HTML Preview Loan Settlement Statement page number 1.
The Public Reporting Burden for this collection ofinformation is estimated at 35 minutes per response for collecting, reviewing,and reporting the data. This agency may not collect this information, and you are
notrequired to complete this form, unless it displays a currently valid OMBcontrol number. No confidentiality is assured;this disclosure is mandatory. This is designed to provide the parties to a RESPA c overed
transaction with information during the settlement process.
HUD-1
Page 1 of 3
(SAMPLE.PDF.PFD/SAMPLE.PDF/3)
OMB Approval No. 2502-0265
A. Settlement Statement (HUD-1)
B. Type of Loan
1. FHA 2. RHS 3.
X
Conv. Unins. 6. File Number: 7. Loan Number:
8. Mortgage Insurance Case Number:
SAMPLE.PDF
4. VA 5. Conv. Ins.
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.
D. Name and Address of Borrower: E. Name and Address of Seller: F. Name and Address of Lender:
John F. Doe and Joe S. Title Bank of Roanoke
Jane E. Doe
G. Property Location: H. Settlement Agent:
I. Settlement Date:
1425 XYZ Lane Covenant Real Estate Services, LLC
Roanoke, VA 24015 1626 Apperson Drive, Ste. C
August 31, 8201
Salem, VA 24153 Ph. (540)404-3213
Place of Settlement:
1626 Apperson Drive, Ste. C
Salem, VA 24153
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 price 150,000.00 401. Contract sales price 150,000.00
102. Personal property 402. Personal property
103. Settlement Charges to Borrower (Line 1400) 7,427.47 403.
104. 404.
105. 405.
Adjustments for items paid by Seller in advance Adjustments for items paid by Seller in advance
106. City/Town Taxes to 406. City/Town 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
157,427.47
420. Gross Amount Due to Seller
150,000.00
200. Amounts Paid by or in Behalf of Borrower 500. Reductions in Amount Due Seller:
201. Deposit or earnest money 1,000.00 501. Excess deposit (see instructions)
202. Principal amount of new loan(s) 100,000.00 502. Settlement charges to Seller (Line 1400) 9,325.00
203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
204. 504. Payoff First Mortgage to ABC Bank 89,500.22
205. 505. Payoff Second Mortgage
206. 506.
207. 507. (Deposit disb. as proceeds)
208. 508.
209. 509.
Adjustments for items unpaid by Seller Adjustments for items unpaid by Seller
210. City/Town Taxes 07/01/01 to 09/01/01 235.87 510. City/Town Taxes 07/01/01 to 09/01/01 235.87
211. County Taxes to 511. County Taxes to
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
101,235.87
520. Total Reduction Amount Due Seller
99,061.09
300. Cash at Settlement from/to Borrower 600. Cash at settlement to/from Seller
301. Gross amount due from Borrower (line 120) 157,427.47 601. Gross amount due to Seller (line 420) 150,000.00
( ) ( )
302. Less amount paid by/for Borrower (line 220) 101,235.87 602. Less reductions due Seller (line 520) 99,061.09
X
303. Cash From To Borrower
56,191.60
603. Cash
X
To From Seller
50,938.91
* Paid outside ofclosing by borrower(B), seller(S), lender(L),or third-party(T)
The undersigned hereby acknowledge receipt of a completed copy of this statement & any attachments referred to herein
Borrower Seller
_________________________________
John F. Doe
_________________________________
Jane E. Doe
_________________________________
Joe S. Title
TO THE BEST OF MY KNOWLEDGE, THE HUD-1 SETTLEMENT STA TEMENT WHICH I HAVE PREPARED IS A TRUE AND ACCURATE ACCOUNT OF THE FUNDS
WHICH WERE RECEIVED AND HAVE BEEN OR WILLBE DISBURSED BY THE UNDERSIGNED AS PART OF THE SETTLEMENT OF THIS TRANSACTION.
Covenant Real Estate Services, LLC, Settlement Agent
WARNING: IT IS A CRIME TO KNOWINGLY MAKE FALSE STATEMENTS TO THE UNITED STA TES ON THIS OR ANY SIMILAR FORM. PENALTIES UPON
CONVICTION CAN INCLUDE A FINE AND IMP RISONMENT. FOR DETAILS SEE: TITLE 18 U.S. CODE SECTION 1001 & SECTION 1010.