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P74 LowryPROJECT 07 -08; Keystone Parkway 131 Street PARCEL 74 COUNTY Hamilton CODE N/A NAME ADDRESS OF OWNER Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 NAME ADDRESS OF PERSON CONTACTED Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 (List other interested parties on reverse side including nature of their interest) DATE ASSIGNED 6/30/09 DATE OF CONTACT 7/8/09 TIME OF CONTACT OFFER 135,000.00 TYPE OF CONTACT: PERSONAL VISIT, (X) TELEPHONE CALL, (X) MAIL Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space: 1. YES Checked Abstract with owner? 2. N/A Any affidavits taken? 3. NO Any mortgage(s)? 4. NO Any other liens, judgments, etc.? 5. N/A Showed plans? Explained take? 6. N/A Explained about retentions? 7. N/A Any major item retained? 8. N/A Any minor item retained? 9. N/A Walked over property? 10. N/A Arranged for owner to pay taxes? 11. NO Secured Right -of -Entry? 12. N/A Secured Driveway Right -of -Entry? REMARKS: I telephoned the number provided within the appraisal report and spoke with Ms. Lowry. I explained that I am assisting the City of Carmel with the acquisition phase of the Keystone /131st Street project. I conjunction with the project I need to present an offer to purchase the needed right -of -way. Ms. Lowry was aware that the proposed right -of -way will entail the purchase of her entire property, including the dwellinq. I provided the option to meet for the presentation of the offer or it could be mailed. She preferred that the offer be mailed and confirmed ownership and mailing address. Consequently, the offer and related information were mailed via "Certified mail, Return Receipt Requested on July 9, 2009, with a date of delivery on July 10, 2009. Included within the packet were the following forms /documents: an introductory letter, the Statement of the Basis for Just Compensation, a copy of the Appraisal Report, the Uniform Property or Easement Acquisition Offer letter, the Warranty Deed with Limitation of Access with Exhibits "A" and "B the Sales Disclosure Forms, the Accounts Payable Voucher, the Request for Taxpayer Identification Number and Certification (Form W -9), the Retention of Ownership (Fixtures and Parts) Form, the Disclosure of Lead Based Paint Form, the form, "Owner's Private Appraisal Letter and the Status of Parcel: Secured, Condemned, -Other (Explain) Distribution Made: (X) Parcel Attorney (X) Owner Other (Specify) Weekly Summary State Form 2601 (R2/3 -91) CITY OF CARMEL BUYER'S REPORT (1) PHONE 317.846.0464 3:00 pm 13. N/A Sent Daily Notice to Relocation Section? 14. NO Secured W -9 Form? LEFT FOLLOWING PAPERS WITH OWNERS: MAILED 15. YES Written Offer? 16. N/A Land Acquisition Brochure? 17. YES Retention Letter? 18. YES Statement of Just Compensation? 19. N/A Tax memo (interim period)? 20. N/A Receipt of Conveyance Instrument? 21. YES Copy of Conveyance Instrument? 22. YES Owner's Appraisal Letter? 23. N/A Brochure, "Relocation You Si n at re El a, Srk_ izabeth g lizabeth A. Sullivan Page 1 of 2 State Form 20625 (R/5 -90) BUYER'S REPORT (1) PROJECT 07 -08; Keystone Parkway 131s Street PARCEL 74 COUNTY Hamilton CODE N/A REMARKS (Cont'd): Right of Entry. The Uniform Property or Easement Acquisition Offer letter, in accordance with I.C. 32- 24 -1 -5, provides only 30 days from its receipt to accept or reject the City's offer. The 30 days may be waived and the offer accepted or rejected now or at anytime during this period. It was also indicated that the legally protected rights and options under Indiana's eminent domain law are set forth on page two of the Uniform Property or Easement Offer Letter. It was explained that typically, the City makes payment within 90 days after receiving the secured parcel file from the consultant and Indiana law dictates that possession of the property will transfer to the City thirty (30) days after payment is received. The introductory letter mailed in conjunction with the offer explained that the project is to improve N. Keystone Parkway and 131S Street. More specifically, the subject property is required as permanent right -of -way with full limitation of access. The permanent (fee simple) right -of- way with full limitation of access, known as Parcel 74, contains 3,851 square feet. The remaining area being acquired, known as Parcel 74A, contains 10,179 square feet and includes dwelling. As explained in the form, "Owner's Private Appraisal Letter the Ms. Lowry may submit an independent appraisal for review at her own expense. The forms /documents requiring signatures and notarization were indicated. Ms. Lowry was encouraged to call with any questions or to schedule an appointment. 7/� -►Joy (Signat re) Elizabeth A. Sullivan Date Distribution Made: (X) Parcel (X) Owner Weekly Summary State Form 2601 (R2/3 -91) Attorney Other (Specify) CITY OF CARMEL BUYER'S REPORT (2) PROJECT 07 -08; Keystone Parkway 131s Street PARCEL 74 COUNTY Hamilton CODE N/A NAME ADDRESS OF OWNER Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 NAME ADDRESS OF PERSON CONTACTED Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 (List other interested parties on reverse side including nature of their interest) DATE ASSIGNED 6/30/09 DATE OF CONTACT 714/09 TIME OF CONTACT 10:00 am OFFER 135,000.00 TYPE OF CONTACT: PERSONAL VISIT, (X) TELEPHONE CALL, (X) MAIL Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space: 1. N/A Checked Abstract with owner? 13. N/A Sent Daily Notice to Relocation Section? 2. N/A Any affidavits taken? 14. NO Secured W -9 Form? 3. NO Any mortgage(s)? 4. NO Any other liens, judgments, etc.? 5. N/A Showed plans? Explained take? 6. N/A Explained about retentions? 7. N/A Any major item retained? 8. N/A Any minor item retained? 9. N/A Walked over property? 10. N/A Arranged for owner to pay taxes? 11. NO Secured Right -of -Entry? 12. N/A Secured Driveway Right -of -Entry? LEFT FOLLOWING PAPERS WITH OWNERS: 15. N/A Written Offer? 16. N/A Land Acquisition Brochure? 17. N/A Retention Letter? 18. N/A Statement of Just Compensation? 19. N/A Tax memo (interim period)? 20. NO Receipt of Conveyance Instrument? 21. N/A Copy of Conveyance Instrument? 22. N/A Owner's Appraisal Letter? 23. N/A Brochure, "Relocation You REMARKS: I telephoned Ms. Lowry in response to a message she had left. She requested a copy of the second appraisal, which was later provided to her for review. Status of Parcel: Secured, Condemned, -Other (Explain) Q- (Signature) Elizabeth A. Sullivan Page 1 of 1 Distribution Made: (X) Parcel (X) Owner Weekly Summary State Form 2601 (R2/3 -91) Attorney Other (Specify) CITY OF CARMEL BUYER'S REPORT (3) PROJECT 07 -08; Keystone Parkway 131s Street PARCEL 74 COUNTY Hamilton NAME ADDRESS OF OWNER Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 NAME ADDRESS OF PERSON CONTACTED Jack G. Hittle, CHURCH, CHURCH, HITTLE ANTRIM 938 Conner Street, P.O Box 10, Noblesville, IN 46061 PHONE 317.773.5320 (List other interested parties on reverse side including nature of their interest) DATE ASSIGNED 6/30/09 DATE OF CONTACT 7/16/09 TIME OF CONTACT N/A 4. NO Any other liens, judgments, etc.? 5. N/A Showed plans? Explained take? 6. N/A Explained about retentions? 7. N/A Any major item retained? 8. N/A Any minor item retained? 9. N/A Walked over property? 10. N/A Arranged for owner to pay taxes? 11. NO Secured Right -of -Entry? 12. N/A Secured Driveway Right -of- Entry? OFFER 135,000.00 TYPE OF CONTACT: PERSONAL VISIT, TELEPHONE CALL, (X) E -MAIL Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space: CODE N/A 1. N/A Checked Abstract with owner? 13. N/A Sent Daily Notice to Relocation Section? 2. N/A Any affidavits taken? 14. NO Secured W -9 Form? 3. NO Any mortgage(s)? LEFT FOLLOWING PAPERS WITH OWNERS: 15. N/A Written Offer? 16. N/A Land Acquisition Brochure? 17. N/A Retention Letter? 18. N/A Statement of Just Compensation? 19. N/A Tax memo (interim period)? 20. NO Receipt of Conveyance Instrument? 21. N/A Copy of Conveyance Instrument? 22. N/A Owner's Appraisal Letter? 23. N/A Brochure, "Relocation You REMARKS: I received a letter from Mr. Jack Hittle with Church, Church, Hittle Antrim dated July 16 He stated that he would be representing Ms. Wanda Lowry. He will be reviewing the offer and related documents and will provide a response. 8/25/09 (2:00 pm) Mr. Hittle forwarded a letter and counter via e-mail. He stated that Ms. Lowry would accept $162,500.00, which is an additional $27,500.00. Mr. Hittle provided support from a real estate agent, Thomas E. Kenley, which reportedly is knowledgeable about values in the area. He also stated that Ms. Lowry is looking for another home, but has not found one as of yet. He also requested that Ms. Lowry be allowed to stay in her home until December 1 I forwarded her request to the City for consideration. Status of Parcel: Secured, Condemned, -Other (Explain) (Signature) Elizabeth A. Sullivan Page 1 of 1 PROJECT 07 -08; Keystone Parkway 131 Street PARCEL 74 COUNTY Hamilton CODE N/A NAME ADDRESS OF OWNER Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 NAME ADDRESS OF PERSON CONTACTED Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 (List other interested parties on reverse side including nature of their interest) DATE ASSIGNED 6/30/09 DATE OF CONTACT 8/27/09 TIME OF CONTACT 3:15 pm OFFER 135,000.00 TYPE OF CONTACT: PERSONAL VISIT, (X) TELEPHONE CALL, MAIL Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space: 1. N/A 2. N/A 3. NO 4. NO Any other liens, judgments, etc.? 5. N/A Showed plans? Explained take? 6. N/A Explained about retentions? 7. N/A Any major item retained? 8. N/A Any minor item retained? 9. N/A Walked over property? 10. N/A Arranged for owner to pay taxes? 11. NO Secured Right -of -Entry? 12. N/A Secured Driveway Right -of- Entry? REMARKS: Ms. Lowry telephoned. I explained that the City has not made a decision regarding her counter, but that I will contact her and her attorney, Mr. Hittle, once a decision has been made. She stated that she is concerned about finding a home. Status of Parcel: Secured, Condemned, -Other (Explain) Distribution Made: (X) Parcel (X) Owner Weekly Summary State Form 2601 (R2/3 -91) Checked Abstract with owner? Any affidavits taken? Any mortgage(s)? Attorney Other (Specify) CITY OF CARMEL BUYER'S REPORT (4) 13. N/A Sent Daily Notice to Relocation Section? 14. NO Secured W -9 Form? LEFT FOLLOWING PAPERS WITH OWNERS: 15. N/A Written Offer? 16. N/A Land Acquisition Brochure? 17. N/A Retention Letter? 18. N/A Statement of Just Compensation? 19. N/A Tax memo (interim period)? 20. NO Receipt of Conveyance Instrument? 21. N/A Copy of Conveyance Instrument? 22. N/A Owner's Appraisal Letter? 23. N/A Brochure, "Relocation You a (Signature) Elizabeth A. Sullivan Page 1 of 1 CITY OF CARMEL BUYER'S REPORT (5) PROJECT 07 -08; Keystone Parkway 131s` Street PARCEL 74 COUNTY Hamilton NAME ADDRESS OF OWNER Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 CODE N/A NAME ADDRESS OF PERSON CONTACTED Jack G. Hittle, CHURCH, CHURCH, HITTLE ANTRIM 938 Conner Street, P.O Box 10, Noblesville, IN 46061 PHONE 317.773.5320 (List other interested parties on reverse side including nature of their interest) DATE ASSIGNED 6/30/09 DATE OF CONTACT 9/18/09 TIME OF CONTACT 10:00 am OFFER 155,000.00 TYPE OF CONTACT: PERSONAL VISIT, TELEPHONE CALL, (X) E -MAIL Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space: 1. N/A 2. N/A 3. NO Checked Abstract with owner? Any affidavits taken? Any mortgage(s)? 4. NO Any other liens, judgments, etc.? 5. N/A Showed plans? Explained take? 6. N/A Explained about retentions? 7. N/A Any major item retained? 8. N/A Any minor item retained? 9. N/A Walked over property? 10. N/A Arranged for owner to pay taxes? 11. YES Secured Right -of -Entry? 12. N/A Secured Driveway Right -of -Entry? Distribution Made: (X) Parcel Attorney (X) Owner Other (Specify) Weekly Summary State Form 2601 (R2/3 -91) 13. N/A Sent Daily Notice to Relocation Section? 14. YES Secured W -9 Form? LEFT FOLLOWING PAPERS WITH OWNERS: 15. N/A Written Offer? 16. N/A Land Acquisition Brochure? 17. N/A Retention Letter? 18. N/A Statement of Just Compensation? 19. N/A Tax memo (interim period)? 20. N/A Receipt of Conveyance Instrument? 21. N/A Copy of Conveyance Instrument? 22. N/A Owner's Appraisal Letter? 23. N/A Brochure, "Relocation You REMARKS: Mr. Jack Hittle inquired if the City had provided a response to Ms. Lowry's counter. He stated that Ms. Lowry had found a house and had put on offer on it, which is to expire on September 21s 9/21/09 (7:00 pm) The City provided a counter in response to Ms. Lowry's counter. They approved an additional $8,000 in compensation for her property, bringing the total value to $143,000 and she can stay in the home until December 1s Mr. Hittle responded stating that the counter was not acceptable and that Ms. Lowry had spoken directly with Mayor James Brainard. Mayor Brainiard had approved $155,000.00 plus $10,000.00 for relocation expenses. That was later confirmed and the revised forms /documents were forwarded for signature /notarization. The documents were promptly returned fully executed. These forms were forwarded to the City and Chicago Title to prepare for a closing. Status of Parcel: Secured, Condemned, -Other (Explain) (Sian urel Elizabeth ure) Elizabeth A. Sullivan Page 1 of 1 PROJECT 07 -08; Keystone Parkway 131s Street PARCEL 74 COUNTY Hamilton CODE N/A NAME ADDRESS OF OWNER Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 PHONE 317.846.0464 NAME ADDRESS OF PERSON CONTACTED Wanda L. Lowry 810 Main Street East, Carmel, IN 46032 (List other interested parties on reverse side including nature of their interest) 1. N/A 2. N/A 3. NO 4. NO Any other liens, judgments, etc.? 5. N/A Showed plans? Explained take? 6. N/A Explained about retentions? 7. N/A Any major item retained? 8. N/A Any minor item retained? 9. N/A Walked over property? 10. N/A Arranged for owner to pay taxes? 11. N/a Secured Right -of -Entry? 12. N/A Secured Driveway Right -of -Entry? Distribution Made: (X) Parcel Attorney (X) Owner Other (Specify) Weekly Summary State Form 2601 (R2/3 -91) Checked Abstract with owner? Any affidavits taken? Any mortgage(s)? CITY OF CARMEL BUYER'S REPORT (6) PHONE 317.846.0464 DATE ASSIGNED 6/30/09 DATE OF CONTACT 10/13/09 TIME OF CONTACT 11:00 am OFFER 155,000.00 TYPE OF CONTACT: (X) PERSONAL VISIT, (X) TELEPHONE CALL, MAIL Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space: 13. N/A Sent Daily Notice to Relocation Section? 14. N/A Secured W -9 Form? LEFT FOLLOWING PAPERS WITH OWNERS: 15. N/A Written Offer? 16. N/A Land Acquisition Brochure? 17. N/A Retention Letter? 18. N/A Statement of Just Compensation? 19. N/A Tax memo (interim period)? 20. N/A Receipt of Conveyance Instrument? 21. N/A Copy of Conveyance Instrument? 22. N/A Owner's Appraisal Letter? 23. N/A Brochure, "Relocation You REMARKS: Ms. Lowry, her realtor, Dolly Austin, and I met at Chicago Title offices. The closing was completed and all forms were signed. Chicago Title will be responsible for forwarding a check to the Treasurer's office to pay the Fall 2008 taxes due in 2009. The property taxes were prorated to the day of closing and thus the City was credited for 1/1/09 10/13/09 property taxes. Status of Parcel: (X)- Secured, Condemned, -Other (Explain) (Sign"ature) Elizabeth A. Sullivan Page 1 of 1 Note to file: Lowry property Keystone at Main 810 East Main Street On October 12 our office received a HUD statement for closing on above property. This HUD statement contained language on page two line 1305- 1306 regarding taxes for 2009 pay 2010. The tax amount was increased by 25% per mike McBride and we were paying Midwest Title $325 to hold in escrow until the taxes were due in June of 2010. Because Ms. Lowry has been debited the portion of these taxes that she owes and the city credited this amount it is not necessary to have this money held in escrow. The city will owe these taxes. A. CHICAGO TITLE INSURANCE COMPANY CLOSER: Gina Y. McKeon DATE OF PRINTING: 10/13/09 TIME OF PRINTING: 07:27 SETTLEMENT HOUSING STATEMENT URBAN DEVELOPMENT U.S. DEPARTMENT B. TYPE OF LOAN 1. FHA 2. FmHA 3.0 CONV. UNINS. 4• VA 5. El CONV INS. 6. File Number: 424820 TLW 000424820 -001 GYM CFS 7. Loan Number 8. Mortgage Insurance Case Number C. NOTE This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items marked "(p.o.c.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME OF BORROWER: City of Carme I Indiana ADDRESS: One Civic Square Carmel Indiana 46032 E. NAME OF SELLER: Wanda L. Lowry ADDRESS: 810 E. Main Street Carmel Indiana 46033 F. NAME OF LENDER: None ADDRESS: G. PROPERTY LOCATION: 810 E Main Street Carmel Indiana 46033 H. SETTLEMENT AGENT: CHICAGO TITLE INSURANCE COMPANY ADDRESS: 6925 E. 96th St Suite 100 Indianapolis Indiana 46250 PLACE OF SETTLEMENT: 6925 E 96th St Su i to 100 ADDRESS: Indianapolis Indiana 46250 I. SETTLEMENT DATE: October 13, 2009 DISBURSEMENT DATE: October 13, 2009 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 101. Contract sales price 155 000.00 401. Contract sales price 155,000.00 102. Personal Property 402. Personal Property 103. Settlement charges to borrower (line 1400) 970.00 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106. City /town taxes to 406. City /town taxes to 107 County taxes to 407. County taxes to 108. Assessments to 408. Assessments to 109 No Mandatory HOA Dues Hold Harmless 409. No Mandatory HOA Dues Hold Harmless 110. 410. 111. 411. 112. 412. 120. GROSS AMT DUE FROM BORROWER 1 55 970.00 420. GROSS AMT DUE TO SELLER 155,000.00 200. AMOUNTS PAID BY OR IN BEHALF OF BORROWER 500. REDUCTIONS IN AMOUNT DUE TO SELLER: 201. Deposit or earnest money 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 502. Settlement charges to seller (line 1400) 203. Existing loan(s) taken subject to 503. Existing loan(s) taken subject to 504. Payoff of first mortgage loan No Mortgage Lien of Record 204. 205. 505. Payoff of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. City /town taxes to 510. City /town taxes to 211. County taxes 01/01/09 to 10/13/09 434 511. County taxes 01/01 to 10/13/09 434.26 212. Assessments to 512. Assessments to 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519. 220. TOTAL PAID BY /FOR BORROWER 434.26 520. TOTAL REDUCTIONS AMT DUE SELLER 434.26 300. CASH AT SETTLEMENT FROM /TO BORROWER 600. CASH AT SETTLEMENT TO /FROM SELLER 301. Gross amt due from borrower (line 120) 1 55 97f) 601. Gross amt due to seller fine 420) 155,000.00 302. Less amts paid by /for borrower (line 220) 434.26) 602. Less reductions in amt due seller (line 520) 434.26) 303. CASH( 51 FROM) TO) BORROWER 155, 535.74 603. CASH(® TO) (p FROM) SELLER 154, 565.74 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 the HUD -1 Settlement Statement. Borrower Seller City of Carmel, Indiana Wanda L. Lowry 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 disbursed by the undersigned as part of the settlement of this transaction. Settlement Agent 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 imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. GYM OMB No. 2502 -0265 Page 1 HUD -1 (3/86) RESPA, HB 4305.2 2 /ABS# 000424820 GYM CFS L. SETTLEMENT CHARGES DATE OF PRINTING 1 700. TOTAL SALES /BROKER'S COMMISSION based on price 5 155,000.00 44= PAID FROM BORROWER'S FUNDS AT SETTLEMENT PAID FROM SELLER'S FUNDS AT SETTLEMENT Division of Commission (line 700) as follows: 701. LB: to None 702. SB: to None 703. Commission paid at Settlement (Money retained by broker applied to commission 704. Other sales agent charges: 705. Additional commission: to 800. ITEMS PAYABLE IN CONNECTION WITH LOAN 801. Loan Origination Fee 802. Loan Discount 803. Appraisal Fee to 804. Credit Report to 805. Lender's Inspection Fee to 806. Mortgage Insurance Application Fee to 807. Assumption Fee to 808. 809. 810. 811. 812. goo. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901. Interest from to /day for 0 days 902. Mortgage Insurance Premium for 0.00 months to 903. Hazard Insurance Premium for 0.00 years to 904. 905. 1000. RESERVES DEPOSITED WITH LENDER 1001. Hazard insurance 0.00 month per month 1002. Mortgage insurance 0.00 month @S per month 1003. City property taxes 0.00 month per month 1004. County property taxes 0.00 month per month 1005. Annual assessments 0.00 month per month 1006. 000 month per month 1007. 0.00 month per month 1008. Aggregate Accounting Adjustment 0 00 0 00 1100. TITLE CHARGES 1101. Settlement or Closing Fee to CT IC /MC 200.00 1102. Abstract or title search to 1103. Title examination to 1104. Title insurance binder to 1105. Document preparation to 1106. Notary fees to 1107. Attorney's fee to 1108. Title insurance 10 CT IC 680.00 (includes above items numbers:) 1102 1103 1109. Lender's coverage 0.00 1110. Owner's coverage 155,000 .00 680.00 1111. TIEFF- Title Insurance ENF Fund Fee to 1001 c/o CTIC 5.00 1112. Del ivery Fee to CTIC 25.00 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed 20.00 Mortgage Release 20.00 1202. City /county tax /stamps: Deed Mortgage 1203. State tax /stamps: Deed Mortgage 1204. Sales Di sclosure Fee to County Auditor 15.00 1205. 1300. ADDITIONAL SETTLEMENT CHARGES 1301. Survey to NONE 1302. Pest inspection to 1303. Recording Service Fee to 1ST 25.00 1304. May Nov. 08/09 Taxes to Hamilton County are PAID 1305. 1306. 1307. 1400. TOTAL SETTLEMENT CHARGES (enter on lines 103, Section J and 502, Section K) 970.00 I have carefully reviewed the HUD -1 Settlement Statement and to the best of my knowledge and belief, it is a true and accurate sta ement 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 the HUD -1 Settlement Statement. Borrower Seller City of Carmel, Indiana Wanda L. Lowry 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 disbursed by the undersigned as part of the settlement of this transaction. Settlement Agent Date WARNING: 1 is a crime to knowingly make false statement to the United States on this or any other similar torte. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S. Code Section 1001 and Section 1010. GYM F- 2857 -01 4/80 Page 2 OMB No. 2502-0265 HUD -1 (3/86) RESPA, HB 4305.2 920 CITY OF CARMEL, INDIANA ONE CIVIC SQUARE CARMEL, INDIANA 46032 CITY OF CARMEL, INDIANA ONE CIVIC SQUARE CARMEL, INDIANA 46032 4470502 CITY OF CARMEL, INDIANA ONE CIVIC SQUARE CARMEL, INDIANA 46032 PAY 1O !Qi ORE r O WANDY LOWRY .der Of VCNUVM: VENDOR: WANDY LOWRY t :PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER 4470502 WANDY LOWRY REMITTANCE ADVICE DETACH AND RETAIN FOR YOUR RECORDS APPROVED BY THE STATE BOARD OF ACCOUNTS FOR THE CI OF CARMEL 2002 PAYABLE AT FIFTH THIRD BANK INDIANAPOLIS, INDIANA rage 1 OT 1 CHECK AMOUNT: $10,000.00 CHECK NUMBER: 178473 CHECK DATE: 10/20/2009 AMOUNT DESCRIPTION 10000.00 MOVING EXPENSES DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION Page 1 of 1 CHECK AMOUNT: $10,000.00 CHECK NUMBER: 178473 CHECK DATE: 10/20/2009 10000.00 MOVING EXPENSES CHECK NO. 71 -859 178473 749 DATE: 10/20/2009 GENERALACCOUN4 AMOUNT X:. $1o,000.00 O co THIS WARRANT IS VOID IWO (2) YEARS AF TER DECEMBER 31 OF THE YEAR OF ISSUE