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Buyer/Seller Settlement Statement Page 2 <br /> Q Settlement charges Buyer•• Paid from Paid from <br /> 700.Total Sales/Brokers Com. based on price $51,000 00 @ %= Buyer's Seller's <br /> 701 %to Funds at Funds at <br /> 702. %to Settlement Settlement <br /> 703. Commission paid at settlement <br /> 704 to <br /> 900.Items payable in connection with loan: Buyer POC Seller POC <br /> 801 Loan origination fee %to <br /> 802. Loan discount %to <br /> 803. Appraisal fee to <br /> 804 Credit report to <br /> 805 Lender's inspection fee to <br /> 806 Mortgage insurance application fee to <br /> 807 Assumption Fee to <br /> 808. to <br /> 809 to <br /> 810 to <br /> 811 to <br /> 900. Items reauired by lender to be paid in advance: Buyer POC Seller POC <br /> 901 Interest from to /day <br /> 902.Mortgage insurance premium for months to <br /> 903 Hazard insurance premium for years to <br /> 904. Flood insurance premium for years to <br /> 905. vears to <br /> 000 POC Seller•• <br /> 1001 Hazard insurance monthsper month <br /> 1002. Mortgage insurance monthsper month <br /> 1003. City property taxes monthsper month <br /> 1004 County property taxes monthsper month <br /> 1005. Annual assessments monthsper month <br /> 1006. Flood insurance months a per month <br /> 1007 monthsper month <br /> 1008. monthsper month <br /> 1009 Aggregate accounting adjustment <br /> 00 POC Seller•• <br /> 1101 Settlement or closing fee to <br /> 1102. Abstract or title search to Old Republic National Title Insurance Company 175.00 <br /> 1103. Title examination to <br /> 1104 Title insurance binder to <br /> 1105. Document preparation to <br /> 1106. Notary fees to <br /> 1107 Attorney's Fees to Rossway Swan Tierney Barry Lacey&Oliver P L. 500001 <br /> (includes above item numbers. <br /> 1108. Title Insurance to Old Republic National Title Insurance Company/Rossway Swan 293.25 <br /> (includes above item numbers: <br /> 1109 Lender's coverage(Premium): <br /> 1110 Owner's coverage(Premium): $51,000 00($293.25) <br /> 1111 Endorse: <br /> 1112. Title- Insurance Policy Surcharge to Old Republic National Title Insurance Company 1 3.28 <br /> 1113. Reimburse Good Standing Cert to FL Di to Rossway Swan Tierney Barry Lacey&Oliver P L. 8.75 <br /> 00 Government recordinq <br /> 1201 Recording fees Deed $18.50 Mortgage(s) Releases 18.50 <br /> 1202.City/county tax/stamps Deed Mortgage(s) <br /> 1203.State tax/stamps Deed $35700 Mortgage(s) 35700 <br /> 1204 Seller's Corporate Affidavit to Indian River County Clerk of Court 2700 <br /> 1205 to <br /> 00 Additional settlement charqes: BuyerPCC •• <br /> 1301 Survey to <br /> 1302. Pest Inspection to <br /> 1303. to <br /> 1304 to <br /> 1305. to <br /> 1306. to <br /> 1307 to <br /> 1308. to <br /> 1309 <br /> 1400.Total settlement charges: <br /> Enter on lines 103,Section J and 502,Section K 1 1,355781 27001 <br /> I have carefully reviewed the 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 <br /> my account or by me in this transaction.I further certify that I have received a copy of the Settlement Statement. <br /> Indian River County Be Golf Club, Inc. <br /> By - Buyer By. Seller <br /> William K. DeBraal, Deputy County Attorney Kenneth Watson, President <br /> Buyer Seller <br /> The 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 <br /> statement. <br /> Rossway Syvan Tierney Barry Lacey&Oliver P L. <br /> By- <br /> As Its Authorized R p ntative Date <br /> WARNING:It is a crime tolkKowingly make false statements to the United States on this or any other similar form.Penalties upon conviction can include a fine DoubleTime® <br /> and imprisonment.For details see:Title 18 U S.Code Section 1001 and Section 1010. <br />