This form is a standardized mortgage lending document that is used by creditors or their closing agents. The form contains an itemized list of all charges or credits to the buyer and to the seller in a consumer credit mortgage transaction. This form is most commonly used for reverse mortgages and mortgage refinance transactions.

Supported fields on this form:

• LoanNumber

• SettlementDate

• DisbursementDate

• BorrowerName_1

• BorrowerName_2

• BorrowerName_3

• BorrowerName_4

• Lender

• PropertyAddressStreet

• PropertyAddressCity

• PropertyAddressState

• PropertyAddressZipCode

• PropertyAddress2

• SettlementChargesToBorrower

• LoanAmount

• CashType

• CashAmount

• Borrower_1_Signature

• Borrower_2_Signature

• Borrower_3_Signature

• Borrower_4_Signature