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.k�."g f_SY. � .i., <br /> . �,. �'������`, <br /> ��y,.�.,�, ,��'�` , . <br /> _oie:October 18,2013 File Number�13286 <br /> du ers --------------- ------------ <br /> ELIZABETH 8 CHURCHWELL i � <br /> P O. BOX 1358 ; � <br /> �ADE CITY FL 33526 � <br /> � <br /> SeHers — - - - --- -�-- — <br /> DEBBIE L.SOEILNER � � , AUGUST JOHN SOELLNER <br /> -------�._-------------—--------- <br /> 38446 18TH AVE <br /> ZEPHYRHlLIS,F{orida 33542 , <br /> Pro Acldresses <br /> 38446 4$TI-f AVE � <br /> ZEPHYRHILLS, Florida 33542 ; <br /> I have carefuily reviewed the HUD-1 Settlement Statement,and to the best of my knowiedge and belief,it is a true and accurate statement of all <br /> 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 <br /> 5tatemeni. Substitute For 1099 Se�er Skatement: The information contained herein is important tax information and is being furnisheti to the Intemal <br /> Revenue Service. If you are required to f�e a reh►m,a negligenc;e penalty or other sanction will be imposed on you if tlhis item is required to be <br /> reported and the IRS detertnines that it has nat been r�eported. <br /> Pursuant to Florida Administrative Code 690-186.E110,the undersgned agrees arn!understands that in order to reduce the overall costs of title <br /> insurance and other rviCes retated hereto,that atl interest inctxne,Aany eamed oR the disbursement account shall be retained by the Title Insurance <br /> Agent. ����'" <br /> �"_~ r � } '' <br /> / ,> ; � Lr� <br /> Buyer EL H `� Selle ��������--- <br /> C URCHWEL� DEBBIE l.50ELLNER <br /> /Y <br /> Seller � <br /> A US OHN S LNERi <br /> Seller. <br /> The HUD-1 Seu�ement Statement which I have prepared is a true and accurate account of this uansaction. I have cawsed ar will cause the funds ta be <br /> disbursed a�a�cordance with the instructions o the paRies hereto. <br /> Settlement Agent ��_ / Date. October 18,2013 <br /> _.-�f�sey-6ca€fui .!',�r.,,,, �.��......,�{f�- <br /> WARNlNG. !t is a crirt�e to knowingly make false statements to the United States on this or any other simlar form. Penalties upon conviction can <br /> include a fine aM imprisonment. For details see Title 18 U.S.Code Section 1 QQ1 and SectioR 1010. <br /> ;�; <br />