VACANT LAND
MULTIPLE LISTING SERVICE
 DATA FORM  

Owner Information
Please Print:

________________________________          __________________________________
Last Name                                                         First Name
________________________________          __________________________________
Last Name (2nd Owner)                                    First Name
________________________________          __________________________________
Street Address                                                   City                       State                 Zip
________________________________          __________________________________
Daytime Phone                                                   Evening Phone
________________________________          __________________________________
Fax                                                                    Email Address

Property Address
Please Print:

________________________________          __________________________________
Street Address                                                   City                      State                 Zip
________________________________          __________________________________
County                                                               Subdivision Name
________________________________          __________________________________
Model Name                                                      Development Name

Tax I.D. ( Folio Number) ____________________________________________________________________
Legal Description___________________________________________________________________________
________________________________________________________________________________________
Number of Parcels__________________________________________________________________________


Ownership (Check One)
_____________ Fee Simple       __________________ Fee Simple w/Home Owner’s Association   

General Information
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Directions from a major road or intersection
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Remarks
_________________________________________________________________________________________
Property Description or additional information (Maximum 250 characters)
_________________________________________________________________________________________

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Financial Information

Selling Terms
___Assumption ___Conventional ___FHA/VA ____Lease Option ____Owner Financing_____ Exchange________ Installment_______ Owner Financing______ Owner hold second mortgage________________________________

Total Mortgage Balance _________________________Taxes Paid:__________________  Tax Year___________

Do you pay any special tax assessments ___Yes ___No (Description)________________
Tax I.D # (as shown on tax bill) _____________________________________________

Deed Restrictions: ____________ No Deed Restrictions, _______________________ Subdivision Deed Restrictions
________________________________________________________________________ Other Deed Restrictions

Available Documents: _________ Abstract, _______ Aerial Photo, _____ Appraisal,_____ Building Permit,
 ________  Bore Test, _______ Deed Restrictions, _____ Engineering Studies,  ______ Environmental Impact Study,
 _____________________________________________________________________________________ Leases,
_______________________________________________________________________ Other Documents Available,
_____ Perc Test, __________________ Plans Available,_____ Previous Title Policy,  _______ Subdivision Requirements, ____ Survey Available,_____ Topography Map

MINIMUM SQ. FT. LIVING AREA REQUIREMENTS__________________________________________________________________________

PROPERTY IS ZONED____ Residential,______ Duplex,_______ Multi-Family

Associations and memberships
Home Owners Association ____Yes ___No Association Name__________________________________________
Association Fee_______   ____Monthly,  ___Quarterly, ___Semi Annually, ___Annually

Association Fee Includes
______Maintenance, _______Club House, _________Cable, ________Common Area, _________Exterior
______Insurance, _____Lawn Care, _____Security, ____Trash Pick-Up, _____Recreation, ________________Other

Membership Purchase Requirements ___Yes ___No   Membership Amount______________________________

Subdivision Information:__________ Buyer Approval Required, ________________________Covenant Restrictions,
__________ Golf Course Community, ______________Gate Guarded, __________Horses Permitted,
___________________ Mandatory Home Owners Association, ________________Community Pool,  
_______________________________________________________________________ Subdivision Restrictions,
__________________ Community Tennis Courts,  ______________________Voluntary Home Owners Association.

Parking Restrictions ____No Motorcycle, ____No RV/Boat, ____No Tractor Trailer,
Other Parking Restrictions_______________________________________________________________________

Lot Description ___Corner Lot, ____Cul-de-Sac, ____Flood Zone, ___On Golf Course, ___Interior, ___Irregular,  ___Oversize, ___Lake Front, ___Zero Lot Line
________________________________________________________________________________________Other,

Lot Dimensions______________________________________________________________________________

PAVED ROAD_________, OTHER_____________________________________________________________

Ground Cover___________ Brush, ______________Grass, ______________Marsh,  _________________ weeds,  ______________________________________________________________________________________ Other

TYPES OF TREES ON PROPERTY______________________________________________________________

Waterfront Property __Yes __No (if yes) ___Canal Front,___Ocean Access ,___Lake, ____Pond, ___Seawall,  _______________________________________________________________________________________Other
_________Community Boat Dock,________ Community Boat Ramp, ________ Dock Available, ______ Private Dock

Water Access __Yes __No (if yes) ______Beach Access, ______Boat Lift, ______Private Dock, _____Dock Available,  ________________________________________________________________________________________Other

WATERFRONT FRONTAGE (Square Feet)________________________________

Property Faces ___East, ___West, ___North, ___Northeast, ____Northwest, ___South, ____Southeast, ____Southwest

Property View ___Garden, ___Golf, ___Intracoastal, ___Ocean, ___Pool, ______Other

DOCK INFORMATION _____Electric Available, _____ Living Aboard Permitted, _______ None, __________________________________________________________________________ Other Dock Information,
____ Parking Available, _______ Phone Available, _________Pump Available, _____Rest Room Facilities,
_______ Water Available, ___________________________ Subject to Lease.

LENGTH OF THE BOAT THE DOCK CAN ACCOMMODATE_______________________________________.

Miscellaneous/Improvements Information: __________ Above Ground Irrigation, ____ Alley, ____ Build to Suit,
 ____ Lot Cleared, _____ Compact Soil, ____, Curb, ____ De-Mucked, _____ Drainage Canal, ______Drip System,
____Fenced, ____ Filled, ______ Gutter, _______No Miscellaneous Improvements,
_____________________________________________________________________________ Other Improvements,
____ Partially Filled, ______Septic System, _______ Well, ____Sidewalk, _____ Street Lights.

Soil Type: ______ Clay,_____ Dirt, _____ Marl, ______ Marsh/Mangrove, _______ Muck,
______________________________________________________________________________ Other Soil Type,
­­____Sand, ____ Sandy/Loam.

Utilities Available on Lot ______Cable T.V., _______________ Electric, _____________ Gas,
________________________________________________________________________ Other Utilities Available,
____ Phone Line, ____ Sewer, _____Trash Removal, _____Water, ______ Underground Utilities.

Are Any of the Above Utilities On-Site Now_____________________________________________________

Sprinkler System ____None, ____Automatic, ____City Sprinkler System, ___Well Sprinkler, ___Manuel Sprinkler

Water Description _____Lake Worth Drain, ______Municipal Water, ______Well Water, ________________________________________________________________Other Water, _______ None

Sewer Description ____ At-Site, _____ Lift Station Required, ___Municipal Sewer, ___Septic System, ________________________________________________________Other Sewer, _______ None,
____Outside of Easement, ___With-In Easement, ____ Private Treatment, _______With-In 500 Feet of Property


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Owners Signature                                                 Owners Signature
_________________________________          ________________________________
Date                                                                     Date