Settlement Statement B. Type of Loan
Land Title Services, Inc. 1. ❑ FHA 2. ❑ FmHA 3.❑ CONY UN[NS.
4. ❑ VA 5. ❑ CONV.INS. 5.❑.OTHER
A. U.S. Department of Housing& Urban Development 6. File Number 7. Loan Number
T115-12308 •
Settlement Statement 8. Mortgage Ins.Case No.
C. Notes: 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"[POC]"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,Address,Tax ID of Seller F.'Name and Address of Lender
The City of Salina,Kansas Dennis M.Fry . CASH
300 W.Ash St 332 S.Ohio Street
Salina,KS 67401 Salina,Ks.67401
G. Property Location: 330 S.Ohio St/332 S.Ohio
Saline County,Kansas
Tr 1 Lot 9,Surveyors Plat 12
less E.15'&less a tract •
Tr 2 Lots 10& 11,Sur.Plat 12
H. Settlement Agent: Land Title Services,Inc. TIN: 48-0974247
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Place of Settlement: 136 N.7th St. -
Salina,KS 67401
1. Settlement Date: 'May 15,2015 Disbursement Date: May 15,2015
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 175.000.00 401.Contract Sales Price 175.000.00
102.PersonafPropertv 402.Personal Property
103.Settlement Charges to Buyer(Line 1400) 900.00 403.
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. Relocation Assistance Payment 1.320.00 410.Relocation Assistance Payment 1.320.00
111. 411.
112. 412.
120.Gross amount due from borrower 177,220.00 420.Gross amount due to seller 176,320.00
200.Amounts paid by or in behalf of the borrower 500.Reduction in amount due to seller
201. Deposit or earnest money 501.Excess Deposit(See Instructions)
202.Principal Amount of New Loan(s) 502.Settlement Charges to Seller(Line 1400)
203.Existing loan(s)taken subject to 503.Existing loan(s)taken subject to
204. 504. Payoff First Mortgage to First Bank Kansas 42.784.59
205. 505. Payoff Second Mortgage
206. 506.
207. 507.
208. • 508.
209. 509.
Adjustments for items unpaid by seller Adjustments for items unpaid by seller
210. City/Town Taxes to 510. City/Town Taxes to
211. County Taxes 01/01/15 to 05/16/15 704.20 511. County Taxes 01/01/15 to 05/16/15 704.20
212. Assessments to 512. Assessments to
213. 513.
214. 514.
215. 515.
216. • 516.
217. 517.
218. I 518.
219. 519.
220.Total paid by/for borrower 704.20 520.Total reduction in amount due seller 43,488.79
300.Cash at settlement from/to borrower 600.Cash at settlement to/from seller
301.Gross Amount Due From Borrower(Line 120) 177.220.00 601.Gross Amount Due To Seller(Line 420) 176.320.00
302.Less Amount Paid By/For Borrower(Line 220) I( 704.20) 602.Less Reductions Due Seller(Line 520) I( 43.488.79;
303.Cash( X From)( To)Borrower 176,515.80 603.Cash( X To)( From)Seller 132,831.21
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Land Title Services,Inc. File Number: T115-12308
L. Settlement Charges •
700.SALES/BROKER'S COMMISSION Based o6 Price n % PAID FROM PAID FROM
Division of Commission(line 700)as Follows: BUYER'S SELLER'S
701.$ to For Sale By Owner FUNDS AT FUNDS AT
702.$ to For Sale By Owner SETTLEMENT SETTLEMENT
703.Commission Paid at Settlement
704. to
800.Items payable in connection with loan
801.Loan Origination Fee
802.Loan Discount
803.Appraisal Fee to
804.Credit Report to
805.Lender's Inspection Fee to
806.Mortgage Ins.App.Fee • to
807.Assumption Fee to
808.Tax Service Fee
809.Underwriting Fee
810.Document Preparation Fee
811.Flood Certification Fee
900.Items required by lender to be paid in advance
901.Interest From to ( $ /day ( days %)
902.Mortgage Insurance Premium for months to
903.Hazard Insurance Premium for 1.0 years to
904.
905.
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1000. Reserves deposited with lender
1001.Hazard Insurance $ per -
1002.Morteage Insurance n. $ per
1003.City/Town Taxes n $ per
1004.County Taxes (ci). $ per
1005.Assessments a• $ per
1006.
1007.
1008.Aggregate Adjustment
1100.Title charges
1101.Settlement or Closing Fee to Land Title Services.Inc. 150.00
1 102.Abstract or Title Search to
1 103.Title Examination to
1 104.Title Insurance Binder to
1 105.Document Preparation to
I 106.Notary Fees to •
1 107.Attomev's Fees to
(includes above item numbers:
1 108 Title Insurance to Old Republic Title Insurance C9 S Central Div. 630 00 0 00
(includes above item numbers:
1 109 Lender's Coverage $
1 1 I0.Owner's Coverage $ 175.000.00 630.00
1 11 1.Courier/Wire/Email Doc Fees
1112.Loan Closing Fee
113.Additional Tract Search to Land Title Services,Inc. 100.00
1200.Government recording and transfer charges
1201.Recording Fees: Deed $ 20.00 Mortgage $ Releases $ 20.00
I 202.City/County Tax/Stamps: Deed Mortgage
1203.Mortgage Registration Tax: Mortgage
1204.
1205.
1300.Additional settlement charges
1301.Survev to
1302.
1303.
1304.
1305. •
1400.Total settlement charges(entered on Lines 103,section J and 502,section K) 900.00
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CERTIFICATION
I have carefully reviewed the HUD-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 the HUD-I Settlement Statement.
I further certify that I do understand and agree that the proration for general property taxes and/or special assessments provided in
the HUD-1 Settlement Statement was calculated by using information available at the time of closing and tax prorations for the
current year may have been estimated. Accordingly, the undersigned do hereby hold Land Title Services, Inc. and/or Lender
harmless from any liability or damages caused by an inaccurate proration for taxes resulting from any variation or difference in
the actual property taxes assessed for the current year.
1 agree that any interest accrued to Escrow agent's Trust Account shall belong to Escrow Agent.
Buyers/Borrowers:
The Cit !,f Salina, Kansas
BY: Lam.,, / A L,1
ason A. .°e, City Mana•er
Sellers:
Nef
Dennis M. Fry
To the best of my knowledge, 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 this statement.
Land Title Services, Inc.
Kim Mowery Date: May 15, 2015
Settlement-Agent
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.
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