2015-06-02 Closing Statement - 10688 51st Street NE/AZI11' OMB Approval No. 2502-0265
,* , \ A. Settlement Statement (HUD-1)
%
B. Type o1 Loan
FHA 2.❑ RHSNumb
413VA 5.❑Conv. Ins. ❑Other
Number.
15.290.00350C
7mnB.
Number
18. Mortgage Insurance Case Number.
C. Note: Ills form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown.
Items marked "(POC)" were paid outside the closing; they are shovm here for Informatonal purposes and are not Included
in the totals.
D. Name & Address Fieldstone Family Homes, Inc., 801 Cliff Road E. Suite 135, Burnsville, MN 55337
of Borrower:
E. Nerne & Address City of Albenvlle, 5959 Main Avenue NE� P.O. Box 9, Albertville, MN 55301
of Seller:
F. Nome & Address
of Lender:
G. Property Location: 10688 51 st Street NE AlbeMllle, M Innesota 55301
Will, Block 2, Prairie Run, Wright County, Minnesota
101-t03-002110
H. Settlement Agent: Bankers Title, 760 South Plaza Drive, Suse 221, Mendota Heights, MN 55120. (e51) 681-0382
Place of Settlement: 350 W Burnsville PkWy, Suite 400, Burnsville, MN 55337
I. Settlement Dale: 512MO15 Proration Data: 529/2015 Disbursement Dale: 52mo%
$12,500.00
401. Contract sales price
$12,500.00
101. Contract sales pace
102. Personal property
402. Personal property
103. Settlement charges to borraver(line 1400)
$221.00
403.
104.
404.
105.
405.
q.'
106. Cityltown taxes
1406.
Cityltom taxes
107. County taxes
1407.
County taxes
108. Assessments
408. Assessments
109.
409.
110.
410.
111.
411.
112.
412
120. Grose Amount Due from Borrower
$12,721.00
420. Gross Amount Dusto Seller
$12,500.I10
201. Deposit cr earnest money
501. Excess deposit (see instructions)
202. Principal amount of new Icen(s)
1502,
Settlement charges to seller ill na 1400)
$76.25
203. Existing loan(s) taken subject to -
603. Existing loa n (s) take n subject to
204.
504. Payoff of first mortgage loan
205.
505. Payoff of second mortgage loan
206.
506.
207.
507.
208•
508.
209.
509.
1% Cftykown faxes
510. City/town taxes
211. County taxes
511. Countytaxes
212. Assessments
512. Assessments
213.
513.
214.
514.
215.
515.
216.
516.
217.
1517.
218.
518.
219.
519.
220. Total Paid by/for Borrower
$0.00
520. Total Reduction Amount Due Seller
$7625
$12,721.00
601. Gross amount due to seller (line 420)
$12.500.00
301. Gross "mount due from borrower Qine 120)
302. Less amounts paltl bytror borrower (line 220)
$0.00
602. Less reductions In amount due seller (line 520)
($76.25)
303. Cash ®From OTo Borrower
$12,721.00603.
Cash IS Top From Seller
$12,42335
The Public Repoding Burden for this ocil-tion of information Is estimated at 35 minutes per response for collecting, reviewing, and reporting the data. This agenry may nor
collect this informellon, and you are not required to complete this form, unless It displeys a eunentlyvelld OMB oontrd number. No confidentiality Is assured; this dsclosum
is mandatory. This is designed to provide the peones to a RESPA covered transecaon withinformeeen during the settlement process.
Previous edeloro are obsolete Page 1 HUD-1
SUBST I`UT FORM 1022 SELLER STATEMENT- The intormetlm contained in Blocks E, G, H and I end m line 401 (R, If line 401 Is asterisked,11— 403 and 404), 405,407
and 408-412 (applicable part of buyers real estate tax mporteble u the IRS) Is impotent taxlnformatlm and Is being fumished tothe Intemel Revenue SeMce. If yeu are
required to file a return, a negllgenw penalty or other sanctim will be Imposed on you If this item Is required to be reported and the IRS determines that It has not been reputed.
SELLER INSTRUCTION - If this real estate was your Principal residence, file /mn 2119, Sale m &change of Principal Residence, for any gain, with yvurinoeme tax rctum:
for dhertransecems, complete the applicable pats orform 4797, Fenn M2 end/m Schedule U (Form 1040),
You are required to praNde the Sctuement Agcm with your carved taxpayer identllicedm number. -
If you do_rd pMAdy{he Settlement Agent wlth your cored taxpayer Identlflcetim number, yW may be subject to civil or criminal penalties.
City of A1berhille
Previous editions are obsolete Page 2 , HUD-1
700. Total Real Estate Broker Fees
Paid From
Borrowers
Funds at
Settlement
Paid From
Sellers
Funds at
Settlement
Division of commission (fine 700) as follows:
701.
702.
703. Commission paid at settlement
704.
801 Our origination charge (from GFE #1)
802 Your credit or charge (points) forthe specific Interest rate chosen (Tram GFE #2)
803. Your adjusted origination charges (horn GFE A)
804. Appraisal fee (from GFE 93)
805. Credit report (from GFE #3)
806. Tax service (Ir- GFE #3)
80T Flood certification (from GFE #3)
806.
901. Daily interest charges from (from GFE #10)
902. Mortgage insurance premium for (fr- GFE #3)
903. Homeowners insurance for (from GFE #11)
904.
905,
1001. Initial deposit for your escrow accou nt (from GFE #9)
1002 Homeowner's insurance
1003. Mortgage insurance
1004. City property taxes
1006. County property taxes
1006
1007.
1008
1009. Aggregate Adjustment
URTUMMEW
1101. Title services and lender's title insurance (from GFE #4)
$175.00
1102. Settlement or closing fee to Bankers Closing Services, LILC $175.00
1103. Owners title insurance (it- GFE #5)
1104. Lander's title insurance
1105. Lenders title policy Jrnit
1106. owners title policy limit
1107. Agents portloo of the total Me Insurance prard..
1108. Underwriters portion of the total Cite Insurance premium
1109.
1110. Construction Draw Fee
1111. Real Estate Closing Fee
IIIZ Seller Closing Fee
1113. Recording Servicehredricallon Fee
1114. Payoff Processing Fee
1115, Wine Transfer Fee to Bankers Title, LLC
$30M
12DI. recording charges (from GFE #7)
$46.00
i 2D2. Deed M.00 Mortgage Releases $46.00
12M.-Transfartaxes (from GFE i18)
EGovemmnt
1204. Cirty/Counlytax/stamps;
V,Cd
:,
I i t -
205. State tax/stamps Deed $41.26
$41.25
_ _ W "0
.
120,6. Conservation Fee Deed $5.001
$5.00
1301. Required services that you can shop for (from GFE #6)
1302
1303.
1304.
1305.
1400. Total Settlemem Charges (enter on lines 103, Section J and .502, Section IQ
M1.00,
$7825
Iterns marked TOC'Were pald outside the closing by. Born-ir (POCK), Lender (POCL), Mortgage Broker (POCM), Other (POGO), Real Estate Agent (POCR), . seller (POM.
Previous editions we obsolete Page 3 HUD-1
CERTIFICATION:
I have ."Mlyreld—c! the HUD-1 Settement Statement and to the better my knoMed9e and belief, it Is a true and accurate statement ciell receipts and disbursements
made on my account a bymein this transaction.I fudhercarttlythat I nave 1—Wed a copy of HUD1 Settlement Statement. The Settlement Agent does rid —manta
present the acoumry of Information provided by any party, including Information emcaming POC Items and informed., supplied by the lender In this tmnsactlon eppeadng on
this HUD-1 Settlement Statement penelning to 'Comparison of Good Felth Estimate (GFE) and HUO-i Charges' and'Lo0n rims", end the parties led harmless the
Setlement Agent as to any inaccuracies in such matters.
Flelctstme amity Hanes, Ine. CI ofAlbertAle
7oiFe best'�f>7yknpWledge. the HU61 SettlemenFrSteternenj Whlrh I have prepared Is a true and accurate account Oche fund Wero recdxd end have been a will be
d sbursed b e urriers Qnedxs pair oWhe settlement of Ihlisft—dloh.
�..lesslpe Wdb
WARNNG Itis a crime to knoMngly make false slelemants to the United States on this or any other similar form, penalties upon comlctw can include a fine and
imprisonment. For details we: Title 18: U.S. Ced, $action 1001 and,96ction 1010.
Previous editions are obsolete Page 4 HUD1
5/28/2015 6:30:21 PM File Number: 15.290.00350C
CERTIFICATION:
I have carefully reviewed the HUD-1 Settlement 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 HUD-1 Settlement Statement. The Settlement Agent does not warrant or
represent the accuracy of information provided by any party, including information concerning POC items and information supplied by the lender in this transaction appearing on
this HUD-1 Settlement Statement pertaining to "Comparison of Good Faith Estimate (GFE) and HUD-1 Charges' and "Loan Terms', and the parties hold harmless the
Settlement %gantas to any inaccuracies in such matters.
Fieldstone Family Homes, Inc. City of Albertville
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 received and have been or will be
disbursedby the undersigned as part ofthe settlement of this transaction.
,, r
ssioa Wolfe Date ,
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
impr,isoninent. For details see: Title 18: U.S. Code Section 1001 and Section 1010.
e
are obsolete Page 4 HUD-1
rJ.'�).Yes4. jlt .„'�..� after: "`J ,,.,P,"y1'cYM1�S'PY 5117.yLr'N!tli .�nA'�-^%s�i '/Ft7,a^•t i1i�-.�i � .: �L?2 ��!
2,'.l�l!'n��MY'1: 1`;�1f3�`ly'i
�,il'E'. �()�efk� .r'S.'":J�`
Our origination charge # 801
$0.00
$0.00
Your creditor charge (points) for the specific interest rate chosen # 802
$0.00
$0.00
Your adjusted origination charges # 803
$0.00
$OAO
Transfer taxes # 1203
$0.00
$0.00
Government recording charges # 1201
$0.00
$46.00
#
#
#
#
i
$0.001
$46.00
$46.00 or 0.000000%
e s.
Initial deposit for your escrow account # 1001
$0.00
$0.00
Daily interest charges # 901
$0.00
$0.00
Homeowners insurance # 903
$0.00
$0.00
1 mrn Term
Your initial loan amount is
$0.00
Your loan term is
years N/A
Yourinitial interest rate is
Yourinhlalmonthly amount owed for principal, interest,
includes
and any mortgage insurance is
r Principal N/A
C Interest
Mortgage Insurance
Can your interest rate rise?
rj No� Yes, lean rise to a maximum of %. The first change will be on
and can change again everyafter . Every
change date, your interest rate can increase ordecrease by_%. Overthe
fife of the loan, your interest rate is guaranteed to never be lower than_% or
higher than _%.
Even if you make payments on time, can your loan
[_'; Nor7 Yes, it can rise to a maximum of. unknown
balance rise?
Even if you make payments on time, can your monthly
[j Nor? Yes, the first increase can be on and the monthly amount
amount owed for principal, interest, and mortgage
insurance rise?
awed can rise to
The maximum it can ever rise to is
Does your loan have a prepayment penalty?
No[ Yes, your maximum prepayment penalty is
Does your loan have a balloon payment?
Ci No[ Yes, you have a balloon payment of due in
years or
Total monthly amount owed including escrow account
You do not have a monthly escrow payment for items, such as property taxes
payments
and homeowners insurance. You must pay these items directly yourself.
'Paid by or through draws from the principal limit.
r You have an additional monthly escrow payment of
that results in a total initial monthly amount owed of . This
includes principal, interest, any mortgage insurance and any items checked below.
[-; Property fazes C Homeowner's insurance
Flood insurance
rj
Nora: Ifyouhave enyquesticns abortlha,9eW.e tCharges and Loan Terms batedon this Tam, please carted year lender.
Pmvlous editions are obsolete Page 5 HUD-1
Corporation or Partnership to Corporation
No delinquent taxes and transfer entered;
Certificate of Real Estate Value ( ) filed
( ) not required Certificate of Real Estate
Value No. 20
County Auditor
by
Deputy
STATE DEED TAX DUE HEREON: $ rr4I ( , 25
Date: May , 2015 ec r v ?t-
FORM No. 9-M
WARRANTY DEED
FOR VALUABLE CONSIDERATION, the City of Albertville, a municipal corporation under
the laws of the State of Minnesota, Grantor, hereby convey(s) and warrant(s) to Fieldstone
Family Homes, Inc. a Minnesota Corporation, Grantee, real property in Wright County,
Minnesota, described as follows:
Lot 11, Block 2, Prairie Run, Wright County, Minnesota
together with all hereditaments and appurtenances belonging thereto, subject to the following
exceptions: None.
This deed is subject to the following restrictions in favor of the City of Albertville:
a. The lowest floor elevation and lowest opening elevation of any building
constructed on said Lot 11, Block 2 shall be no lower than the following: 949 feet above
sea level for the lowest floor elevation and 953.5 feet above sea level for the lowest
opening elevation.
b. The finished grade for said Lot 11, Block 2 shall be constructed and
maintained in accordance with the grading plan attached hereto as Exhibit A.
The Seller certifies that the Seller does not know of any wells on the described real property.
13ANKERS CLOSING SERVICES LLC
350 W BURNSVILLE PICWY SUITE 400
BURNSVILLE MN 55337
(Affix Deed Tax Stamp Here)
STATE OF MINNESOTA )
) ss.
COUNTY OF WRIGHT )
CITY OF ALBE TVILLE
Jillan Hendrickson
�or
f
Kimberly -A. Olson
City Clerk
The foregoing was acknowledged before me this 9 7 day of May, 2015, by Jillian
Hendrickson, Mayor, and Kimberly A. Olson, City Clerk, on behalf of the Grantor.
NOTARIAL STAMP OR SEAL (OR OTHER TITLE OR RANY)
Tracey Lynn Nubbe
Notary Public
Minnesota
Canmiss'w Expires Jstwary 31, 2017
THIS INSTRUMENT WAS DRAFTED BY (NAME & ADDRESS)
Michael Couri
Couri & Ruppe, PLLP
P.O. Box 369
St. Michael, MN 55376
763-497-1930
SI0NATu-R5oF—PERS0N T,�KING ACKNOWLEDGMENT
Tax statements for the real property described in this
instrument should be sent to (Include name and address
of Grantee):
F
•*1 OR VWl
Jillj
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