This exhibit displays a blank Form HUD-1, Settlement Statement. The following are the key fields which the tax examiner will focus on.Form HUD-1, Settlement Statement (Page 1)Box D: Name and Address of Borrower {TRANSFEREE}Box E: Name and Address of Seller {TRANSFEROR}Box G: Property Location {UNITED STATES REAL PROPERTY INTEREST (USRPI)}Box I: Settlement Date {DATE OF TRANSFER}Column J: Summary of Borrower's TransactionItem 100: Gross Amount Due from BorrowerItem 101: Contract Sales Price {AMOUNT REALIZED}Column K: Summary of Seller's TransactionItem 400: Gross Amount Due To SellerItem 401: Contract Sales Price {AMOUNT REALIZED}Item 500: Reductions In Amount Due To SellerItem 502. Settlement charges to seller (line 1400) {FIRPTA withholding tax may be rolled up in this line that was transferred from line 1400}Item 506, 507, 508 and 509: These are fill in lines {FIRPTA WITHHOLDING TAX can appear on either one of these lines}