NorthstarMLS SINGLE FAMILY RESIDENTIAL LISTING INPUT FORM Disclosures By signing the authorization section below, the Seller acknowledges the following disclosures: 1. The Seller s real estate broker (the Broker) is a participant in the Regional Multiple Listing Service of Minnesota, Inc. (RMLS). 2. The Seller has authorized the Broker to give the information on this form about the Seller s property to RMLS. 3. All data submitted to RMLS becomes the sole property of RMLS. 4. RMLS assumes no responsibility or liability to the Seller for errors or omissions on this form or in the RMLS computer system. 5. The Broker is required to promptly provide information to RMLS about any change in status or price of the Seller s listing. 6. If the Seller s property is sold, the Broker must report to RMLS the price and terms of the sale. 7. Neither the Seller nor any prospective buyer of the property can alter the Broker s responsibility to report all such data to RMLS by agreement among them. 8. RMLS shall retain and make available all such data and photographs to all its participants (real estate brokers, appraisers, and affiliated professionals) for an indefinite period. 9. Under no circumstances will RMLS permit data about the Seller s listing to be deleted from RMLS s systems in order to conceal any information, including information that the property was listed for a period of time by another broker or brokers. 10. The Broker s use of RMLS s systems is subject to the duties imposed on the Broker by the rules and regulations of RMLS and by the Code of Ethics of the National Association of REALTORS. 11. At the request of the Broker, unless the field called Advertising Selection is marked NO, RMLS will electronically transmit information about the Seller s property to Internet web sites to aid in marketing the property for sale. 12. At the request of the Broker, unless the field called Display Address is marked NO, RMLS will include the address of the Seller s property in transmissions of data to web sites. Authorization: I have read and understood the disclosures above. I certify that the information contained on this form is accurate to the best of my knowledge. 100 The Listing Contract Starts 101 and ends at 11:59 P.M. on 102 Owner (Signature) 103 Owner (type or print) 104 Owner (Signature) 105 Owner (type or print) 106 Real Estate Company 107 By (Agent)
200 List Number 201 Date Entered 202 Status BLACK BOXES are required, Active Comp Sold except on Comp Sold listings. BLACK OVALS are required for 203 Listing Office Name 204 Listing Office Phone Comp Sold listings and all others WHITE BOXES are not required LOCATION 210 State 211 County 212 Municipality 213 Zip Code 214 Zip Plus 4 215 Postal City 216 House Number 217 Street Direction Prefix N S E W NW NE SW SE 218 Street Name 220 Street Suffix Avenue Boulevard Circle Drive Lane 219 Street Direction Suffix Parkway Place Road Street Trail N S E W NW NE SW SE Terrace Way 221 Unit Number 222 Fire Number 223 School District 224 Map Page 225 Map Coordinate 226 Complex/Development/Subdivision Name 227 Directions (200 Characters Available) TAX 240 Property ID Number 241 Multiple PIDs? 242 Tax Year 243 Homestead Yes No Yes No 244 Tax Amount 245 Assessment Pending 246 Assessment Balance 247 Tax with Assessments Yes No Unknown 248 Legal Description (200 Characters Available) 249 Property ID #2 250 Property ID #3 LISTING 260 List Price 261 List Date 262 Expiration Date 263 Buyer Broker Comp 264 Sub-Agent Comp 265 Facilitator Comp 266 Variable Rate Comp 267 Listing Office # Yes No 268 Listing Agent ID # 269 List Agent Name 270 Co-List Agent ID # 271 Co-List Agent Name 272 List Agent Phone # 273 Co-List Agent Phone # 274 Team Name 275 Appointment Phone 276 List Type (Choose Only 1) Exclusive Right to Sell Exclusive Agency Exclusive Right with Exclusions Exclusive Agency with Exclusions Service Agreement 277 Construction Status (Choose Only 1) Previously Owned Completed New Construction Under Construction/Spec home To Be Built/Floor Plan Model 278 In Foreclosure? 279 Lender Owned? 280 Potential Short Sale? 281 Owner is an Agent? Yes No Not Disclosed Yes No Not Disclosed Yes No Not Disclosed Yes No 282 Yearly/Seasonal 283 For Rent MLS# (if also renting) 284 Auction? Yearly Seasonal Yes No 285 Auction Type (choose only 1, required if auction) 286 Auctioneer License # (if auct) 287 Buyer s Premium? (If auct) Absolute Minimum Bid Reserve Yes No
Address Page 3 of 7 NEW DEVELOPMENT 300 New Development? If yes, these fields required: (Multiple units included in this listing) 301 Total Units Available 302 Minimum Price 303 Maximum Price Yes No NEW CONSTRUCTION 310 Projected Completion Date (required on Under Construction/Spec homes) 311 Model Location (required on Models) 312 Model Phone 313 Hours Model Open 314 Lot Price 315 Low Range Price 316 High Range Price INTERNET (Default is Yes) 320 Display Listing on Internet 321 Display Address on Internet 322 Allow Auto Valuation 323 Allow Consumer Comment Yes No Yes No Display? Yes No Yes No FINANCIAL 330 Association Fee 331 Association Fee Frequency (required if there is an Association Fee) Yearly Quarterly Monthly 332 Association Fee Includes (required if there is an Association Fee) Heating Air Conditioning Sanitation Snow/Lawn Care Outside Maintenance Hazard Insurance Cable TV Water/Sewer Building Exterior Security Staff Security System Professional Management Beach Access Shared Amenities Parking Space Valet Parking 333 Association Mgmt Co. Name (required if there is an Association) 334 Assoc Mgmt Co. Phone # (required if there is an Association) 335 Insurance Fee (if separate from Association Fee) 336 Insurance Fee Frequency (required if there is an Insurance Fee) Yearly Quarterly Monthly BED & BATH (system will calculate Bath-Total) 340 Bedrooms 341 Bath Full 342 Bath Three Quarters 343 Bath Half 344 Bath - Quarter ROOM DIMENSIONS Living Room Dining Room Family Room Kitchen Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Level Approx. Dimensions Extra Room Name Level Approx. Dimensions LAND 350 Acres 351 Lot Dimensions EX-1 EX-2 EX-3 EX-4 EX-5 EX-6 353 Pasture Acres 354 Tillable Acres 355 Wooded Acres
Address Page 4 of 7 STRUCTURE (system will calculate Total Finished Square Footage) 400 Year Built 401 Foundation Size 402 Common Wall 403 Number of Fireplaces Yes No 404 Above Ground Finished Square Footage 405 Below Ground Finished Square Footage 406 Garage Stalls 407 Garage Dimensions 408 Other Parking Spaces 409 Garage Stall # (for condos) 410 Manufactured Home? 411 Green Certified? 412 HERS Score Yes No Yes No 415 Style (Choose only 1) (SF) One Story (SF) One 1/2 Stories (SF) Two Stories (SF) More Than Two Stories (SF) Modified Two Story 416 Accessible Ramp 417 Air Conditioning Central Window 418 Exterior Shakes Metal 419 Heating Forced Air Baseboard Hot Water Gravity Space Heater 420 Basement Walkout Full Partial Crawl Space Finished (Livable) 421 Fuel Natural Gas Oil 422 Zoning Residential Single Family Residential - Multi-Family 423 Parking Characteristics Attached Garage Detached Garage Tuckunder Garage Tandem Garage Insulated Garage Heated Garage Underground Garage 424 Sewer City Sewer-Connected City Sewer-In Street Private (SF) Three Level Split (SF) Four or More Level Split (SF) Split Entry (Bi-Level) (SF) Other (TH) Quad/4 Corners Counters Switches/Outlets (TH) Side x Side (TH) Detached (CC) High Rise (4+ Levels) (CC) Low Rise (3- Levels) (CC) Manor/Village No Stairs Hallways/Doors (CC) Two Unit (CC) Converted Mansion Twin Home Time Share Elevator/Lift Wall Geothermal Vinyl Stucco Brick/Stone Heat Pump Steam In-floor Heating Radiant Partial Finished Drain Tiled Drainage System Sump Pump Daylight/Lookout Windows Solar Business/Commercial Agriculture Covered Carport Uncovered/Open Driveway-Gravel Driveway-Concrete Driveway-Asphalt Driveway-Other Surface Shared System Mound Cement Board Fiber Board Log Home Geothermal Boiler Dual Fuel/Off Peak Fireplace Egress Windows Concrete Block Poured Concrete Insulating Concrete Forms Slab Propane Industrial Lot Driveway-Shared Secured More Parking Onsite for Fee More Parking Offsite for Fee Valet Parking for Fee Contract Parking Req. Assigned Holding Tanks Tank with Drainage Field Log Siding Block Stove Outdoor Furnace Stone Unfinished Shoreline Unassigned On-Street Parking Only Units Vary Garage Door Opener No Interior Access to Dwelling
Address Page 5 of 7 STRUCTURE (continued) 500 Water City Water-Connected City Water-In Street Well Shared System 4-Inch Submersible Drilled Sand Point OPTIONAL PROPERTY INFORMATION - GENERAL 510 Assumable Loan Not Assumable Yes w/ Qual. (approval) Yes w/ Rate Change Information Coming Yes w/ NO Qualifying 511 Appliances Range Cooktop Wall Oven Indoor Grill Microwave Exhaust Fan/Hood Dishwasher Trash Compactor Refrigerator Freezer Washer Dryer Water Softener-Owned Water Softener-Rented Disposal Central Vacuum Electronic Air Filter Air-to-Air Exchanger Furnace Humidifier 512 Amenities - Unit Deck Patio Porch Natural Woodwork Hot Tub Sauna 513 Dining Room Description Separate Formal Dining Room Informal Dining Room 514 Bath Description Main Floor Full Bath Main Floor 3/4 Bath Main Floor 1/2 Bath Upper Level Full Bath Upper Level 3/4 Bath Upper Level 1/2 Bath Balcony Kitchen Window Skylight Vaulted Ceiling(s) Ceiling Fan(s) Hardwood Floors Tile Floors Eat In Kitchen Breakfast Area Private Master Full Master 1/2 Master 3/4 Master Master Walk Thru Walk Thru 515 Existing Financing (choose only one) FHA Conventional FHA Rehab 203k Conventional Rehab DVA Rural Development 516 Family Room Characteristics Main Level Lower Level 517 Fencing Wire 518 Fireplace Characteristics Living Room Family Room Amusement Room Master Bedroom 519 Lot Description Irregular Lot Corner Lot Tree Coverage-Light 2 Story/High Vaulted Ceiling 2 or More Chain Link Rail Privacy Stove Burning Gas Burning Tree Coverage-Medium Tree Coverage-Heavy Additional Land Available Walk-In Closet Exercise Room Tennis Court Sun Room Washer/Dryer Hookup Security System Kitchen/Dining Room Living/Dining Room Jack & Jill Full Basement 3/4 Basement 1/2 Basement Basement Rough In ARM/GPM Contract for Deed Great Room Family Room Invisible Full Partial Brick Stone Zero Lot Line City Bus (W/in 6 blks) No T.C. Metro Phone In-Ground Sprinkler Local Area Network Multiple Phone Lines Unspecified Separate Tub & Shower Whirlpool Two Master Baths Two Basement Baths Special Funding Free and Clear Loft Entertainment/Media Center Free Standing 2-Sided On Golf Course Sod Included in price
Address Page 6 of 7 OPTIONAL PROPERTY INFORMATION GENERAL (continued) 600 Out Buildings Stables Indoor Arena Additional Garage Shop Pole Building 601 Pool Above Ground Below Ground 602 Road Frontage Private City Township County 603 Roof Asphalt Shingles Pitched Flat Unspecified Shingle Barn Silo Machine Shed Grain Bin Hog House Indoor Outdoor State US Highway Interstate Cul De Sac Tar/Gravel Age 8 Years or Less Age Over 8 Years Slate Hen House Storage Shed Dog Kennel Gazebo Boat House Heated Shared Paved Streets Unpaved Streets Unimproved No Outlet/Dead End Tile Shakes Rubber Metal Bunk House Guest House Curbs Sidewalks Shingles Concrete 604 Second Unit Existing In-Law w/kitchen Existing In-Law w/bath Formerly Subdivided Easily Divided 605 Special Search Main Floor Laundry 2nd Floor Laundry 606 Terms (seller will accept) FHA FHA Rehab 203k DVA Conventional WATERFRONT INFORMATION 610 Lake/Waterfront Lake Front River Front Deeded Access Main Floor BR 3 BR on One Level Conventional Rehab Rural Development Assumable Adj. Rate/Gr. Payment Lake View River View Pond 4 BR on One Level Contract For Deed Special Funding Cash Creek/Stream Channel Shore All Living Facilities on One Level Contract/Deed w/assumption Exchange/Trade Association Access Shared 611 Lake/Waterfront Name 612 Waterfront Frontage (feet) 613 DNR Lake ID # 614 Lake Acres 615 Lake Depth (feet) 616 Lake Chain Name 617 Lake Chain Acreage 618 Road Btwn WF & Home? Yes No 619 Elevation Highpoint to Waterfront Slope Gradual Level Steep 620 Elevation Highpoint to Waterfront Feet 0-4 10-15 26-40 40+ 4-10 15-26 621 Lake Bottom Gravel Hard Rocky Sand Excellent Sand Soft Undeveloped Weeds Reeds Wetland 622 Waterfront View Bay City Lights Golf Course Harbor Lake Panoramic OPTIONAL PROPERTY INFORMATION - CONDO/TOWNHOUSE 630 Amenities - Shared Deck Patio Porch Tennis Courts Hot Tub Sauna Beach Coin-op Laundry Owned Coin-op Laundry Leased River See Remarks North 24 Hour Guard Security Building Lawn Sprinkler Common Garden Fire Sprinkler System South East West Elevator(s) Car Wash Concrete Floors & Walls
Address Page 7 of 7 OPTIONAL PROPERTY INFORMATION - CONDO/TOWNHOUSE (continued) 700 Approved Financing (by Association) FHA DVA FNMA FHLBB 701 Restrictions/Covenants (Required if Condo/Townhouse) Pets Not Allowed Pets-Cats Allowed Pets-Dogs Allowed Pets-Weight/Height Limit Pets-Number Limit Pets-Breed Restriction Seniors-55+ Seniors-62+ Easements Rental Restrictions May Apply Rentals Not Permitted Right of First Refusal Horses/Livestock Allowed Architecture Committee Building Restrictions Land Leased Minimum Lot Size Covenants Mandatory Owners Assoc. Builder Restriction 702 Shared Rooms Sun Room Exercise Room Amusement/Party Room Play Area 703 Townhouse Characteristics (Required if Townhouse) Not Applicable End Unit Street-Level Single-Level Guest Suite Club House OPTIONAL PROPERTY INFORMATION - FARM 710 Agricultural Water Well Pond 711 Crop Type Corn Wheat 712 Farm Type Hobby Crop Hay/Alfalfa Beans Dairy Horse Multi-Level No Interior Stairs Beef Tree No Exterior Stairs 713 Soil Type Sand Loam Clay 714 Topography Rolling Level Sloped Hilly Low Land High Ground REMARKS Agent Remarks (Generally for agent to agent communication) Solar Oriented Flood Plain Walkout Ravine Public Remarks (Additional property information - do NOT include contact information, or marketing or promotional messages made on behalf of the listing broker, seller or third party) Financial Remarks (Generally for agent to agent communication regarding financial information. Do NOT include contact information, or marketing or promotional messages)