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10/15/13 5:03 PM OMB 140.2502.0265
<br /> �MENio A.U.S.Department of Housing B.Type of Loan
<br /> and Urban Development 1.[ I FHA 2[I RHS 3.[ I Conv.Unins.
<br /> !j1j1jj 4. VA 5. Conv.Ins.
<br /> • �z �II'���� >?� 6.File Number 7.Loan Number
<br /> � 410591
<br /> Settlement Statement 6.Mortgage Ins.Case No.
<br /> C.Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are
<br /> shown. Items marked("POC")were paid outside the closing: they are shown here for Information purposes and are not
<br /> Included in the totals.
<br /> D.Name of Borrower: By Jill,LLC,280 Hollander Road,Wayzata,MN 55391
<br /> E.Name of Seller: CTW Group,Inc.DBA Homestead Road
<br /> F.Name of lender:
<br /> G.Property Location: Lot 9,Block 10,Townsite of Langdon Park
<br /> 3745 Togo Road,Orono,MN
<br /> H.Settlement Agent: Land This,Inc.(651)638-1900
<br /> Place of Settlement: 14985 Glazier Avenue,#410,Apple Valley,MN 55124
<br /> I.Settlement Date: 10/16/2013 Proration Data: 10/16/2013
<br /> Disbursed Date: 10/16/2013
<br /> .Y...
<br /> J:'t3umniai�ix�•BoirclwersTrattsaotion: G` msriafSrlkf�srafsaotioR;
<br /> _
<br /> 100.�k#i"ass tYNiiunt Der nom BorrowM'.. _. 4 WS1400aaM °W_b fo
<br /> 101. Contract sales price 108,000.00 401. Contract sales price 108,000.00
<br /> 102. Personal property 402. Personal property
<br /> 103. Settlement charges to borrower One 1400 126900 403.
<br /> 104. 404.
<br /> 105. 405.
<br /> Arile�tajotftami:peldbji$e5erinadvenCe ' ,- .`
<br /> ,.A�tmetpi icf�telyd�dd by'seMet'ie'6dvance
<br /> 106. CftyAowntaxes 406. CRyApwntaxes
<br /> 107. County taxes 10/16/2013 to 1/1/2014 329.26 407. County taxes 10/18/2013 to 1/1/2014 329.26
<br /> 106. Assessments 406. Assessmerts
<br /> 1109. Association Dues 409. Association Dues
<br /> 110. 410.
<br /> 111. 411.
<br /> 112. 412.
<br /> 120. Grose Amount Due from Borrower: 109,598.26 420. Gross Amount Due to Seller 108,329.28
<br /> 200.WArrrourts Paid by or InBehall of Borrower.tom= 1 *3 SK R%Wc*M in Amount Due to Seller
<br /> 201. Deposit or earnest money 1,000.00 501. Fess deposit see Instructions
<br /> 202. Principal amount of new loans 502 Settlement charges to seller line 1400 3,764.20
<br /> 203. Existing loans taken sublect to 503. Existing bans taken sublect to
<br /> 204. 504. Payoff of first mortgage ban
<br /> 205. 16M. Payoff of second mortgage ban
<br /> 206. 506.
<br /> 207. 507.
<br /> 208. 509.
<br /> 200. 509.
<br /> Adjusbnerts for tternis Unpaid Weelleir :,' :-' :_. Adfustmantsfor`trams` Adler *+ �
<br /> 210. CkyAovm taxes 510. CltvAown taxes
<br /> 211. County taxes 511. Coun taxes
<br /> 212. Assessments 612 Assessments
<br /> 213. Association Dues 513. Association Dues
<br /> 214. 514.
<br /> 215. 51L
<br /> 216. 616.
<br /> 217. 517.
<br /> 218. 518.
<br /> 219. 610.
<br /> 220. Total Paid by/for Borrower 1,000.00 520. Total Reduction Amount Der Seller: 3,764.20
<br /> 300. Cash at Settlement fromko Wtho�7 E °€.: " 600.f T.eeN 811 Sef116ment tohnom SeSer' a k "- �
<br /> 301. Gross amount due from borrower One 120 109,598.26 601. Gross amount due to Seiler pine 420 108,329.26
<br /> 302. Less amount paid b lfor borrower line 220 1,000.00 602 Less total reduction in amount due se0er line 520 3,764.20
<br /> 303. CASH())FROM OTO BORROWER 108,598,26 1603. CASH QFROM(X)TO SELLER 104,565,06
<br /> SUBST111"l1TE FORM 1090 SELLER STATEMENT-The Information con Ined in Blocks E,G,Hand I and on Ine 401(or,I Ione 401 N asterisked,Ann 403 and 404),406,407 and
<br /> 409412(applicable pan of huyefa real estate tax reportable to the IRS)M Mportant tax Information and is being furnished to the Internal Revenue Service.I you are required to Me a
<br /> return,a negligence penalty or other sanction will be Imposed an you I this Item N required to be reported and the IRS determines that it las not been reported.
<br /> SELLER INSTRUCTION-I title real estate was your pdmVal residence,Ile form 2119.Sale or Exchange at Principal Residence,for any gale,with your Income tax return;for other
<br /> transactions,oon"als the applicable parts of form 4797,Foran 6252 and/or Schedule D(Form 1040).
<br /> You are required by law to provide Land Title,Mc.(651)639-1900 with your correct taxpayer klerdllntlon number,
<br /> I you do not provide Land TWO.Inc.(551)638.1900 with your correct taxpayer identification member,you may be subject to civil or criminal penalties.
<br /> The Pubic Reportirp Burden for this collection of Information is estimated at 35 minutes per response for collecting,reviewing,and reporting the data.This agency may
<br /> not collect this Information,and you are not required to complete this form,urfess it displays a currently valid OMB control number.No confidentiality Is assured;this
<br /> disclosure Is mandatory.This Is designed to provide the parties to a RESPA covered transaction wtih Information during the settlement process.
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