* = Required Field Land/Lot For Sale Data Input Listing Contract Information General Property Info Adult 55 Gated Horse Property Seasonal On leased Land *Sub Property Type *Property ID No: *Listing *Expiration *Listing Price ($): Agricultural Land Commercial Land *Service Type Full Service Limited Service Entry Only Industrial Land Residential Land *Listing Contract Type Exc. Right to Sell/Lease Exc. Agency to Sell/Lease Exc. Right to Sell/Lease w/ Reserved Prospect Exc. Agency w/ Reserved Prospect Exc. Right to Sell/Lease w/ Variable Rate Comp Exc. Agency w/ Variable Rate Comp *Buyer Agent Compensation Percentage % Dollar Amount $ Commission/Compensation Compensation Notes Potential Short Sale Yes No Short Sale Comments Agent & Office Information *List Agent ID List Agent Office Co-List Agent ID Co-List Agent Office List Agent Co-List Agent Listing Address Information Street # Pre-Direction Street Name Street Type Post Direction Unit # * *State *County *City *Zip *Neighborhood *Subdivision School Information *Elementary School Middle School Intermediate School *High School *Property Tax $ *Assessment $ Tax Information *Mil Rate *Tax Year District Tax $ 1
Lot & Location Information *Acres: *Acres Source Approximate Owner Public Records *# of lots: Subdividable *Zoning: *Road Frontage Approx Unknown In Flood Zone *Direct Waterfront Elevation Certificate Restrictions & Encumbrances Boat(s) Trailer(s) Truck(s) Regulated Historic District Conservation Restrictions Flood Plain Restrictions Subject to Probate Architect Review Covenant Deed Restrictions Eastments House Plan Approval Inland-Wetland Restrictions Lot Restriction(s) Square Footage Minimums Style Approval Subject to Lot Release *Location (5 Max) Highway Access Downtown Urban Suburban Rural Historic Area Industrial Park Office Park Shopping Mall Strip Mall *Lot Improvements (9 Max) Lot Staked Curbs & Gutters Curb Cut(s) Finish Graded Rough Graded Sidewalk Storm Drain(s) House(S) Barn(S) Horse Stable Garage(S) Shed Fence - Full Fence - Partial Fence - Privacy Fence - Chain Link Fence - Rail Fence - Stone Fence - Wood *Lot Description (6 Max) n Conforming Lot Rear Lot Interior Lot On Cul-De-Sac Historic District Water Frontage Zero Lot Line In Subdivision May be Subdividable Additional Land Avail. In Flood Zone Some Wetlands Dry Cleared Secluded City Views Water View Corner Lot Golf Course Frontage Golf Course View Level Lot Lightly Wooded Rocky Rolling Sloping Lot Treed Wooded Nearby Amenities (8 Max) Basketball Court Bocci Court Commuter Bus Golf Course Health Club Lake Library Medical Facilities Paddle Tennis Playground/Tot Lot Putting Green Private Rec Facilities Private School(s) Public Pool Public Rec Facilities Public Transportation Shopping/Mall Stable\Riding Tennis Courts Walk to Bus Lines HOA Amenities (8 Max) Basketball Court Bocci Court Club House Elevator Exercise Room/Health Club Gardening Area Golf Course Guest Parking Health Club Medical Facilities Paddle Tennis Playground/Tot Lot Pool Private Rec Facilities Putting Green Security Services Shuttle Service Tennis Courts *Road Frontage Description (3 Max) Interstate Highway U.S. Highway State Road Municipal Street Private Road Right of Way Cul-De-Sac Paved Road Unpaved Road Dirt/Gravel Road Unimproved Road 2
Lot & Location Information (continued) *Waterfront Features (4 Max) Direct Waterfront Frontage L. I. Sound Fronage Ocean Frontage Brook Harbor Pond Lake Access River Dock or Mooring Water Community Association Optional Association Required Beach Beach Rights View Walk to Water t Applicable *Documents Available (10 Max) Appraisal Building Plan Demographic Data Environmental Site Assess. Environmental Site Assess. (Phase 1) Environmental Site Assess. (Phase 2) Feasibility Study Flood Elevation Certificate HOA Docs Legal Description Percolation Test Photo/Survey Plot Plan/Survey Property Disclosure Recorded Site Plan Soil Survey Subdivision Approval Topographical Survey Zoning Approval *Available Utilities (6 Max) Utility Information Electric Electric Available Gas Gas Available Telephone Phone Available Cable Cable Available Underground Required /Unknown *Water (2 Max) Public Water Connected Public Water In Street Private Water System Private Well Shared Well Well Required *Sewage System Public Sewer Connected Public Sewer In Street Septic Shared Septic Cesspool Septic Required Annual Sewer Usage Fee Sewer Assessment Info *Septic Plan Available *Septic Plan Approval HOA Information *Home Owners Association Association Fee Frequency Annual Monthly Quarterly Special Assessments Special Assessment Details: Property Management type Professional On Site Professional Off site Unit Owners Association Property Management Company Property Manager s Name Property Management s Phone Property Management s Email Association Fee Includes (9 Max) Club House Trash Pickup Tennis Snow Removal Lake/Beach Access Heat Security Service Air Conditioning Grounds Maintenance Hot Water Water Property Management Pest Control Pool Service Road Maintenance Insurance Flood Insurance Taxes 3
Acceptable Financing Assumable Owner CHFA FHA VA Additional Information/ShowingTime *Where My Listings Go Homes.com IDX Realtor.com Zillow Group Homesnap *Display Property Address on Internet? *Showing Instructions (Limit: 125 Characters) ShowingTime Instructions (Limit: 300 Characters) *Directions (Limit: 255 Characters) *Lockbox Description SmartMLS Elec. n-compatible Elec ECAR-SentriLock Combo Call List Office None *Public Remarks Lockbox Location: *Possession: *Owner: Owner Phone: (Limit: 1500 Characters) Remarks *Sign Occupied By: Owner Tenant Vacant Related MLS # *Bank Owned (REO) 4
Remarks/Directions Public Remarks (Addendum) (Limit: 2400 Characters) Agent Remarks (Limit: 500 Characters) Agreement/Disclosure VALID LISTING AGREEMENT STATEMENT I, the undersigned Broker or Authorized Agent, represent to the SmartMLS Inc, its members and cooperationg agents, that I have a valid and legally enforceable: (1.) Exclusive Right to Sell listing agreement; or (2.) Exclusive Agency listing agreement; or (3.) Exclusive Right to Lease agreement, with the owners of the above entitled property. The information contained in the data information sheet is, to the best of my knowledge and belief, true and accurate. Listing Broker or Authorized Agent Signature: AUTHORIZATION TO USE THE MULTIPLE LISTING SERVICE AND DISCLAIMER The Undersigned Owner(s) authorize and instruct(s) the Broker to submit the information contained herein to the SmartMLS Inc, for the purpose of offering the property for sale or lease through its participants during the period specified. This information has been furnished by the Seller and/or other sources and is not guaranteed by the Broker. Owner(s) agree that the information herein is true and correct to his/her/their knowledge. It is understood that there is no contractual relationship between the Owner(s) and the SmartMLS Inc. Receipt of a copy of this Property Data Form is Acknowledged by Owner(s). Listing Broker or Authorized Agent Signature: Seller s Signature: Seller s Signature: 5