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) Selling Office (FMLS Broker Code) Selling Agent Name (mm/dd/yyyy ) (mm/dd/yyyy ) Binding Agreement Date (Contract Acceptance Date) Closing Date CLOSING COSTS PAID BY SELLER FMLS will compute this number by totaling amounts from settlement docs that are indicated as being closing costs paid by seller. $ Sold Price Lender Mediated (Check one): Yes No Check 'Yes' if the former lender had to approve final sales price (i.e. short sales & foreclosures). If neither box is checked, FMLS will d.

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