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Loan Number Settlement Statement C. Note: 8. Mortgage Ins. Case No. 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 ("POC") were paid outside the closing: they are shown here for information purposes and are not included in the totals. D. Name of Borrower: E. Name of Seller: F. Name of Lender: G. Property Location: H. Settlement Agent: Residential Title & Escrow Company (410) 653-3400 TIN: Place.

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