General Information. Residential Land/Boat Docks. Min SqFt Liv Area Restr. : # of Parcels : County : See Table. For Lease : Yes No.

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1 Residential Land/Boat Docks INSTRUCTIONS: Area: Street Number: CP : Street Name: Compass Point County : See Table Folio # : Folio # for 2nd Parcel : City: See Table State: FL Zip Code Zip4 Legal Zoning Lot : Municip Code : Township/Range: Section: Subdivision Code Parcel Number: Map Coordinates: Development Name: Subdivision Name : Geo Area: See Table General Information Short Sale: Yes No Lender Approval : Approved REO: Yes No req d if Short Sale = Yes Unapproved $ Per Acre : $ Style: B96 Zoned Boat Dock Select One V90 Zoned Residential V91 Zone Duplex V92 Multifamily Type: Dockominium Other Residential Range Price: Range Price List Price: $ Lower List Price: $ Required if Range Price Listing County Land Use : Types of Usage : Select Up To 2 Agriculture Recreation Groves Unused Check Land Use Plan Wooded Other Use Approx Lot Size : Total Acreage : Lot SF : Building Includes : Select Up To 2 Barns Other Building Incl Horstall Run Down Livable Utility Building None Well Kept # of Parcels : For Lease : Yes No Min SqFt Liv Area Restr. :

2 General Information Development Info: Select Up To 2 Other Development Included Recorded Plat Undeveloped Unrecorded Plat Rail Type : Select Up To 2 Mainline No Rail Service Siding Spur Land Fill : Select Up To 2 Must De-Muck Must Fill Grade Fill Not Required Fill Unknown Location : Select Up To 4 City Location Lake Worth Corner Location Near Airport County Location Near Business Park Cul-De-Sac Location Near Industrial Park Dead-End Location Near School Lot Located n a Flood Zn Near Seaport Golf Course Location Other Location Inside Location Road Surface : Select Up To 3 Dirt Road Gravel Lime Rock Road Paved Road Road : Select Up To 3 Legal Access Road Paved Road City/County Maintained Private Road No Road Access Public Road Other Road Trees : Select Up To 3 Avocado Mostly Cypress Brazilian Pepper Mostly Oaks Citrus Mostly Pines Clusters No Trees Heavily Wooded Other Trees Mango Partial Tree Coverage Mangroves Sable Palm Ground Cover : Select Up To 3 Brush Other Ground Cover Exotics Palmetto Grass/Pasture Weeds Marsh Waterfront : Yes No Elevation :Select One Lot Description : Select Up To 3 0 to 1/4 Acr 4 to 5 Acr Golf Course Lot 1/4 to 1/2 Acr 5 to 10 Acr Interior Lot 1/2 to 3/4 Acr 10+ Acr Irregular Lot 3/4 to 1 Acr Corner Other Lot Descript. 1 to 2 Acr Cul-De-Sac Lot Oversized Lot 2 to 3 East of US 1 Regular Lot 3 to 4 Flood Zone Lot West of US 1 Zero Lot Line Lot Waterfront Description: req d if Waterfront = Yes Select up to 4 Bay Intracoastal Front Ocean Front Canal Front Lagoon Front One Fixed Bridge Creek Front Lake Front Other Waterfront Canal Wdth1-80 Lake Access Point Lot Canal Width 121 Mangrove Front Pond Front Canal Wdth Navigable Rip Rap Fixed Bridge(s) No Fixed Bridges River Front Intersecting Canal Ocean Access Seawall Water Access : req d if Waterfront = Yes Select up to 4 Deeded Beach Access Boat Hoists/Davits Boatift None Boatlock Other Community Boat Dock Private Dock Community Boat Ramp Restricted Salt Water Access Deeded Dock Unrestricted Salt Water Access Dock Available Water View Select Up To 2 Bay View None Canal View Ocean View Direct Ocean View Other Water View Lagoon View Pond View Lake View River View Waterfront Frontage :

3 Remarks Remarks : 510 Characters Directions : 255 Characters Broker Remarks : 250 Characters Internet Remarks : 150 Characters

4 Additional Information Terms Available : Subdivision Information : Select Up To 7 Buyer Approval Required Mandatory HOA Covenant Restrictions Community Pool Golf Course Committee Subdivision Restrictions Gate Guarded Community Tennis Courts Horses Permitted Voluntary HOA Boat Dock Information : Select Up To 5 Electric Available Phone Available Living Aboard Permitted Pump Available None Restroom Facilities Other Dock Information Subject To Lease Parking Water Available Length Dock Will Accommodate : Select One 0-20 Foot Boat Foot Boat Foot Boat Foot Boat Foot Boat Foot Boat Foot Boat Foot Boat Foot Boat More Than 100+ Foot Boat Misc/Improvements : Select Up To 7 Above Ground Irrigation Gutter Alley No Misc/Improvements Build To Suit Other Cleared Partially Filled Compact Soil Septic Curb Sidewalk De-Mucked Sprinklers Drainage Canal Street Lights Drip System Well Fenced Waterfront Bulkhead Filled Documents Available : Select Up To 7 Abstract Other Documents Available Aerial Photo Perc Test Appraisal Plans Available Building Permit Plat Map Bore Test Previous Title Policy Deed Restrictions Subdivision Requirements Engineering Studies Survey Available Environmental Impact Studies Topography Map Copies of Lease(S) Deed Restrictions : Select Up To 4 Call Listing Office County No Deed Restrictions Deed Restrictions on Record Other Deed Restrictions Subdivision Deed Restrictions Soil Type : Select Up To 2 Clay Other Soil Type Dirt Rock Land Mari Sand Marsh/Mangrove Sandy/Loam Muck Utilities Available : Select Up To 7 Cable TV Phone Line Electric Sewer Gas Trash Removal Irrigation Water Underground Utilities No Utilities Water Other Utilities Avail Utilities On Site : Select Up To 7 Cable Tv Phone Line Electric Sewer Gas Underground Utilities Irrigation Water Water No Utilities Well-Pump Other Utilities Avail. Water Description : Select Up To 2 Laked Dain Municipal Water None Other Well Water Sewer Description : Select Up To 2 At Site Outside Easement Lift Station Req d Private Treatment Plant Municipal Sewer Septic None With-In 500 Other Sewer With-In Easement

5 Financial/Office Information Terms Considered : Select Up To 4 Assumption FHA 403K Owner Financing Less 20K Down Cash Only Lease Option Owner Hold 2nd Mortgage Conventional Lease Purchase Owtb Wrap Exchange No Terms Seller Will Pay Closing Cost FHA Other Terms VA FHA-VA Approved Owner Financing Will Rent Tax Ammount : $ Tax Year : Assumable : Yes No Dade Assess/Save Our Home Val : $ Dade MKT $ / Assessed Value : $ Total Mortgage : $ Monthly Maintenance Fee : $ Fee Description : Select One Monthly None Quarterly Semi-Annually Yearly Special Information : Select Up To 3 Agricultural Exemption Flood Zone Releases Or Subordination Bank Owned Property Foreign Seller Subject To Impact Fees Bonus Homestead Exemption Title Insurance Sell Complete Parcel Institution Owned Property Wetland Jurisdiction Corp. Owned Property No Exemptions Wheelchair Designed Meets Concurrency Req d No Surveys Widow Exemption Disclosure Other Special Will Subdivide Disability Exemption Other Exemptions Will Subordinate Easement Owner Licensed Real Estate Agent Sell Subject to Zoning Change Environment Restrictions Plan Approval Required Possession Information : Select Up To 2 Before Closing Funding Long Closing Preferred Negotiable Other Subject To Lease

6 Financial/Office Information con t Agent & Office Information List Agent MLS ID : Agent Name : Office Name : Office ID : Agent Phone : Office Phone / Ext. : Co List Agent MLS ID : Co Agent Name : Co Office Name : Co Office ID : Co Agent Phone : Co Office Phone : Compensation and Misc. Information IDX : Yes No Internet : Yes No AVM : Yes No Blogging : Yes No Address on Internet : Yes No Listing Type : Select up to 1 Exclusive Agency Exclusive With Exceptions Exclusive Right To Sell Exclusive Variable Limited Service Limited Representation List Date : Owners Name : / / MM DD YYYY Expiration Date : / / MM DD YYYY Owners Phone : Compensation Trans Broker : $ or % Compensation Non Rep : $ or % Compensation Buyers Agent : $ or % Variable/Dual Rate : Yes No Joint Agency : Yes No ebrokerhouse : Disabled SUBMIT AN OFFER Showing Instructions : Select up to 3 Call Listing Agent Other Showing Instructions Call Listing Office Showing Assist Call Tenant Sign On Property Go Directly See Broker Remarks No Sign Virtual Tour / Web Link / Photo Information URL : Virtual Tour : Photo Instructions : Realtor to Upload Images 1 35 Listing Agent Signature: Owners Name : Date :

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