List Price________________________        MLS Listing Period (up to 1 year)______

Owner Information                                           Minimum listing period is 3 months but you

Please Print:                                                      can cancel the listing at any time without                                                                                   penalty.

________________________________          __________________________________
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

Ownership (Check One)
___ Fee Simple, ____ Fee Simple w/Home Owner’s Association, ____Condominium,
___Deed Restrictions, ___Planned Unit Development (PUD), ___Homeowners Association Required, ___Homeowners Assoc.Optional, ______ Land Lease, ______Owner Occupied, ______Vacant, _____Rented, __________New Construction, ________Never Lived In

Condition of Property
___New, ___Excellent, ___Above Average, ___Average, ___Fair, ___Poor

General Information
_______________________________________________________________________
Directions from a major road or intersection
_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Remarks
_______________________________________________________________________
Property Description or additional information (up to 300 characters)
_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Financial Information
Selling Terms
___Assumption ___Conventional ___FHA/VA ____Lease Option ____Owner Financing
Other Terms Considered___________________________________________________
Total Mortgage Balance ___________________________________________________
Taxes Paid:_________________________ , Tax Year____________________________

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

Associations and memberships
Home Owners Association __Yes ___No Association Name_______________________
____Association Fee Required, _________Association Fee,   ____Monthly,  ___Quarterly, ___Semi Annually, ___Annually

Association Fee Includes
___Building Maintenance, ___Club House, ____Cable, ___Common Area, ____Exterior
___Insurance, ___Lawn Care, __Security, __Trash Pick-Up, ___Recreation, _____Other

Membership Purchase Requirements ___Yes ___No   Membership Amount___________

Subdivision Amenities Available
___Club House, ___ Dock Access, ___Exercise Room,  ____Card Gate, ___Guard Gate
___Golf Course, ___Horse Stables,___ Private Roads, ___Tennis Courts, ___Security Patrol, ___Play Area, ___Pool, ___Racquet Ball, ___Recreation Building,___Sauna, ___Shuffle Board, ___Storage, ___ Laundry Facilities, ___Underground Utilities, 
___Water Access, _______________________________________________Other 

School Information
Elementary School______________________________________________________
Middle School _________________________________________________________
High School ___________________________________________________________ 

Property Information
Type of Home/Style
___Single Family, ___Manufactured Home, ___Modular, ___Duplex
___One Story, ___1.5 Story, ___Two Story, ___Three Story, ___Bungalow, ___Cape Code, ___Colonial, ___Contemporary, ___ Historical, ___Ranch, ___Spanish, ___Traditional, ___Tudor, ___Victorian, ___Villa, __________________________Other

Approximate Year Built_____ # Bedrooms______ # Full Baths_____ # Half Baths____
Approximate Square Feet (under air)___________Total Square Feet______________
Approximate Land Size or Dimensions______________________________________

Attached Garage: __Yes __No ___ Detached Garage: __Yes __No  # Garage Spaces__ 
Carport: ___Yes ___No _____Attached  _____Detached  # Carport Spaces__________
Garage Features ___Door Opener, ___Converted,____ A/C Unit, ___ Storage________

Additional Parking Information ___Circle Drive, ___Driveway, ___Covered, __Guest
___Pavers, ___Unpaved, ___Off Street, ___None, __________________________Other

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, Greenbelt _____,
___Conservation Area, ___ Sidewalk, ___ Paved Street, ___ Brick Street, ___Unpaved Street, ___Private Street, ___One Way Street, ___Dead End Street, ___Highway Frontage,
___Close to Bus Line, ___In City Limits, ___Hilly, ___Historic District, ___Zoning Permits
Hourses, ___Flood Insurance Required, ___Pasture

Waterfront Property __Yes __No (if yes) ___Bay, ___Canal (fresh), ___Canal Front (Salt),___Intracoastal, ___Gulf,___Ocean Access ,___Lake,____Pond, ___River,
___ Seawall, _______________________________________________Other

Water Access __Yes __No (if yes) ___Boat Ramp, ___Boathouse, ___Beach Access, ___Boat Lift, ___Private Dock, ___No Boats Allowed, ___Private Lake Dues Required,
___Dock Available, ___Skiing Allowed,________________________________Other

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

Property View ___Garden, ___Golf, ___Intracoastal, ___Ocean, ___Pool, ______Other
Property is available ______Furnished, _______Part Furnished, ________Unfurnished 

Exterior Property Features
Exterior Features 
_____Brick, _____CBS (Concrete Block & Stucco), _____Frame, _____Frame Stucco,
___Modular, ____Pre-Fab, ___Aluminum Siding, ___Vinyl Siding, ___Slab,___ Wood, ____Stone, ____Wood, _____ New Construction, __________________________Other

Foundation
___Slab, ___Crawlspace, ___Basement

Roof Type
___Bahama Tile, ___Barrel Tile, ___Concrete Tile, ___Flat Tile, ___Metal, __S-Tile,
___Shake, ___Shingle, ___Slate, ___Tar & Gravel, ______________________Other

Private Pool __Yes __No (if yes) ___Above Ground, ___Below Ground, __Child Gate,
___Concrete, __Fiberglass, ___Freeform, ___Gunite, ___Heated, ___Screened, __Solar,
___Whirlpool, __________Other,  Pool Dimensions____________________________,
Spa/Hot Tub ___Yes ___No

__Awnings, __Barbeque, __Barn-Stall, __Built in Grill, ___Deck, ___Fence, ___Patio,
__Fruit Trees, __Greenhouse, __Open Balcony, __Room for Pool, ___Satellite Dish,
__Screened Balcony, ___Screened Porch, ___Shed ,___Shutters, ___Sprinkler System,
Other_________________________________________________________________

Guest House on Property ___Yes ___No (if yes) Describe Guest House______________
_______________________________________________________________________

Windows/Treatments
___Arched, ___Awning, ___Bay, ___Blinds, ___Casement, ____Drapes, ____Jalousie, ____Picture, ___Double Hung, ___Sash,  ___Sliding, ___Tinted, ___Thermal, ___Vertical, ________________________Other

Additional Information
Flooring
__Carpet, __Ceramic Tile, __Concrete, __Marble, ___Parquet, ___Slate, ___Terrazzo,
__Vinyl, ___Wood, ___Brick.Stone, ___Quarry Tile, ______________________Other

Room Dimensions 
For each room please indicate the size rounded to the nearest foot. 
Living Room ___x___, Dining Room ___x___, Kitchen ___x ___, Family Room___x__, Florida Room ___x___, Master Bedroom ___x___, 2nd Bedroom ___x___, 
3rd Bedroom ___x ___, 4th Bedroom ___x___, 5th Bedroom ___x___, Den ___x___

Bedroom Description
___Master Bedroom Upstairs, ____Master Bedroom Ground Level, ____Sitting Room 
___One or more Bedrooms on Ground Level, ____________________________Other

Master Bath Description
___2 master baths, ___Tub & Shower, ___Separate Tub & Shower, ___Tub Only, ___Shower Only, ___Whirlpool/Spa, ___Dual Sinks, ___Handicapped Accessible,

Interior Features
___Attic,___Bar, ___Built-Ins, ___Cook Island, ___Custom Mirrors, ___Elevator, ___
___Fireplace, ___Foyer, ___French Doors, ___Pantry, ___Roman Tub, ___Skylight,
___Vaulted Ceiling, ___Walk In Closets, ___Wet Bar, ___Wheelchair Access

Attic Details
___None, ___Drop Stairs, ___Finished, ___Floored, ___Heated/Cooled, ___Scuttle,
___Stairs

Insulation
___None, ___,Ceiling, ___Floor, ___Roof, ___Walls, ___Unknown

Fireplace Information
___Electric, ___Family Room, ___Gas Fireplace, ___Living Room, ___Master Bedroom,
___Wood Burning, ___Other Room

Door Details
___Folding, ___French, ___Hollow Core, ___Metal, ___Pocket, ___Sliding ,___Solid

Rooms
Additional Rooms
___Bonus Room, ___Family Room, ___Florida Room, ___Garage Conversion, ___Glass Porch, ___ Game Room, ___Great Room, ___Separate Guest/In Law Quarters, ___Maid/In Law Quarters, ___Study/DenLibrary ___Utility/Laundry in Garage, ___Utility/Laundry Room

Dining Area
___Breakfast Area, ___Dining/Living Room, ___Family Room/Dining Combination,
___Formal Dining, ___Kitchen Dining, ___Snack/Bar/Counter, ___Closet Pantry,
___Cooking Island, ___Walk In Pantry

Equipment/Appliances Included
___Automatic Garage Door Opener, ___Bottled Gas, ___Central Vacuum, ___Trash Compactor, ___Dishwasher, ___Disposal, ___Dryer, ___Electric Water Heater, 
___Exhaust Fan, ___Freezer,___Fire Alarm, ___Gas Water Heater, ___Washer/Dryer Hook-Up, ___Water Heater Leased, ___Ice Maker, ___Intercom, ___Microwave, ___Electric Range, ___Gas Range,___Refrigerator, ___Security System Leased, ___Self Cleaning Oven, ___Solar Hot Water Owner, ___Solar Hot Water Leased, ___Smoke Detector, ___Solar Water Heater, ___Washer/Dryer Leased, ___Wall Oven, ___Water Softener/Filter Owned, ___Water Softener/Filter Rented 

# Of Ceiling Fans________________

Heating Description
___Central Heat, ___Electric, ___Gas, ___Solar Heat, ___Window/Wall Unit, ___Zoned Heat Cycle, ___No Heat, ______________________________________________Other

Cooling Description
___Central Air Conditioning, ___No Air Conditioning, ___Window/Wall Unit, ___Attic Fan, ___Thermal Attic Fan, ___Zoned Cooling, ___Heat Pump

Sprinkler System ____None, ____Automatic, ____City Sprinkler System, ___Well Sprinkler, ___Manuel Sprinkler, ___Sprinkler Meter, ___Sprinkler Recycled

Water ___Municipal Water, ___Well Water, ___City Water, ___County Water,
___Fire Hydrant, ______________________Other

Sewer Description ___Municipal Sewer, ___Septic System, _________________Other

Is Cable Available ___Yes ___No, ___Cable Connected

Property Restrictions ___Association Approval Required, ___Dock Restrictions, ___No Leasing, ___OK to Lease, ___No Restrictions, __________________Other

Are Pets Allowed ___________________________Restrictions or Possible Restrictions
___Cats OK, ___Dogs OK, ___More than 20 LBS, ___Maximum 20 LBS

The owner(s) acknowledges that the foregoing information provided in this data form is believed to be true and correct and will become a part of the listing agreement. The above property is not currently listed on the Multiple Listing Service (MLS).

_________________________________          ________________________________
Owners Signature                                                 Owners Signature
_________________________________          ________________________________
Date                                                                     Date