ADDENDUM TO HUD-1 SETTLEMENT STATEMENT LOAN NO.: CASE NO.: MORTGAGOR(S): PROPERTY ADDRESS: NOTICE TO ALL PARTIES: If information is obtained which indicates that the source of the borrower’s financial contribution is other than from the borrower or other than stated by the lender in its closing instructions, the settlement agent is to obtain written instructions from the lender before proceeding with settlement. CERTIFICATION OF BUYER IN AN FHA-INSURED LOAN TRANSACTION I certify that I have no knowledge of any loans that have been or will be made to me (us) or loans that have been or will be assumed by me (us) for purposes of financing this transaction, other than those described in the sales contract dated (including addenda). I certify that I (we) have not been paid or reimbursed for any of the cash down payment. I certify that I (we) have not and will not receive any payment or reimbursement for any of my (our) closing costs which have not been previously disclosed in the sales contract (including addenda) and/or my application for mortgage insurance submitted to my (our) mortgage lender. _____________________________ ___________ Date _________________________________ ___________ Date CERTIFICATION OF SELLER IN AN FHA-INSURED LOAN TRANSACTION I certify that I have no knowledge of any loans that have been or will be made to the borrower(s) , or loans that have been or will be assumed by the borrower(s) for purposes of financing this transaction, other than those described in the sales contract dated (including addenda). I certify that I have not and will not pay or reimburse the borrower(s) for any part of the borrower’s closing costs which have not been previously disclosed in the sales contract (including any addenda). ____________________________ ___________ Date _________________________________ ___________ Date CERTIFICATION OF SETTLEMENT AGENT IN AN FHA-INSURED LOAN TRANSACTION To the best of my knowledge, the HUD-1 Settlement Statement which I have prepared, is a true and accurate account of the funds which were (i) received, or (ii) paid outside closing, and the funds received have been or will be disbursed by the undersigned as part of the settlement of this transaction. I further certify that I have obtained the above certifications which were executed by the borrower(s) and seller(s) as indicated. AGENT: By:___________________________________ , Escrow Officer DATED: (The certifications contained herein may be obtained from the respective parties at different times or may be obtained on separate addenda). 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. American LegalNet, Inc. www.FormsWorkflow.com