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ESCROW STATEMENT

Escrow No.________
Date______________

STATEMENT OF:___________________________

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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