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A. Settlement Statement u.s. Departmmt of Housing ~ and Urban Development 1r Land Title, Inc. OMB No. 2502.0265 B. Type of Loan 16. F,'e N"mbec 17. Loa" N"mbm I B. Mortgage '",",a"ce Case N"mbe, 1. o FHA 2. o FmHA 3. 0 Conv. Unins. TC- 103791 4.0 VA 5. o Conv. Ins. C. Note: This form is furnished to give you a statement of actual se~lement costs. Amounts paid to and by the seWement agent are shown. items marked "(p.o.G.)" were paid outside the closing; they ale shown here for informational purposes and are not included in the totals. O. Name and Address of Borrower t. Name and Address of Seller F. Nama and Address of Lender City of Roseville Michael G. Vrudny Cash 2660 civic Center Drive Melissa F. vrudny Roseville, MN 55113 G. Property Location H. SeltlE!menl Agent Land Title, Inc. 2018 Hamline Avenue Roseville, MN 55113 Place 01 Selllemord Phone: (651)638-1900 I. Setuement Date Ramsey County, MN 1900 Silver Lake Road,Suite 200 5/15/01 16-18110 Midland Hills Rearran New Brighton, MN 55112 J. Summarv of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due From Borrower 400. Gross Amount Due To Seller 101. Contract sales price 63,000.00 401. Contract sales price 63,000.00 102. Personal properlY 402. Personal properlY 103. Settlement charges to borrower (line 1400) 456.50 403. 104. 404. 105. Closing Cost Credit 400.00 405. Closing Cost Credit 400.00 Adlustments for Items paid bv seller In advance Adjustments for items paid by seller In advance 106. City/town taxes to 406. City/town taxes to 107. County taxes 5/15/01 to 7/ 1/01 73.12 407. County taxes 5/15/01 to 7/ 1/01 73.12 108. Assessments to 408. Assessments to 109. I 409. 110. 410. 111. 411. 112. 412. t20. Gro99 Amount Due From Borrower 63,929.62 420. Gross Amount Due To Seller 63,473.12 200. Amounts Paid Bv Or In Behalf 01 Borrower 500. Reductions In Amount Due To Seller 201. Deposit or eamest money 501. Excess deposit (see Instructions) 202. Principal amount of new loan(s) 502. Settlement charQes to seller (line 1400) 642.40 203. ExistinQ loan(s) taken subject to 503. Existing loan(s) taken subject to 204. 504. Payoff of first mortgage loan US Bank 27,388.25 205. 505. Payoff of second mortgaoe loan 206. 506. 1st 1/2 2001 Taxes/Ramsey Co 283.56 207. 507. Messenger / Service Fee 25.00 208. 508. 209. 509. Adlustments for Items unpaid bv seller Adiustments for Items unpaid bv seller 210. City/town taxes to 510. City/town taxes to 211. Countv taxes 10 511. County taxes to 21~. AOI08emlot' to 81~. Al4os.mlnl. to Il1B. I ni~. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. Total Paid BylFor Borrower 520. Total Reduction Amount Due Seller 28,339.21 300. Cash At Settlement FromfTo Borrower 600. Cash At Settlement To/From Seller 301. Gross amount due from borrower (line 120) 63,929.62 601. Gross amount due to seller (line 420) 63,473.12 302. Less amounts paid by/lor borrower (line 220) ( 602. Less reductions in amI. due seller (line 520) ( 28,339.21 303. Cash ~From o To 13orrower 63,929.62 603. Cash 19 To. OFrom Seller 35,133.91 SUBSTITUTE FORM 1099 SELLER STATEMENT: The information contained in Blocks E, G, H and I, lines 401 (or, if line 401 is asterisked, lines 403 and 404), 406, 407 and 408-412 (applicable part of buyer's real estate tax reportable to the IRS) is important tax information and is being furnished to the Internal Revenue Service. If you are required to file 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 been reported. P.reVlQUs Edition Is Obsolela OCMUOO5 Inltlal(s) FIRST OA fA SYSTEMS, INC. FDS (Rev. 12192) RESPA. He 43052; HUD.j REV. 131M) HH5-361-8404