File No./Escrow No.:

Title Company Name

Title Company

Print Date & Time:

ALTA Universal ID

Logo

Officer/Escrow Officer:

Title Company Address

Settlement Location:

Description

Seller

Debit

Credit

Financial

Sales Price of Property

Personal Property

Deposit including earnest money

Loan Amount

Existing Loan(s) Assumed or Taken Subject to          

Seller Credit

Excess Deposit

Prorations/Adjustments

School Taxes from (date) to (date)

County Taxes from (date) to (date)

HOA dues from (date) to (date)

Seller Credit

Loan Charges to (lender co.)

Points

Application Fee

Origination Fee

Underwriting Fee

Mortgage Insurance Premium

Prepaid Interest

Other Loan Charges

Appraisal Fee to          

Credit Report Fee to          

Flood Determination Fee to          

Flood Monitoring Fee to          

Tax Monitoring Fee to          

Tax Status Research Fee to          

Impounds

Homeowner's Insurance           mo @ $          /mo

Mortgage Insurance           mo @ $          /mo

City/town taxes           mo @ $          /mo

County Taxes          mo @ $          /mo

School Taxes          mo @ $          /mo

Aggregate Adjustment

Title Charges & Escrow / Settlement Charges

Owner's Title Insurance ($ amount) to          

Owner's Policy Endorsement(s)          

Loan Policy of Title Insurance ($ amount) to          

Loan Policy Endorsement(s)          

Title Search to          

Insurance Binder to          

Escrow / Settlement Fee to          

Notary Fee to          

Signing Fee to          

Commission

Real Estate Commission to          

Real Estate Commission to          

Other

Government Recording and Transfer Charges

Recording Fees (Deed) to          

Recording Fees (Mortgage/Deed of Trust) to          

Recording Fees (Other) to          

Transfer Tax to          

Transfer Tax to          

Payoff(s)

Lender: Payoff Lender Co.

Principal Balance ($ amount)

Interest on Payoff Loan ($ amount/day)

Additional Payoff fees/Reconveyance Fee/Recording

Fee/Wire Fee

Lender: Payoff Lender Co.

Principal Balance ($ amount)

Interest on Payoff Loan ($ amount/day)

Additional Payoff fees/Reconveyance Fee/Recording

Fee/Wire Fee

Miscellaneous

Pest Inspection Fee to          

Survey Fee to          

Homeowner's insurance premium to          

Home Inspection Fee to          

Home Warranty Fee to          

HOA dues to          

Transfer fee to Management Co.

Special Hazard Disclosure

[Utility] Payment to          

Assessments

School Taxes

City/town taxes

County Taxes/County Property taxes

Buyer Attorney fees to          

Seller Attorney fees to          

Debit

Credit

Subtotals

Due From/To Borrower

Due From/To Seller

Totals