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5/10/04 1 :55 PM OMB No. 2502-0265
<br /> A. U .S . Department of Housing B. Type of Loan
<br /> and Urban Development 1 . [ ] FHA 2. [ J FMHA 3. [ ] Conv. Unins .
<br /> 4. [ ] VA 5. [ ] Conv. Ins. [X] Other.
<br /> 6. File Number 7. Loan Number
<br /> 2003-11 -19
<br /> Settlement Statement 8. Mortgage Ins. Case No.
<br /> Wool
<br /> C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement
<br /> agent are shown . Items marked ("POC') were paid outside the closing: they are shown here for information
<br /> purposes and are not included in the totals.
<br /> D. Name of Borrower: INDIAN RIVER COUNTY, 1840 25th Street, Vero Beach , FL 32960
<br /> E. Name of Seller: STELLA A. ARENDAS, AS TRUSTEE, 190 Pinellas Lane, #509, Cocoa Beach , FL TIN :
<br /> 32931 -5069
<br /> as to an undivided one-half interest TIN :
<br /> F. Name of Lender:
<br /> G. Property Location : METES AND BOUNDS, 2 PARCELS, Section 30-33-40
<br /> XXX 9th Street SW, Vero Beach, FL 32962; 946 U S Highway 1 , Vero Beach, FL
<br /> 32960
<br /> H. Settlement Agent: Stewart Title of Indian River (772) 569-7603 TIN : 59-1998428
<br /> Place of Settlement: 333 17th St. , Ste, S , Vero Beach , FL 32960
<br /> I. Settlement Date: 5/12/2004 Proration Date: 5/12/2004
<br /> Noll, iiii
<br /> 100. Gross amount due from borrower: 400. Gross amount due to seller:
<br /> 101 . Contract sales price 399,000.00 401 . Contract sales price 399,000. 00
<br /> 102. Personal property 402. Personal property
<br /> 103. Settlement charges to borrower (line 1400) 10. 50 403.
<br /> 104, 404,
<br /> 105. 405.
<br /> .,. _ _ .
<br /> 106. City/town taxes 406. City/town taxes
<br /> 107. County taxes 407. County taxes
<br /> 108. Assessments 408, Assessments
<br /> 109. 409,
<br /> 110. 410.
<br /> 111 . ESCROW FOR 2004 RE TAXES 682 .71 411 ,
<br /> 112. 412,
<br /> 120. Gross amount due from borrower: 399,693.21 420. Gross amount due to seller: 399 ,000. 00
<br /> 201 . Deposit or earnest money 100.00 501 . Excess deposit (see instructions)
<br /> 202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) 36, 953 . 00
<br /> 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to
<br /> 204. 504. Payoff of first mortgage loan
<br /> 205. 505. Payoff of second mortgage loan
<br /> 206. 506. Deposit or earnest money 100. 00
<br /> 207, 507.
<br /> 208, 508. 2003 taxes paid 11 -25-03
<br /> 209, 509.
<br /> 210. City/town taxes 510. City/town taxes
<br /> 211 . County taxes 1 /1 /2004 to 5/12/2004 682.71 511 . County taxes 1 /1 /2004 to 5/12/2004 682 . 71
<br /> 212. Assessments 512, Assessments
<br /> 213, 513.
<br /> 214, 514,
<br /> 215. 515.
<br /> 216, 516,
<br /> 217. 517.
<br /> 218, 518,
<br /> 219, 519,
<br /> 220. Total paid by/for borrower: 782.71 520. Total reduction in amount due seller: 37, 735 . 71
<br /> 301 . Gross amount due from borrower (line 120) 3999693.21 601 . Gross amount due to seller (line 420) 399, 000.00
<br /> 302. Less amount paid by/for borrower (line 220) 782 . 71 602. Less total reduction in amount due selier(line 520) 37, 735 .71
<br /> 303. CASH (X)FROM ()TO BORROWER 398,910 .50 603. CASH ()FROM (X)TO SELLER 361 ,264. 29
<br /> SUBSTITUTE FORM 1099 SELLER STATEMENT - The information contained in Blocks E, G, H and I and on line 401 (or, if line 401 is asterisked, lines
<br />403 and 404), 406, 407 and
<br /> 408-412 (applicable part of buyer's real estate tax reportable to the IRS) is important tax information and is being fumished to the Internal Revenue Service.
<br /> If you are required to file
<br /> a return, a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has not
<br /> been reported.
<br /> SELLER INSTRUCTION - If this real estate was your principle residence, file form 2119, Sale or Exchange of Principal Residence, for any gain, with your
<br /> income tax return; for other
<br /> 'transactions, complete the applicable parts of form 4797, Form 6252 and/or Schedule D (Form 1040).
<br /> You are required by law to provide Stewart I itle of Indian Kiver it /2) bby- /bU3 with your Correct taxpayer wentlncation number.
<br /> If you do not provide Stewart Title of Indian River (772) 569-7603 with your correct taxpayer identification number, you may be subject to civil or
<br />criminal penalties.
<br /> STELLA A. ARENDAS , AS TRUSTEE
<br />
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