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.
Page 2 of 3 HUD-1
(SAMPLE.PDF.PFD/SAMPLE.PDF/3)
L. Settlement Charges
700. Total Real Estate Broker Fees
$ 9,000.00
Paid From Paid From
Division of commission (line 700) as follows:
Borrower's Seller's
to
Funds at Funds at
701. $ 9,000.00 ReMax
Settlement Settlement
702. $ to
703. Commission paid at settlement 9,000.00
704.
800. Items Payable in Connection with Loan
801. Our origination charge $ 1,000.00 (from GFE #1)
802. Your credit or charge (points) for the specific interest rate chosen $ (from GFE #2)
803. Your adjusted origination charges (from GFE #A) 1,000.00
804. Appraisal fee to Appraisers United (from GFE #3) 400.00
805.805. Credit Report to Credit Solutions (from GFE #3) 45.00
806. Tax service to (from GFE #3)
807. Flood certification to (from GFE #3)
808. (from GFE #3)
809. (from GFE #3)
810. (from GFE #3)
811. (from GFE #3)
900. Items Required by Lender to Be Paid in Advance
901. Daily interest charges from 08/31/15 to 09/01/15 0 @ $/day (from GFE #10)
902. Mortgage insurance premium for months to (from GFE #3)
903. Homeowner's insurance for 1.0 years to Elephant Insurance (from GFE #11) 1,750.00
904. (from GFE #11)
905. (from GFE #11)
1000. Reserves Deposited with Lender
1001. Initial deposit for your escrow account (from GFE #9) 1,322.14
1002. Homeowner's insurance 3.000 months @ $ 145.83 per month 437.49$
month
1003. Mortgage insurance months @ $ per $
1004. Property taxes $
1005. Property Taxes 5.000 months @ $ 176.93 per month 884.65$
1006. months @ $ per month $
1007. months @ $ per month $
1008. $
1009. Aggregate Adjustment $
1100. Title Charges
1101. Title services and lender's title insurance (from GFE #4) 893.00
1102. Settlement or closing fee $
1103. Owner's title insurance to Fidelity National Title Insurance Company (from GFE #5) 585.00
1104. Lender's title insurance to Fidelity National Title Insurance Company 208.00$
1105. Lender's title policy limit $ 100,000.00
1106. Owner's title policy limit $ 150,000.00
Agent's portion of the total title insurance premium
1107. to Covenant Real Estate Services, LLC 594.75$
1108.
Underwriter's portion of the total title insurance premium
to Fidelity National Title Insurance Company 198.25$
1109. Deed Preparation to Sam Jones Esq $ 100.00
1110. $
1111. $
1112. $
1113. $
1200. Government Recording and Transfer Charges
1201. Government recording charges to Clerk of the Circuit Court (from GFE #7) 99.00
1202. Deed $ 43.00 Mortgage $ 56.00 Releases $ Other $
1203. Transfer taxes to Clerk of the Circuit Court (from GFE #8) 833.33
1204. City/County tax/stamps Grantee Tax 125.00$ Grantee Tax 83.33$
1205. State tax/stamps Grantee Tax 375.00$ Grantee Tax 250.00$
1206. Grantor Deed Recording Tax to Clerk of the Circuit Court 150.00
1207.
1300. Additional Settlement Charges
1301. Required services that you can shop for (from GFE #6) 500.00
1302. Survey to Top Surveyors 500.00$
1303. Pest Inspection to Pest Control Inc $ 75.00
1304. $
1305. $
1400. Total Settlement Charges (enter on lines 103, Section J and 502, Section K)
7,427.47 9,325.00
* Paid outside ofclosing by borrower(B), seller(S), lender(L),or third-party(T)
By signing page 1 ofthis statement, the signatoriesacknowledge receipt of a completed copy ofpage 2 &3 ofthis three page statement.
Covenant Real Estate Services, LLC, Settlement Agent
Certified to be a true copy.
Page 3 of 3 HUD-1
Comparison of Good Faith Estimate (GFE) and HUD-1 Charges Good Faith Estimate HUD-1
Charges That Cannot Increase HUD-1 Line Number
Our origination charge # 801 1,000.00 1,000.00
Your adjusted origination charges # 803 1,000.00 1,000.00
Transfer taxes #1203 833.33 833.33
Charges That in Total Cannot Increase More than 10% Good Faith Estimate HUD-1
Government recording charges #1201 99.00 99.00
Appraisal fee # 804 350.00 400.00
Credit report # 805 55.00 45.00
Title services and lender's title insurance #1101 785.00 893.00
Owner's title insurance to Fidelity National Title Insurance Company
#1103 600.00 585.00
Total
1,889.00 2,022.00
Increase between GFE and HUD-1 Charges $ 133.00 or 7.04%
Charges That Can Change Good Faith Estimate HUD-1
Initial deposit for your escrow account #1001 1,322.14 1,322.14
Homeowner's insurance # 903 1,750.00 1,750.00
Survey #1302 550.00 500.00
Loan Terms
Yo ur initial loan amount is
$ 100,000.00
Yo ur loan term is
30.00 years
Yo ur initial interest rate is
4.5000 %
Yo ur initial monthly amount owed for principal, interest and
any mortgage insurance is
$ 506.69 includes
Principal
X
Interest
X
Mortgage Insurance
Can your interest rate rise?
X No Yes, it can rise to a maximum of _________%. The first
change will be on ________ and can change again every ___ months after
________. Every change date, your interest rate can increase or decrease
by _________%. Over the life of the loan, your interest rate is guaranteed
to never be lower than _________% or higher than _________%.
Even if you make payments on time, can your loan balance rise?
X No Yes, it can rise to a maximum of $_________.
Even if you make payments on time, can your monthly
amount owed for principal, interest, and mortgage insurance rise?
X No Yes, the first increase can be on ________ and the monthly
amount owed can rise to $_________.
The maximum it can ever rise to is $_________.
Does your loan have a prepayment penalty?
Yes, your maximum prepayment penalty is $_________.
X No
Does your loan have a balloon payment?
Yes, you have a balloon payment of $_________
X No
due in ___ years on ________.
Total monthly amount owed including escrow account payments
You do not have a monthly escrow payment for items, such as property
taxes and homeowner's insurance. You must pay these items directly
yourself.
X You have an additional monthly escrow payment of $322.76 that results
in a total initial monthly amount owed of $829.45. This includes
principal, interest, any mortgage insurance and any items checked below:
X Property taxes X Homeowner's insurance
Flood insurance
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this form, please contact your lender.
WA RNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can
include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
(SAMPLE.PDF.PFD/SAMPLE.PDF/3)
HUD-1 Attachment
Borrower(s):
John F. Doe and Jane E. Doe
Seller(s):
Joe S. Title
Lender:
Bank of Roanoke
Settlement Agent:
Covenant Real Estate Services, LLC
(540)404-3213
Place of Settlement:
1626 Apperson Drive, Ste. C
Salem, VA 24153
Settlement Date:
August 31, 8201
Property Location:
1425 XYZ Lane
Roanoke, VA 24015
Seller Loan Payoff Details
Payoff First Mortgage to
ABC Bank
Loan Payoff As of
@ Per Diem
Total Additional Interest days
89,500.22
Total Loan Payoff
Adjusted Origination Charge Details
Origination Charge
Origination Fee 1,000.00
to Bank of Roanoke
Total $
1,000.00
Origination Credit/Charge (points) for the specific interest rate chosen
Total $
Adjusted Origination Charges $ 1,000.00
Reserves Deposited with Lender
Homeowner's Insurance 437.49
3.000 at 145.83 per month
884.65
5.000 at 176.93 per month
Total $ 1,322.14
Title Services and Lender's Title Insurance Details
BORROWER SELLER
Settlement Fee 500.00
Covenant Real Estate Services, LLC
to
Title Search Fee 125.00
Title Exams Inc
to
CPL Fee 20.00
Fidelity National Title Insurance Company
to
Update and Recording Fee 40.00
Covenant Real Estate Services, LLC
to
Lender's title insurance 208.00
to Fidelity National Title Insurance Company
HUD-1 Attachment - Continued
WA RNING: It is a crime to knowingly make false statements to the United States on this or any similar form. Penalties upon conviction can
include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010.
(SAMPLE.PDF.PFD/SAMPLE.PDF/3)
Total $ 893.00 $ 0.00
Owner's Title Insurance
BORROWER SELLER
Owner's Policy Premium 585.00
to Fidelity National Title Insurance Company
Total $$ 585.00 $ 0.00
Lender's Title Insurance
BORROWER SELLER
*fees also shown above in Title Services and Lender's Title Insurance Details
Lender's Policy Premium 208.00
to Fidelity National Title Insurance Company
Total $$ 208.00 $ 0.00
