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 2)Column L: Settlement ChargesItem 800: Items Payable In Connection With LoanItem 810: This is a fill in line {Date of Transfer can appear on this line}Item 811: This is a fill in line {Amount Realized can appear on this line}Item 1200: Government Recording and Transfer ChargesItem 1204 and 1205: These are fill in lines {FIRPTA WITHHOLDING TAX can appear on either one of these lines but in the Paid From Seller's Funds at Settlement column}