SS60-6-16. CLOSING STATEMENT Page 1 of 3 The printed portions of this form, except differentiated additions, have been approved by the Colorado Real Estate Commission. (SS60-6-16) (Mandatory 1-17) ESTIMATE FINAL CLOSING STATEMENT PROPERTY ADDRESS SELLER BUYER SETTLEMENT DATE DATE OF PRORATION LEGAL DESCRIPTION: DEBITS CREDITS 1 . Purchase Price 2. Deposit (Earnest Money) Paid to : 3. Principal amount of new 1st Loan Payable to : 4. Principal amount of new 2nd Loan Payable to : 5 . 1st Loan Payoff to : 6. 2nd Loan Payoff to : 7. Taxes for Preceding Year(s ) 8. Taxes for Current Year 9. Personal Property Taxes 10. Transaction Fee 11. Loan Origination Fee 12. Loan Discount Fee 13. Appraisal Fee 1 4 . Loan Processing Fee 15 . Tax Service Fee 16 . Flood Certification 17 . Loan Documen t Preparation Fee 18 . Loan Underwriting Fee 19 . Interest on New Loan 20 . Mortgage Insurance Premium/PMI 21 . Premium for N ew Hazard Insurance 22 . Reserves Deposited With Lender 22. 1 . Hazard Insurance Reserve 22. 2 . Mortgage Insurance R eserve 22. 3 . County Property Tax Reserve 23 . Aggregate Adjustment American LegalNet, Inc. www.FormsWorkFlow.com SS60-6-16. CLOSING STATEMENT Page 2 of 3 2 4 . Real Estate Closing Fee 25 . Loan Closing Fee 26 . Title Insurance Premium 27 . 28 . Title Insurance Premium 29 . Endorsements: 30 . Certificate of Taxes Due 31 . Overnight Delivery Fee 32 . E - Doc Fee (Loan) 33 . Release Facilitation Fee 34 . 35 . Recording: 35. 1 . Warranty Deed 35. 2 . Deed of Trust 35. 3 . Release 35. 4 . Other 36 . Survey 37 . Documentary Fee 38 . Transfer Fee 39 . Sales and Use Tax 40 . HOA CIC Document Procurement Fee 41 . HOA Transfer/Status Letter Fee 42 . HOA Dues 43 . HOA Working Capital 44 . Water and/or Sewer Escrow 45 . Homeowner Warranty 46 . 2% Colorado Withholding 47 . Foreign Investment in Real Property Tax Act (FIRPTA) 10% 48 . Propane/Fuel Oil Proration 49 . Rents/Rent Proration 50 . Security Deposits 51 . Seller Concessions 52 . 53 . Other: Subtotals Balance due to/from Seller Balance due to/from Buyer TOTALS American LegalNet, Inc. www.FormsWorkFlow.com SS60-6-16. CLOSING STATEMENT Page 3 of 3 APPROVED AND ACCEPTED I have carefully reviewed this Closing 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 this Closing Statement. Buyer/Seller Buyer/Seller Broke Broker American LegalNet, Inc. www.FormsWorkFlow.com