line 1,738.88
602.
303.
Cash From Buyer: $51,513.50
603. Cash To Seller: $49,561.12
HUD -1 May 2007
Settlement Date:October 7, 2015
File Number:150702SC
1,. Settlement Charges
700. Total Sales / Broker's Commission:
Based on Price $51,300.00
Division of Commission as follows
Paid from
Buyer's
Funds at
Settlement
Paid from
Seller's
Funds at
Settlement
701.
702.
703. Commission Paid at Settlement
800. Items Payable in Connection with Loan:
801. Loan Origination Fee
802. Loan Discount
803. Appraisal Fee
804. Credit Report
805. Lender's Inspection Fee
806. Mortgage Insurance Application Fee
807. Assumption Fee
900. Items Required by Lender to be Paid in Advance:
901. Daily interest charge from Oct 7, 2015
902. Mortgage Insurance Premium
903. Hazard Insurance Premium
904. Flood Insurance Premium
1000. Reserves Deposited with Lender:
1001. Hazard Insurance
1002. Mortgage Insurance
1003. City Property Taxes
1004. County Property Taxes
1005. Annual Assessments
1100. Title Charges:
1101. Settlement or Closing Fee to Somers Title Company
195.00
395.00
1102. Abstract or Title Search to Tony Gatliff
85.00
1103. Title Examination
1104. Title Insurance Binder
1105. Document Creation Fee
1106. Notary Fees
1107. Attorney Fees
(includes above item numbers:
1108. Title Insurance to Chicago Title Insurance Company
(includes above item numbers:
294.98
1109. Lender's 0.00
Coverage
1110. Owner's 51,300.00 Risk Rate Premium: $294.98
Coverage
1200. Government Recording and Transfer Charges:
1201. Recording Fees: Deed 18.50 Mortgage 0.00 Releases 0.00
18.50
1202. City/County Tax/Stamps: Deed 0.00 Mortgage 0.00
1203. State Tax/Stamps: Deed 359.10 Mortgage 0.00
359.10
1204. Intangible Tax to Clerk of the Circuit Court
1205.
1300. Additional Settlement Charges:
1301. Survey
1302. Pest Inspection
1303. Lien Search to City of Clearwater
10.00
1304. Government Surcharge to Chicago Title Company
3.28
1400. Total Settlement Charges (Enter on line 103, Section J and line 502, Section K)
$213.50
$1,147.36
I have carefully reviewed the HUD -1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate statement of all receipts and
disbursements made on my account or by me in this transaction. I further certify that I have received a copy of HUD -1 Settlement Statement.
Borrower:
Communijj3Redevelopment Agcy of the City of Clearwater,
Flori
Charles H. Lane, Jr., Real Estate Services Coordinator
Seller:
The HUD -1 Settlement Statement which I have prepar >]true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in
accordance with this stateln
Settlement Agent:
1.41ll
Mikell L. St. Germain
Date: October 7, 2015
WARNING: It is a crime to knowingly make false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and
imprisonment. For details see Title 18 U.S. Code Section 1001 and Section 1010.
HUD -1 May 2007