Closing Disclosure
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1
2Closing Disclosure
Closing Information
Transaction Information
Date Issued
Borrower
Closing Date
Disbursement Date
Settlement Agent
Seller
File #
Property
Sale Price
Summaries of Transactions
Contact Information
SELLER’S TRANSACTION
REAL ESTATE BROKER (B)
Name
Due to Seller at Closing
01
Sale Price of Property
Address
02
Sale Price of Any Personal Property Included in Sale
03
__ License ID
04
05
Contact
06
Contact __ License ID
07
Email
08
Adjustments for Items Paid by Seller in Advance
Phone
09
City/Town Taxes
to
REAL ESTATE BROKER (S)
10
County Taxes
to
Name
11
Assessments
to
12
Address
13
14
15
__ License ID
16
Contact
Due from Seller at Closing
Contact __ License ID
01
Excess Deposit
Email
02
Closing Costs Paid at Closing (J)
Phone
03
Existing Loan(s) Assumed or Taken Subject to
04
Payoff of First Mortgage Loan
SETTLEMENT AGENT
05
Payoff of Second Mortgage Loan
Name
06
07
Address
08
Seller Credit
09
__ License ID
10
11
Contact
12
Contact __ License ID
13
Email
Adjustments for Items Unpaid by Seller
14
City/Town Taxes
to
Phone
15
County Taxes
to
16
Assessments
to
?
17
Questions?
If you have questions about the
18
loan terms or costs on this form, use the contact
19
information above. To get more information
CALCULATION
or make a complaint, contact the Consumer
Total Due to Seller at Closing
Financial Protection Bureau at
Total Due from Seller at Closing
Cash
From
To Seller
CLOSING DISCLOSURE
PAGE 1 OF 2
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