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- Escrow No.________
- Date______________
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- STATEMENT OF:___________________________
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- DEBITS CREDITS
- Deposits___________________________________________________
- Loan Proceeds___________________________________________
- Demand for Deed and/or Note________________________________
- Interest___________________________________________________
- Prepayment Bonus___________________________________________
- Forwarding Fee_____________________________________________
- ___________________________________________________________
- Pro Taxes_________________________________________________
- Rata Insurance_____________________________________________
- Commission_________________________________________________
- ___________________________________________________________
- ___________________________________________________________
- Mechanic's Lien Search_____________________________________
- Title Company's Charge_____________________________________
- Reconveyance Fee___________________________________________
- Recording Deed of Trust____________________________________
- Recording Reconveyance_____________________________________
- Recording Deed_____________________________________________
- ___________________________________________________________
- ___________________________________________________________
- Taxes______________________________________________________
- Special Assessments________________________________________
- Insurance__________________________________________________
- ___________________________________________________________
- Tax and Assessment Service_________________________________
- Impounds___________________________________________________
- Fee for Drawing Documents__________________________________
- Credit Report______________________________________________
- Appraisal Fee______________________________________________
- Advance Reconveyance Fee___________________________________
- Office Charge and Inspection Fee___________________________
- ___________________________________________________________
- Deposited to the account of________________________________
- Check Herewith_____________________________________________
- Balance due ____________________________________________
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