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** Indicates a Required Field o Indicates a Single Choice Field □ Indicates a Multiple Choice Field [G] = Green Fields

Office

Association

LISTING TAB-STATUS AND LISTING INFORMATION

Entered Where **List Date **Expiration Date **List Price Range Price Y/N

Yes

NoRepresentation

**Listing Type Exclusive Right to Lease

Seller Not Represented

L.S. / Exclusive Right To Sell

# of Times Per Year

Minimum Lease

1-7 Days 1 Week 2 Weeks 1 Month

2 Months 3 Months 4 Months 5 Months

6 Months 1 Year No Rent No Min

**Office Primary Board ID

Bartow Central Pasco DeSoto East Pasco

East Polk Englewood Interealty Usage Lake and Sumter

Lake Wales Lakeland Manatee Orlando Regional

Osceola Other Pinellas Suncoast Port Charlotte

Sarasota Tampa Venice West Pasco

West Volusia

**Special Sale Provision

Bank Owned / REO

Short Sale

None of the Above

**Special Listing Type

Exclusion

Exclusion / Variable Commission

Not Applicable

Other

Variable Commission

ADDRESS

**Street Number Street Dir Pre **Street Name Street Type Street Dir Post

Unit Number **City **State **Zip Zip + 4

**County Floor Number Building # Floors Building Name/Number Floors in Unit

Exclusive Agency

L.S. / Exclusive

Agency

Seller Represented

Exclusive Right to Sell

Limited Service (L.S.)

Sold Data / Entry Only

Vrange List Low Price

Days Lease

SCHOOLS

Elementary School Middle or Junior School High School

AUCTION

**Auction Auction Date Auction Time

Yes

No

EXTERIOR/POOL TAB - **POOL

None

Private

Pool Dimensions

Community

Pool Type (8) Above Ground Diving Board

Heated Spa

Other Water Feature

Salt Water [G]

Solar Powered Pool Pump [G]

Spa

Auto Cleaner

Fiberglass

In Ground

Other Outside Bath Access

Solar Cover for Pool [G]

Tile Vinyl

Child Safety Fence

Gunite/Concrete

Infinity Edge

Heated Pool

Inside

Pool Sweep

Screen Enclosure Solar Heated Pool [G]

EXTERIOR/POOL TAB - EXTERIOR INFORMATION

½ Duplex Co-op Condo

Manufactured / Mobile Home

Farm

Townhouse Villa

Dock/Rackominium

Single Family Home

**Property Syle

Pre-Fabrication

**Property Description (4)

1st Floor Multi-Story

Elevated

In M / H Community

Penthouse

Tri-Level

2nd Floor / Multi Story

End Unit

Mid-Rise

Split Level

Architectural Styles (6)

Bungalow Cape Cod Colonial Contemporary

Courtyard Custom Dutch Provincial Elevated

Florida French Provincial Historical Key West

Patio Ranch Spanish / Mediterranean Townhouse

Traditional Tudor Victorian Villa

Other

Condo - Hotel

Modular

Mobile Home Style

Ground Floor Unit

Out of M / H Community

Townhouse 2-3 Floors

3rd Floor+above Multi-Story Efficiency

High-Rise

Three Story

Two Story

One Story

Balcony

Corner Lot

End Unit

Golf Course View

Hilly

Level

Lot – Oversized

Pool View

Street One Way

Tennis Court View

Close to Bus Line

Corner Unit

Flood Zone

Greenbelt

Historic District

Lot – Flag

Lot - Tip

Sidewalk

Street Paved

Unincorporated

Coastal Constr Ctrl Lnn

Cul de Sac

Garden View

Greenbelt View

In City Limits

Lot - Irregular

Pasture/Agriculture

Street Brick

Street Private

Wooded View

Conservation Area

Drainage Canal

Golf Course Frontage

Highway Frontage

In County

Lot - Key

Park View

Street Dead-End

Street Unpaved

Zoning Permits Horses

**Location (10)

Mobile Home

E

W

NE

NW

SE

SW

N

S

Front Exposure

**Exterior Construction

(5) Asbestos Brick

Log On Piling

Siding Stem Wall

Stucco Wood Frame

Block

Metal Frame

ICF Insulated Concrete Forms [G]

Other

SIP Structurally Insulated Panel [G]

Stone

Tilt Up Walls [G] Wood Frame (Forestry Stewardship Certified) [G]

**Roof (3)

Built up

Membrane

Metal

Other

Roof Over

Shake

Shingle

Slate

Tile

**Foundation (3)

Basement

Crawlspace

Slab

Stem Wall

Stilt / Wood

Balcony/Sun Deck Barn Detached WorkshopDetached In-Law Apt Dog Run

**Exterior Features

Fenced French Doors Fruit Trees Gazebo Greenhouse

Gutters/Downspouts Handicap Modified Hot Tub/Spa Hurricane Shutters Irrigation System

Mature Landscaping Other Oak Trees Outdoor Grill Outdoor Kitchen

Outdoor Shower Parking - RV/Boat Patio/Porch/Deck Covered

Patio/Porch/Deck Open Patio/Porch/Deck Screened

Rental Apartment Outdoor Lights Satellite Dish Sauna Screen/Covered Enclosure

Sliding Doors Storage Tennis Court - PrivateSprinkler Metered Stables

Trees/Landscaped Xeriscape Wheelchair Accessible Utility Shed

**Garage / Carport (3)

1 Car Carport 2 Car Carport 2 Car Garage 3 Car Carport

4 Car Carport 4 Car Garage 5+ Car Carport

RV Carport Golf Cart Garage RV Garage None

1 Car Garage

3 Car Garage 5+ Car Garage

Under Building parking

Garage Features (10)

Assigned Parking Circular Drive

Door Opener Golf Cart Parking

None

Oversized

Tandem Parking Workshop

Attached Bath In Garage Covered Parking

Detached Drive Space Garage Conversion

Guest Parking No Street Parking Open Parking Other

Parking Pad Portico Secured Parking Side Rear Entry

Street Parking Under Building Parking Washer/Dryer Hookup

Fidelity Bond

Public Insurance

Tennis Courts

CableBuilding Exterior Community Pool Electric Escrow Reserves Fund

Flood Insurance

Garage Dimensions

Gas Ground Maintenance Insurance Building

Internet Maintenance/Repairs Manager Not Applicable Other

Pest Control Private Road Recreational Facilities Roof

Security Trash Removal Water/Sewer

Maintenance Includes (19)

Model / Make MH Width

Single Double Triple

Alt Key/Folio **Taxes **Tax Year **Year Built

**Zoning Zoning Compatible Y/NYes No

LAND AND TAX TAB - LEGAL

**Section **Township

**Legal Description

**Legal Subdivision Name

**Plat Book/Page

**Subdivision Number Subdivision Section Number**Block/Parcel **Lot #

Yes No

**Additional Parcel Y/N

**Tax ID

**Range

SW Subdiv Sub Condo Number SW Subdv Community Name Complex/Community Name/NCCB

Millage Rate

LAND AND TAX TAB - LOT INFORMATION

Flood Zone Code **Lot Dimensions **Lot Size (Square Feet) **Lot Size (Acres)

**Total Acreage

5 to less than 10

Zero Lot Line Up to 10,889 Sq. Ft. 1/2 acre to 1 acre One+ to Two acres

Two + to Five acres 10 to less than 20 20 to less than 50 50 to less than 100

200 to less than 500 500+ acres Non-Applicable

1/4 Acre to 21,779 Sq. Ft.

100 to less than 200

LAND AND TAX TAB - PARCEL

**Homestead Y/N

Yes No

**CDD Y/N CDD FeeOther Exemptions Y/N

Yes NoYes No

Future Land Use

Completed Pre-Construction

Construction Status

Under Construction

Projected Completion Date

Yes No Yes No

**Total Units Land Lease Fee Yes No

Planned Unit Development **New Construction

Special Tax District Y/N (Tampa)

**Full Baths **Half Baths **Square Feet Heated Total SqFt

INTERIOR TAB - INTERIOR INFORMATION

**Bed

Appraisal Builder Measured Owner Provided Public Records

**Sq Ft Source

**Utilities (10)

Electric

Public Municipal Water Septic Sprinkler MeterPrivate Municipal Water

Aerobic Septic BB/HS Internet Avail City Water Cable ConnectedCable Available

Public Utilities

Canal/Lake For Irrigation Fiber Optics Fire HydrantCounty Water

Other Private Sewer Private UtilitiesGasNone

Integrated Generator Public Sewer Mini SewerPrivate Municipal SystemGenerator Hookup

Public Water Avail Street Lights UndergroundSprinkler WellSprinkler Recycled

Well

Additional Rooms (9)

Bonus Room Breezeway Den / Library / Office Family Room

Florida Room

Double Master Bedroom

Inlaw / Rental Apt Inside Utility

Loft

Foyer Game Room

Media Room

**Air Conditioning (2)

Central Humidistat No Air Wall Units/Window Zoned/Multiple

**Heating and Fuel (6)

Fuel - Gas BottledCentral Fuel - Electic Fuel - Gas Natural Fuel - Oil

Heat Pump Heat Recovery Unit No Heat Other Partial

Radiant / Baseboards Radiant / Ceiling Solar Space Heater Wall Furnace

Wall Units / Window Units Zoned / Multiple

**Appliances Included (13)

Built In Oven Compactor Convection Oven Dishwasher

Disposal Dryer Freezer Gas Appliances

Hot Water Electric Hot Water Gas Kitchen Reverse Osmosis Sys

Microwave

Microwave Hood None Oven Oven Double

Range Range Hood Solar Hot Water Ownded Tankless Water Heater

Solar Hot Water Rented Washer

Cook Top Only

Exhaust Fan

Indoor Grill

Other

Refrigerator

Water Softener Owned Water Softener Rented Water Aerator Owned

Water Filter Owned Water Filter RentedWater Aerator Rented Wine/Bar Refrigeration

**Interior Features (14)

Attic Attic Ventilator Blinds/Shades Built in Features Cathedral/Vaulted Ceiling

Ceiling Fan(s) Central Vacuum Corridor Access Crown Moulding Dry Bar

Dumb Waiter Elevator Fire Sprinkler Furnished Furnishing - Optional

Handicapped Modified Hot Tub/Spa In Wall Pest System Inside Utility Intercom System

Medical Alarm Radiant Barrier Rods Sauna Skylights

Smoke Alarms Solid Surface Counters Solid Wood Cabinets Storage Room Thermal Windows

Tray Ceiling TV Antenna Unfurnished Video Monitoring Walk In Closet

Washer/Dryer Hookup Wet Bar Wheelchair Accessible Whole House R.O. System Window Treatment

Other

Interior Layout (8)

Eating Space In Kitchen Formal Dining Room Separate Formal Living Room Separate

Living/Dining Room Combo

Living Room/Great Room Master Bedroom Downstairs

Open Floor Plan

Breakfast Room Separate

Great Room Kitchen/Family Room Combo

'L' Dining

Split Bedroom

Volume Ceilings

Master Bath Features (4)

Bath w Spa/Hydro Massage Tub

Bidet Dual Sinks Garden Bath

Handicapped Accessible Shower - No Tub Tub w Separate Shower Stall

Tub w Shower

Breakfast Bar Closet Pantry

Desk Built In Island

Pantry Walk In Pantry

Kitchen Features (5)Kit

Other – Specify in Remarks

**Floor Covering (6)

Bamboo [G]

Concrete [G] Forestry Stewardship Certified [G]

Quarry Tile

Slate

Brick/Stone

Cork [G]

Marmoleum [G]

Reclaimed Wood [G]

Terrazzo

Carpet

Marble Parquet

Recycled/Composite Flooring [G]

Vinyl

Ceramic Tile

Laminate

Other

Salvaging Flooring [G]

Wood

**Fireplace Y/N

Security System

Yes No

Leased Owned

Fireplace Description (2)

Family Room

Decorative

Gas Fireplace

Master Bedroom

Wood Burning FP

Free Standing

Electric Fireplace

Living Room

Non Wood BurningFire Place

Other Room

ROOMS TAB - ROOM DIMENSIONS

Choices for Room Types are: 2nd Bedroom, 3rd Bedroom, 4th Bedroom, 5th Bedroom, Balcony/Porch/Lanai, Bonus Room, Breezeway, Den/Library/Office, Dinette, Dining Room, Double Master Bedroom, Family Room, Florida Room, Foyer, Game Room, Great Room, Inlaw/Rental Apartment, Inside Utility, Kitchen, Living Room, Loft, Master Bedroom, Media Room, Study/Den, Studio

Choices for Rooms Level are: Basement, Fifth Level, First Level, Fourth Level, Second Level, Third Level

Choices for Primary Floor Covering are: Bamboo, Brick/Stone, Carpet, Ceramic Tile, Concrete, Cork, Forestry Stewardship Certified, Laminate, Marble, Marmoleum, Parquet, Other, Quarry Tile, Reclaimed Wood, Porcelain Tile, Salvaging Flooring, Slate, Terrazzo, Vinyl, Wood

Room Type Room Level Room Dimensions ( WxL) Room Primary Floor Covering

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

WATER/GREEN TAB - WATER ACCESS

Water Access (10)

Beach – PrivateBay/Harbor Beach – Public Beach – Access Deeded

Canal – Freshwater

Gulf/Ocean to Bay

Lake – Chain of Lakes

Canal – Saltwater

Intracoastal Waterway

Limited Access

Creek

Lagoon

Marina

Gulf/Ocean

Lake

Pond

River

Water Access Y/N

Yes No

Water View Y/N

Yes No

Water View (10)

Bay/Harbor – Full

Creek


Marina

Bay/Harbor – Partial

Gulf/Ocean – Full

Lagoon

Pond

Beach

Gulf/Ocean – Partial

Lake

River

Canal

Gulf/Ocean to Bay


Water Frontage (10)

Bay/Harbor

Canal – Saltwater


Marina

Beach – Private

Creek

Lagoon

Pond

Beach – Public

Gulf/Ocean

Lake

River

Canal – Freshwater

Gulf/Ocean to Bay


Water Frontage Y/N

Yes No

Water Extras Y/N

Yes No

Water Extras (10)

Boathouse

Dock – Slip Deeded Off-Site

Private Lake Dues Required

Riprap

Skiing Allowed

Boat Ramp – Private

Dock – Slip Deeded On-Site

Lock

Sailboat Water

Davits

Fishing Pier

Boats-None Allowed

Seawall – Concrete

Dock – Slip 1st Come

Lift

Bridges – No Fixed Bridges

Seawall – Other

Water Name Waterfront Feet

WATER/GREEN TAB - GREEN INFORMATION

Green Certifications (G) (4)

EarthCraft House

FGBC Remodel

Geothermal HVAC

Other – Specify in Remarks

Energy Star Home

Florida Certified Yard

LEED Certified Building

EPA Indoor Air Quality Plus

Florida Friendly Yard Recognition

LEED for Homes

EPA Watersense

Florida Water Star

LEED Neighborhood Development

FGBC Green Certified Home

FORTIFIED for Safer Living

NAHB Certification

Green Water Features (G) (15)

Cistern Drip Irrigation Dual Flush Toilets High Eff. Faucet/Fixtures

High Eff. (Low Flow) Toilet Irrigation – Low Volume Irrigation - None Rain Barrels-Spigot/Overflow

Whole House Water Purification

Grey Water Use-Whole House

Irrigation – Reclaimed Water

Green Landscaping (G) (4)

Non Toxic Fertilizer/Pesticides Veg. (Productive) GardenFl. Friendly/Native Landscape Rain Water Harvesting

Green Energy Features (G) (9)

Energy Star Dishwasher

Gas Tankless Appliances

HVAC SEER 15+

Outdoor Lighting – Solar

Solar Power

Energy Star Refrigerator

Geothermal Heat Pump

HVAC SEER 20+

Programmable Thermostat

Solar Water Heater

Energy Star Qualified Roof Product

Heat Pump Water Heater

Hydro Power

Radiant Barrier

Sprayfoam Insulation – Attic

Energy Star Washer

Heat Recovery Unit

Hydronic Radiant Heating

Reflective Roofing Material

Sprayfoam Insulation – Walls

Energy Star Windows

Humidistat

Outdoor Lighting – None

Solar Hydronic Radiant Heat

Wind

Indoor Air Quality (G) (15) HERS Index

Bath Fans Vented to Outside

No/Low VOC Paint/Finish

HVAC UV/Elec. Filtration

Fireplace - Direct Vent

No/Low VOC Flooring

Range Hood Vented to

Fresh Air Ventilation System

Non Toxic Pest Control

Sealed Combustion

HVAC Filter MERV 8+

HVAC Cartridge/Media Filter

Whole House Vacuum System

Disaster Mitigation (G) (7)

Above Flood Plain Hurricane Insurance Deduction Qual.Fire Resistant Exterior

Lightning Protection System

Fire/Smoke Detection Integration

Safe Room

Owner Phone

Tenant Name Tenant Phone

Hurricane Shutters/Windows

Owner Name

COMMUNITY TAB - ASSOCIATION INFORMATION

Co-Op

Fannie Mae Secured

Fee Simple

Condominium Condo - Hotel

Land-Lease Fractional Ownership

Yes No

**HOA/COMM ASSN

None Optional

Required

HOA Fee

HOA Payment Schedule

Monthly

Semi Annual

Management Contact Information

OWNER TAB - OWNER

Annual

Quarterly

Condo Maintenance FeeCondo Maintenance Fee Schedule

Annual Monthly

Quarterly Semi Annual

Mo. Maintenance $

** OWNERSHIP

Community Features (25)

Buyer Approval Required Association RecreationAssociation Recreation -

Deed Restrictions

Handicap Modified

Elevators

Airport/Runway Boat Slip

Community Hot

Fishing Pier Fitness

Card Entry

Fees RequiredLease

Gated Community

Horse Stables No Truck/RV/ Motorcycle Parking

Dock

Golf Community

No Deed Restriction

Public Boat Ramp

Tennis Courts

Racquet Ball

Laundry Facility

Optional Additional Fees Playground

Recreation Security

Maintenance Free

Storage PUD Water Access

Irrigation By Reclaimed Water [G]None

Private Boat RampPark

Tub/SpaCommunity Boat Ramp

Building

Waterfront Special Comm Tenants No PetsComplex Restrictions

Other Fees Y/N

Yes No

Other Fees Amount Other Fees Term

Annual Monthly

Quarterly Semi Annual

Monthly HOA Amount

Monthly Condo Fee Amount

COMMUNITY TAB - HOUSING FOR OLDER PERSONS

55+ 62+ N/A

FCHR Website

Yes No

Affidavit

Yes No

Deed Restrictions

Y/N

Yes No

Expire Renewal Date

PETSPets Allowed Y/N

Yes NoPet Restrictions Y/N

Yes No

Number of Pets Pet Size

Max Pet Weight Pet Restrictions

REALTOR INFORMATION TAB – REALTOR INFORMATION

Financing Available (10)

Energy Efficient Mortgage [G]

Assumable - Must Qualify Assumable - Non Qualify

FHA Flood Insurance Other

Seller Financing Special Funding

Conventional Exchange/TradeCash

Green Financing Available [G] Lease PurchaseLease Option

USDARequired

VA

Realtor Info (Confidential) (7)

Bonus to Selling Bonus to Lease In Foreclosure Lease AvailableContract for Deed

Tenant Approval Pet on Premises Tenant Occupied Vacant

Go To Site

Variable Rate CommissionPre Foreclosure

Office Office

**HOUSING FOR OLDER PERSONS (2)

Outside

Owned

Realtor Information (25) Agent Related to Agent / Owner Brochure Available CDD Addendum RequiredAssumable Mortgage

Condominium Corporate Owned Fence Restrictions Fixer-UpperEnvironmental Report Available

Floor PlanAvailable

Foreign Seller In-Law Quarters

Lease Leasing Not Owner Will Assist w/

Right Of First Scrub Jay-check Short Term Rental Allowed

Lead Paint Disclosure

Owner Will Consider Financing

Sold As-Is

Home Warranty

Other Disclosures-Contact Agent

Septic Sewer Addendum Req.

Special Assessments

Subject ToApproval

Assoc Approval Required

Docs Available

HOA Disclosure Available

No Sign

Seller Property Disclosure

Survey Available

Owner

Disclosure Avail Relo

Restrictions Allowed Closing Costs

Refusal with county

Termite Bond / Warranty Vehicle Restrictions

AGENT/OFFICE**Agent ID Agent Name Agent Email Office Name and Information

List Agent 2 ID Agent 2 name Agent 2 Email Office 2 Name and Information

Team Name Interoffice Info

COMPENSATION**Single Agent Comp **Non Rep Comp **Trans Broker Comp

Bonus

Bonus Amount

Bonus Expiration Date

Yes No

SHOWING INFORMATION

Call Center Phone Number Showing Time Showing Time Secure Remarks

**Showing Instructions (16)

24 Hour Notice Appointment Only Call Before Showing Call Listing Agent

Call Listing Office Call Owner Call Tenant Gate Code Required

Lock Box - Use RequestLock Box Coded

See Remarks Under Construction (Go to site)

Call Agent 2

Key-Listing Broker Office

Pet on Premises

Contact Call Center

Listing Agent Must Accompany

No Call BoxElectronic Showing Button

Lock Box -Combination

IDX/VOW**Internet Y/N

Yes No

**Show Prop on Address on Internet

Yes No

**IDX Y/N

Yes No

**Realtor.com Y/N **VOW AVM Y/N **IDX/VOW Display Comments Y/N Third Party Y/N

Yes No Yes No Yes No Yes No

MARKETING LINKS and INFORMATION

**Create Automatic Virtual Tour

Yes No

Virtual Tour Link Virtual Tour Link 2 Web Link 1 Web Link 2

**Public Remarks

Realtor Only Remarks

**Driving Directions

The Owner has reviewed the foregoing information contained in this Data Entry Form and acknowledges the information to be true and correct to the best knowledge of the owner.

The Owner agrees to indemnify and hold harmless the My Florida Regional Multiple Listing Service (MFRMLS), the Originating Board, and their employees, the Listing Broker and licensees, the Selling Broker and licensees, and all other cooperating Brokers and licensees against any and all claims or liability (including attorney fees) arising from any breach of warranty by Owner or from any incorrect information supplied by Owner or from any facts concerning the Property which was known or reasonably should have been known to Owner but not disclosed by Owner.

At the request of the Listing Broker, unless otherwise properly indicated on this Data Entry form, MFRMLS will electronically transmit information about the Owner's property to Internet web sites to aid in the marketing of the Property for sale.

MFRMLS shall retain and make available all such data and photographs to all its participants for an indefinite period.

MFRMLS assumes no responsibility or liability to Owner for errors or omissions on this Data Entry Form or in the MFRMLS computer system.

The Owner hereby authorizes Listing Broker to file this Data Entry form with the MFRMLS and the Owner will provide timely notice of all status changes.

DATE OWNER SIGNATURE OWNER SIGNATURE

DATE BROKER

** indicates a required field o indicates a single choice … 3 **garage / carport (3) 1 car carport...

Documents

indicates a required field o indicates a single choice … 3 garage / carport (3) 1 car carport...