Page1 Property Data In-Put Form irealty Flat Fee Brokerage 381 N. York Road Suite 21 Elmhurst, IL 60126 T: 708-542-4577 F: 800-372-7079 save@irealtyflatfeebrokerage.com Address: Owner Name(s) on Deed OwnerEmail(s) Contact info to be advertised Phone or Email (Max 2) Property Information Type of Housing: Single Family / Condo / Townhouse / Coop Property Address City State Zip Property ID #1 Property ID #2 County Township Unincorporated: Yes / No Directions to Property Name of Subdivision Model New Construction: Yes / No If Yes: Expected Occupancy Date Property Rental also listed on MLS: Yes / No MLS# School Information: Name and District Grade / District: Jr. High / District: High School / District:
Page2 Ownership: Condo / Fee Simple / Fee Simple with HO Assn. / Leasehold Approx Year Built: / Unknown Recent Rehab: Yes / No If Yes: Year: Property Currently Being Leased: Yes / No If Yes: Lease Exp Date: Waterfront: Yes / No Type: 1.5 Story / 2 Story / 3 Story / 4+ Story / Coach House / Raised Ranch / Split Level / Split Level with Sub / Other / Tear Down / Condo / Townhome / Duplex Style: American 4 Square / Bi-Level / Brownstone / Bungalow / Cape Cod / Colonial / Contemporary / Cottage /English / Farmhouse / French Provincial / Georgian / Log / Spanish-Mediterranean / Prairie / Quad Level / Queen Ann/ Ranch / Row house / Step Ranch / Traditional / Tri-Level / Tudor / Victorian / Other General Information: School Bus Service / Commuter Bus / Commuter Train / Interstate Access / Flood Zone / Flood Zone Partial / Adult Community / Assisted Living Exposure: North / South / East / West Area Amenities: (Max 6) Clubhouse / Park / Playground / Pool / Tennis Courts / Horse Community Barn / Horse Riding Area /Horse Riding Trail / Landing Strip / Pond-Lake / Dock Community / Water Rights / Curbs/Gutters / Gated Entry / Sidewalks / Street Lights / Street Paved / Other Disability Access: Yes / No Disability Equipment: 2+ Access Exits / 32 inch or more wide doors / 36 inch or more wide halls / Chairlift / Doors-Pocket / Doors-Swing-In Property Description: (No mention of names, phone or fax numbers, emails, commission, or fees are permitted. Limit is 1000 characters including spaces.) Line1 Line2 Line3 Line4 Line5 Line6
Page3 Lot Dimensions: (Enter actual dimensions (frontage-clockwise), acreage or square footage) Acreage: (Enter total acreage to 2 decimal points) Exterior Building Type: (Max 3) Aluminum Siding / Vinyl Siding / Steel Siding / Brick / Cedar / Frame / Block / EIFS (e.g. Dryvit) / Glass / Log / Masonite / Shakes / Stucco / Stone / Marble-Granite / Concrete / Asbestos Siding / Limestone / Slate / Other / Clad Trim Lot Description: (Max 6) Beach / Chain of Lake Frontage / Channel Front / Common Grounds / Corner / Cul-de-sac / Fenced Yard / Forest Preserve Adjacent / Golf Course Lot / Natural Preserve Adjacent / Wetlands Adjacent / Horses OK / Irregular / Lake Front / Professionally Landscaped /Legal Non-Conforming / Paddock / Park Adjacent / Pond / Riverfront / Stream / Water Rights / Water View / Wooded / Rear of Lot Roof Type: Asphalt / Glass (Rolled) / Asphalt/Glass (Shingles) / Metal / Rubber / Slate / Tar & Gravel / Tile / Wood Shank-Shingles / Other Foundation: Block / Brick / Concrete / Pillars / Reinforced Caisson / Stone / Wood / Other Exterior Property Features: (Max 6) Balcony / Deck / Patio / Porch / Greenhouse / Hot Tub / Roof Deck / Porch Screened / Gazebo / Storage Shed / Dog Run &/or Invisible Fence / Horse Barn / Pole Barn / Tennis Court(s) / Screened Patio / Screened Deck / Stamped Concrete Patio / Brick Paver Patio / Boat Dock/Mooring / Above Ground Pool / In Ground Pool / Storms/Screens Grill-Outdoors / Outdoor Fireplace Parking: Garage / Exterior Space / None Garage Ownership: Owned / Transferable Lease / NA Garage Type: (Max 2) Attached / Detached / None Is Parking Included in Price? Yes / No Garage On-Site: Yes / No # Garage Spaces: Garage Details: Garage Door Opener / Transmitter /Carport / Heated / Tandem / 7 Foot or more / None Driveway: Asphalt / Brick / Concrete / Dirt / Gravel / Circular / Shared / Off Alley / Side Drive / Heated / Other Total Above Ground Approx Sq Ft: Square Feet Source: Appraiser / assessor / Builder / Estimated / Landlord / Tenant / Seller / Other / Plans / Surveyor / Taped / Not Reported
Page4 # Bedrooms (all levels): Include all bedrooms regardless of above or below grade. # Full Baths: # Half Baths: Master Bedroom Bath: (Max 2) Full / Half / Shared / None Basement: (Max 2) Full / Partial / Walkout / English / None Basement Description: Finished / Partially Finished / Unfinished / Crawl / Cellar / Sub-Basement / Slab / Exterior Access / Other / Bathroom rough-in Basement Bathrooms: Yes / No # Interior Fireplaces: / None Fireplace Locations: Family Room / Living Room / Basement / Other / Loft Fireplace Details: See through/multi Sided / Wood Burning / Wood Burning Stove / Attached Fireplace Door / Electric / Gas Logs / Gas Starter / Heatilator Type System / Includes Accessories / Portable/ Ventless / Decorative Only / Foundation Only Attic: Dormer / Finished / Full / Interior Stair / Pull Down Stair / Unfinished Bath Amenities: (Max 6) Whirlpool / Sep Shower / Handicap Shower / Steam Shower / Double Sink / Bidet / Garden Tub / European shower / Full Body Spray Shower / Double Shower / Soaking Tub Interior Property Features: (Max 6) Vaulted/Cathedral Ceilings / Skylight(s) / Sauna/Steam Room / Hot Tub / Bar-Dry / Bar-Wet / Elevator / Hardwood Floors / Wood Laminated Floors / Heated Floors / Solar Tubes/Lights Tubes / 1 st Floor Bedroom / In-Law Arrangement / 1 st Floor Laundry / 2 nd Floor Laundry / Pool Indoors / 1 st Floor Full Bath Dining Room: Separate / With Living Room / With Family Room / L Shaped Kitchen: Eat-In Breakfast Bar / Eat-In Table / Galley / Island / Butler Pantry / Closet Pantry / Walk-in Pantry Appliances: Double Oven / Oven-Range / Microwave / Dishwasher / Dishwasher Portable / Refrigerator / High End Refrigerator / Refrigerator in Bar Area / Freezer / Washer / Dryer / Disposal / Compactor / Grill Indoors / All Stainless Steel Kitchen / Wine Cooler/Refrigerator
Page5 Additional Rooms: (any additional rooms need to be listed on room information sheet with room dimensions) 2 nd Kitchen / Atrium / Attic / Balcony / Bar / Bonus / Breakfast room / Den / Dark room / Deck / Eating Area / Enclosed Balcony / Enclosed Porch / Enclosed Porch Heated / Exercise room / Foyer / Gallery / Game room / Great Room / Library / Loft / Maid s Room / Media Room / Mud Room / Nursery / Office / Pantry / Play room / Recreation room / Screened porch / Sewing room / Sitting room. Suite / Study / Storage / Sun-Florida Room / Sun-Florida Room Heated / Tandem Room / Terrace / Theatre Room / Utility Room 1 st Floor / Utility Room 2 nd Floor / Utility Room Lower Level / Walk In Closet / Workroom Air Conditioning: Central Air / Partial / Space Pac / 1 window unit / 2 window units / 3+ window units / Zoned / None / Separate Systems Water: (Max 2) Lake Michigan / Public / Private Company / Well Community / Well Private / Well Private Company / Well Shared / Other Sewer: (Max 2) Septic Mechanical / Septic Private / Septic Shared / Sewer Public / Sewer Storm / Holding Tank(s) / Overhead Sewers / Other Electricity: Circuit Breaker / Fuses / 200+ Amp Service / 150Amp Service / 100Amp Service / 60Amp Service / 30Amp Service / 400 Amp Service or Greater Heat/Fuel: Gas / Electric / Oil / Propane / Solar / Forced Air / Hot Water-Steam / Baseboard / Radiant / Gravity Air /Heat Pump / Radiators / Space Heater / 2 Separate Heating Systems / Individual Controls / Zoned / Other / None Equipment: Humidifier / Water Softener Owned / Water Softener Rented / Central Vacuum / TV Cable / TV Dish /TV Antenna / TV Rotor / Security System / Intercom / Fire Sprinkler / CO Detectors / Ceiling Fan / Fan Attic Exhaust / Fan Whole House / Sump Pump / Sprinkler Lawn / Air Cleaner / Air Exchanger / Back-up Sump Pump / Radon Mitigation System / Power Generator Tax Year: Taxes $: Tax Exemptions: None / Homeowner / Senior / Senior Freeze Assessment/Association Dues $: / None Frequency: Annual / Monthly / Quarterly Monthly Assessment Includes: Heat / Air Conditioning / Water / Electric / Gas / Parking / Tax / Common Insurance /Security / Security System / Doorman / TV Cable / Clubhouse / Exercise Facility / Pool / Exterior Maintenance / Lawn Care / Scavenger / Snow Removal / Lake Rights / Other / None
Page6 Special Assessments: Yes / No Special Service Area: Yes / No Master Association Fee: Yes / No Lockbox: Yes / No If Yes: Combination Possession: Closing / Immediate / Negotiable Sale Terms: Conventional / FHA / VA / Release Required / Lease-Purchase / Owner May Help / Purchase Money Mortgage / Rent with Option / Trade-Exchange / Cash Only / Other Upon Acceptance Of An Offer: Continue to show Yes / No Are any of the owners a licensed Real Estate Agent or Broker? Yes / No ************************************************************************************* REQUIRED FOR CONDO & TOWNHOME SELLERS ONLY: Unit # Unit Level Total # of Units in Bldg Total # of Stories in Bldg # of days condo board has to approve sale For investors, can owner rent units? Yes / No Pets Allowed (Yes / No) Cats OK (Yes /No) Dogs OK (Yes / No) Count Limit (Yes / No) Weight Limit (Yes / No) Max Pet Weight Max Pet Limit Common Area Amenities: Bike Room / Boat Dock / Door Person / Coin Laundry / Commissary / Elevator / Exercise Room / Storage / Golf Course / Health Club / On-Site Manager / Park / Play Ground / Party Room / Sun Deck / Indoor Pool / Outdoor Pool / Receiving Room / Restaurant / Sauna / Security Door Locks / Service Elevator / Steam Room /Tennis Court / Valet-Cleaners / Whirlpool Window Exposures: North / South / East / West / Park / Lake / Water / Pond / Other Unit Features: Handicap Access / Handicap Equipment / Private Entrance / End Unit / Elevator / Laundry in Unit /Door Monitor by TV / Storage / Balcony / Vaulted Ceilings / Skylight / Hardwood Floors / Storm Screen / Fenced Yard / Deck / Patio / Porch / Greenhouse / Sauna-Steam Room / Grill-Outdoors / Dry Bar / Wet Bar / Master Antenna/ Hot Tub
Page7 Management Company - On Site / Off Site Name Address Telephone Contact Email Attorney information: (I advise that if possible your attorney should hold earnest money, irealty does not. Please verify with attorney they do accept earnest money.) Attorney will be holding earnest money Yes / No Name Firm Address City/State/Zip Telephone: Fax Email Seller Address / Forwarding information: Address City/State/Zip Telephone: Fax Email Residence Other Owner Signature(s) X Date Owner Signature(s) X Date