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Okaloosa County BOCC — April 7, 2015 — HUD Form — reading text
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OMB Approval No. 2502.:-0255
A. Settlement Statement (HUD-1)
1.0FHA 2.0 RHS 3. DConv. Unins. 6. File Number: 7. Loan Number: 8. Mortgage Insurance Case Number:
4.0VA 5. 0 Conv. Ins. SAMPLE-CRESruEW
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:
COUNTY CONNIE ROPER
1300 JAMES LEE BLVD PRESCOTT M.R. ROPER
CRESTVIEW, FL 32539 1300 JAMES LEE BLVD
CRESTVIEW, FL 32539
G. Property Location: H. SettlementAgent 59-3638337 I. Settlement Date:
1300 JAMES LEE BLVD Lighthouse Land Title Company
CRESruEW, FL 32539 902B Palm Blvd S April 15, 2015
OKALOOSACounty, Florida Niceville, Fl 32578 Ph.
Place of Settlement:
902B Palm Blvd S
Niceville, Fl 32578
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 orice 425,000.00 401. Contract sales orice 425,000.00
102. Personal orooe"'' 402. Personal orooertv
103. Settlement Charaes to Borrower (Line 1400) 2,746.78 403.
104. 404.
105. 405.
Adiustments for items oaid bv Seller in advance Adiustments for items paid bv Seller in advance
106. Citv!rown Taxes to 406. Citv!rown Taxes to
107. Countv Taxes to 407. Countv Taxes to
108. Assessments to 408. Assessments to
109. 409.
110. 410.
111. 411.
112. 412.
120. Gross Amount Due from Borrower 427,746.78 420. Gross Amount Due to Seller 425,000.00
200. Amounts Paid bv or in Behalf of Borrower 500. Reductions in Amount Due Seller:
201. Deoosit or earnest monev 501. Excess deoosit (see instructions)
202. Princioal amount of new loanfs) 502. Settlement charaes to Seller fline 1400) 31,487.15
203. Existina loanfs) taken subiect to 503. Existina 1oan(s) taken subrect to
204. 504. Payoff First Mortgage to REGIONS 100,000.00
205. 505. Pav11ff Second Mortaaae
206. 506.
207. 507.
208. 508.
209. 509.
Adiustments for items unpaid bv Seller Adiustments for items unpaid bv Seller
210. Citv!rown Taxes to 510. Citv!rown Taxes to
211. CountvTaxes 01/01/15 to 04/16/15 866.51 511. CountvTaxes 01/01/15 to 04/16/15 866.51
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 866.51 520. Total Reduction Amount Due Seller 132,353.66
300. Cash at Settlement from/to Borrower 600. Cash at settlement to/from Seller
301. Gross amount due from Borrower (line 120) 427,746.78 601. Gross amount due to Seller (line 420) 425,000.00
302. Less amount paid by/for Borrower (line 220) ( 866.51) 602. Less reductions due Seller (line 520) ( 132,353.66
303. Cash [8J From D To Borrower 426,880.27 603. Cash ~To D From Seller 292,646.34
*Paid outside of closing by borrower(B), seller(S), lender(L), or th1rd-party{T)
The undersigned hereby acknowledge receipt of a completed copy of this statement & any attachments referred to herein
Borrower Sel Ier
COUNTY CONNIE ROPER
PRESCOTT M.R. ROPER
The Public Reporting Burdon for this collectlon of Information Is estimated at 35 minutes per response for collectlng, reviewing, and reporting the data. This agency may not collect th ls Information, and you aro
not required to complete this form, unless It displays a currently valid OMB control number. No conflden~allty Is assured; this disclosure Is mandatory. This Is designed to provide the parties to a RESPA covered
transaction with lnforma~on during the settlement process.
Page 1 of 3 HUD-1
(SAMPLE-CRESruEW.PFD/SAMPLE-CRESruEW/5)
L. Settlement Charaes
700. Total Real Estate Broker Fees $ 25,500.00
Paid From Paid From
Division of commission (line 700) as follows: Borrower's Seller's
l7n'1 II:: ' l k i::nn nn tn ("':()I r"l\flH I •I •~•rTr-'"'
Funds at Funds at
702.$ to Settlement Settlement
703. Commission naid at settlement 25 500.00
704.
705.
800. Items Pavable in Connection with Loan
801. Our oric ination charae $ lfrom GFE#1)
802. Your credit or charge (points) for the specific interest rate chosen $ (from GFE #2)
803. Your adiusted oriaination charaes I from GFE #Al 0.00
804. Annraisal fee to lfrom GFE #3)
805. Credit Reoort to