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<br />, ;' , .i!":, , " 'PURCHASER'S STATEMENT
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<br />ADDR~SS: 4JJfJ~- V 7 6-;t'Q/'/~
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<br />ij STEWART
<br />}i TITLE GUARANTY COMPANY
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<br />Date
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<br />or BORROWI:R'S STATEMENT
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<br />Escrow ofter ' ~'~P' ~
<br />CHARGES
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<br />TOT AL'CONSIDERA TION
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<br />Attorneys' Fees to -
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<br />Down.payment or.Proration of Insurance
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<br />Tax 'and J.nsurance Trust Account (For..Assl;lmption deal)
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<br />:'Tax and 'Insurance Trust Account with
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<br />Purchaser's signature here-
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<br />proval of tax prorations, and
<br />signifies Purchaser's under-
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<br />ing year, or estimates lor
<br />current year, and in the event
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