W A LEWIS INC (2) A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT B. TYPE OF LOAN
SETTLEMENT STATEMENT
Somers Title Company 1. [:]FHA 2. [:]FMHA 3. E]CONV.UNINS.
1290 Court Street 4. E]VA 5. DCONY JNS.
Clearwater,Florida 33756
(727)441-1088 fax:(727)449-1359 6.He Number
2109010C
7,Loon Number:
8.Medgage loe.Cue No,
C.NOTE. This farm is furnished to give you a statement of actual settlement costs.Amounts paid to and by the settlement agent are shown.Items marked
(poe)were paid outside the closing. They are shown here for informational purposes and are not included in the totals.
The City of Clearwater,Florida,a Municipal Corporation of the State of Florida
D.Buyer: P.O Box 4748
Clear-water,Florida 33758-3683
W.A.Lewis,Inc.,a Michigan Corporation
E.Seller: 535 Griswold Street Ste 2300
Detroit,Michigan 48226
F.Lender:
Martin Luther King Jr.Ave
G.Property: Clear-water,Pinellas County,Florida 33755
PALM PARK BLK D,LOT 8 LESS E 1OFT FOR R/W,Pinellas County,Florida
H.Settlement Agent: Somers Title Company
Place of Settlement: 1290 Court Street,Clearwater,Florida 33756 Pinellas County
1.Settlement Date: December 15,2021
J. Summary of Buyer's Transaction K. Summary of Seller's Transaction
100.Gross Amount Due From Buye r 400.Gross Amount Due To Seller:
101. Contract Sales Price 35,000.00 401. Contract Sales Price 35,000.00
102. Personal Property 402. Personal Property
103. Settlement Charges to Buyer(line 1400) 909.75 403,
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: 35,909.75 420. Gross Amount 000.00
200. Amounts Paid b or in Behalf ofBuyer.. 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) 245.00
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
Adjustments for Items Unpaid by Seller: Adjustments for Items Unpaid by Seller:
210. City/Town Taxes 510. City/Town Taxes
211. Coun /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: 245.00
300. Cash at Settlement from/to Buyer: 600. Cash at Settlement to/from Seller:
301. Gross Amount due from Buyer(line 120) 35,909.75 601. Gross Amount due to Seller(line 420) 35,000.00
302. Less Amount Paid by/for Buyer(line 220) 0.00 602. Less Reductions Amount due Seller(line 245.00
520)
303. Cash From Buyer: $35,909.75 603. Cash To Seller: $34,755.00
HUD-1 May 2007
Settlement Date:December 15,2021 File Number:2109010C
L. Settlement Charges
700. Total Sales/Broker's Commission: Paid from Paid from
Based on Price $35,000.00 Buyer's Seller's
Division of Commission as follows Funds at Funds at
701. Settlement Settlement
702.
703. Commission Paid at Settlement
800. Items Pa able in Connection with Loan:
801. Loan Ori 'nation 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 Dec 15,2021
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 475.00
1102. Abstract or Title Search to Tony Gatliff 85.00
1103. Title Examination
1104. Title Insurance Binder
1105. Document Creation Fee
1106. Notary Fees
HOT Attorney Fees
includes above item numbers:
1108. Title Insurance to Chicago Title Insurance Company 201.25
(includes above item numbers:
1109. Lender's Covera e 0.00
1110. Owner's Coverage 35,000.00 Risk Rate $201.25
Premium:
1111.
1112. Wire Fee $25.00 per wire to Somers Title 50.00
1113. Document Storage to Closers Choice 28.00
1200. Government Recording and Transfer Char es:
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 245.00 Mortgage 0.40 245.00
1204. Intangible Tax to Clerk of the Circuit Court
1205,
1206. Record Corporate Resolution/Proof of Good Standing and corporate officers to Clerk of the 27.00
Circuit Court
1300. Additional Settlement Charges:
1301. Survey
1302. Pest Inspection
1303. 2021 Real Estate Taxes to Pinellas County Tax Collector oc$489.02 by Seller
1304. Lien Search Fee to City of Clearwater 25.00
1400. Total Settlement Charges(Enter on line 103,Section J and line 502,Section K) $909.75 $245.00
I have carefully reviewed the HLID-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.
The City of Clearwater,Florida,a Municipal Corporation of the
State of Florida W.A.Lewis,Inc.
Buyer: Seller:
Suzanne Kramer,Real Estate Services Coordinator David Baker Lewis,President
The HUD-1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I have caused or will cause the funds to be disbursed in
accordance with the instructions of the parties hereto.
Settlement Agent: Date: December 15,2021
Mikell L.St.Germain
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