CLOSING DISCLOSURE PAGE 1 OF 2
Transaction Information
Borrower
Seller
Closing Information
Date Issued
Closing Date
Disbursement Date
Settlement Agent
File #
Property
Sale Price
Closing Disclosure
SELLER’S TRANSACTION
Due to Seller at Closing
01 Sale Price of Property
02 Sale Price of Any Personal Property Included in Sale
03
04
05
06
07
08
Adjustments for Items Paid by Seller in Advance
09 City/Town Taxes to
10 County Taxes to
11 Assessments to
12
13
14
15
16
Due from Seller at Closing
01 Excess Deposit
02 Closing Costs Paid at Closing (J)
03 Existing Loan(s) Assumed or Taken Subject to
04 Payo of First Mortgage Loan
05 Payo of Second Mortgage Loan
06
07
08 Seller Credit
09
10
11
12
13
Adjustments for Items Unpaid by Seller
14 City/Town Taxes to
15 County Taxes to
16 Assessments to
17
18
19
CALCULATION
Total Due to Seller at Closing
Total Due from Seller at Closing
Cash From
To Seller
Summaries of Transactions Contact Information
REAL ESTATE BROKER (B)
Name
Address
__ License ID
Contact
Contact __ License ID
Email
Phone
REAL ESTATE BROKER (S)
Name
Address
__ License ID
Contact
Contact __ License ID
Email
Phone
SETTLEMENT AGENT
Name
Address
__ License ID
Contact
Contact __ License ID
Email
Phone
Questions? If you have questions about the
loan terms or costs on this form, use the contact
information above. To get more information
or make a complaint, contact the Consumer
Financial Protection Bureau at
www.consumernance.gov/mortgage-closing
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Distributed by Judicial Title
Distributed by Judicial Title
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$ 0.00
$ 0.00
$ 0.00
$ 0.00
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Loan Costs
CLOSING DISCLOSURE PAGE 2 OF 2
Seller-Paid
At Closing Before Closing
A. Origination Charges
01 % of Loan Amount (Points)
02
03
04
05
06
07
08
B. Services Borrower Did Not Shop For
01
02
03
04
05
06
07
08
C. Services Borrower Did Shop For
01
02
03
04
05
06
07
08
J. TOTAL CLOSING COSTS
Closing Cost Details
E. Taxes and Other Government Fees
01 Recording Fees Deed: $120.00 Mortgage: $32.00
02
F. Prepaids
01 Homeowners Insurance Premium ( 12 mo.)
02 Mortgage Insurance Premium ( mo.)
03 Prepaid Interest ( $26.31 per day from 3/23/12 to 3/31/12))
04 Property Taxes ( mo.)
05
G. Initial Escrow Payment at Closing
01 Homeowners Insurance per month for mo.
02 Mortgage Insurance per month for mo.
03 Property Taxes per month for mo.
04
05
06
07
08 Aggregate Adjustment
H. Other
01
02
03
04
05
06
07
08
09
10
11
12
13
Other Costs
*will not show on print
Distributed by Judicial Title
$ 0.00
CLOSING DISCLOSURE ADDENDUM
Seller Addendum
By Signing, you are only confirming that you have received this form.
Seller Signature Date Co-Seller Signature Date
ConfirmReceipt