Instructions: Please complete the shaded areas of the form.

Company:
Prepared By:
Seller Name:
Property Address:
Purchase Price		$
Closing Date		(mm/dd/yyyy)
Error, the date must be valid and in the MM/DD/YYYY format
Real Estate Commission (enter value as a percent)			%
Transaction Fee		$
Estimated Payoff #1		$
Estimated Payoff #2		$
Prior Year Tax Amount		$
Prior Year CDD Fees		$
Home Warranty Fee		$
Survey Fee		$
Seller Paid Closing Costs		$
Additional Seller Fee	Description:	$
Additional Seller Fee	Description:	$
Closing Fee		$
Search Fee		$
Title Insurance		$
Real Estate Commission		$
Documentary Stamp Tax		$
Tax Proration		$
CDD Proration		$
Total Closing Costs		$
Total Cash To/From Seller		$

* This total is an estimate and should not be used as a final closing cost figure.