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

Association

**Expiration Date BOM Date **List Price Range Price

Yes No

Vrange List Low Price

Lease Rate

Original List Price **Listing Type Exclusive Right to Lease

Representation

Exclusive Agency

L.S. / Exclusive Agency

Seller Not Represented

LP/Sq Ft

**Deposit

Yes

No

**Security Deposit **Office Primary Board ID

Central Pasco DeSoto

East Pasco

East Polk Interealty Usage

Lake/Sumter

Lake Wales Lakeland

Orlando Regional

Osceola Other Pinellas Suncoast

Sarasota Tampa Venice

West Pasco

Bartow

Englewood

Manatee

Port Charlotte

West Volusia

L.S. / Exclusive Right To Sell

REO/Bank Owned

**Special Listing Type

Exclusion

Not Applicable

Other

ADDRESS

**Street Number

Street Dir Pre **Street Name

Street Type

Street Dir Post

Unit Number

**City **State **Zip Zip + 4

Number Building Name/

Total # Buildings

SCHOOLS

Page 1

Office

LISTING TAB-STATUS AND LISTING INFORMATION

**Entered Where

Exclusive Right to Sell

Limited Service (L.S.)

Sold Data / Entry Only Previous List Price

Seller Represented

**Listing Date

Special Sales Provision

Exclusion / Variable Commision

Variable Commision

Auction*

Yes

NoShort Sale

None of the Above

** County

Elementary School

Middle or Junior School

High School

FINANCIAL INFORMATION

Annual Gross Income

**Annual Net Income

Est Annual Market Income

Total Monthly Rent Total Monthly Expenses

Annual Expenses

Efficiency Avg Rent

Lease Terms (5)

Gross Lease

Seasonal

Limited Pets

Monthly Pet Fee

Tenant Pays Electric

Net Lease

Improvement Allowance

Month to Month

Other

Tenant Pays Association Fee

1 to 2 Years

6 + Years

Renewal Option

Pass Throughs

Pet Deposit

Tenant Pays Sewer Tenant Pays Trash

3 to 5 Years

Annual Rate Increase

Purchase Option

No Pets

Tenant Pays Parking Fee

Tenant Pays Water

Financial Source

Broker

CPA

Owner

Tax Return

EXTERIOR/POOL TAB **POOL

Community None Private

Pool Type (8)

Above Ground Auto Cleaner Child Safety Fence

Diving Board Fiberglass Gunite/Concrete

Heated Pool Heated Spa In Ground

Infinity Edge Inside Other Water Feature

Other Outside Bath Access Pool Sweep

Salt Water [G] Screen Enclosure Solar Cover for Pool [G]

Solar Heated Pool [G] Solar Powered Pool Pump [G] Spa

Tile Vinyl

Page 2

**Location (10)

Conservation Area

Corner Lot

Flood Plain

Gated Community

Greenbelt

Highway Frontage

In City Limits

In County

Lot - Irregular

Lot - Key

Pasture/Agriculture

Park View

Sidewalk

Street Brick

Street Paved

Street Private

Close to Bus Line

Corner Lot/Unit

Golf Course Frontage

Hilly

Level

Lot – Oversized

Pool View

Street Dead-End

Street Unpaved

Coastal Constr Ctrl Lnn

Cul-de-Sac

Golf Course View

Historic District

Lot – Flag

Lot - Tip

Room for Pool

Street One Way

Zoning Permits Horses

**Exterior Construction (5)

Asbestos

Brick

Log

On Piling

Siding

Stem Wall

Stucco

Wood Frame

Block

ICF Insulated Concrete Forms [G]

Metal Frame

Other

SIP Structurally Insulated Panel [G]

Stone

Tilt Up Walls [G]

Wood Frame (Forestry Stewardship Certified) [G]

Porches

**Roof (3)

Built up Membrane Metal

Roof Over

Shake Shingle Slate

TileOther

Front Exposure

North South East West

Northeast Northwest Southeast Southwest

**Exterior Features (12)

Detached In-Law Apt

French Doors

Gutters/Downspouts

Hurricane Shutters

Oak Trees

Outdoor Grill

Patio/Porch/Deck Covered

Rental Apartment

Sidewalk

Stables

Utility Shed

Balcony/Sun Deck

Detached Workshop

Fruit Trees

Handicap Modified

Irrigation System

Open Patio

Outdoor Shower

Patio/Porch/Deck Open

Satellite Dish

Sliding Doors

Storage

Wheelchair Accessible

Barn

Fenced

Greenhouse

Hot Tub/Spa

Mature Landscaping

Other

Parking - RV/Boat

Patio/Porch/Deck Screened

Sauna

Sprinkler Metered

Trees/Landscaped

Xeriscape

**Sidewalk

Yes

No

**Garage / Carport (3)

1 Car Carport 1 Car Garage 2 Car Garage

3 Car Carport 3 Car Garage 4 Car Garage

5+ Car Carport 5+ Car Garage Golf Cart Garage

RV Garage None

2 Car Carport

4 Car Carport

RV Carport

Under Building parking

**Garage Features (10)

Assigned Parking

Circular Drive

Covered Parking

Drive Space

Golf Cart Parking

None

Open Parking

Parking Pad

Portico

Street Parking

Tandem Parking

Attached

Detached

Guest Parking

Other

Secured Parking

Under Building Parking

Bath In Garage

Door Opener

No Street Parking

Oversized

Side Rear Entry

Washer/Dryer Hookup

Workshop

Garage Dimensions Model Name

Page 3

LAND AND TAX TAB - LEGAL

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

**Legal Description **Section **Township **Range

**Subdivision Number Subdivision Section Number **Block/Parcel **Lot # **Legal Subdivision Name **Plat Book/Page

**Additional ParcelYes No

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

LAND AND TAX TAB - LOT INFORMATION

Lot Dimensions Lot Size (Square Feet)* Lot Size (Acres)* Future Land Use

**Total Acreage

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

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

5 to less than 10

100 to less than 200 200 to less than 500

500+ acres Non-Applicable

Yes No

Other Exemptions

Yes No

**CDD

Yes No

**New Construction

Yes No

Special Tax District

Yes No

LAND AND TAX TAB - PARCEL

Construction Status

Completed

Pre-Construction

Under Construction

Projected Completion Date

**Homestead

INTERIOR TAB - INTERIOR INFORMATION

**Property Style

Duplex Five or more units Four Units

Single Family Single Family Home Townhouse

Dock/Rackominium

Triplex

Home with a Rental Unit

**Property Description (4)

1 Level 2 Levels 3 Levels 4 + Level

Attached Detached

Architectural Styles (6)

Cape Cod Colonial Contemporary

Custom Dutch Provincial Florida

Historical Key West Ranch

Townhouse Traditional Tudor

Bungalow

Courtyard

French Provincial

Spanish / Mediterranean

Victorian Villa Other

**Utilities Data (10)

BB/HS Internet Avail City Water

Electric Fiber Optics

None Gas

Public Sewer Public Utilities

Sewer Sprinkler Recycled

Aerobic Septic

Cable Connected

Fire Hydrant

Private Municipal Water

Septic

Sprinkler Well Street Lights

Cable Available

County Water

Other

Private or Subdivision

Sprinkler Meter

Underground Well

**Square Feet Heated

**Sq Ft Source

Builder

Measured

Owner Provided

Public Records

Appraisal

Total Units

Annual CDD Fee

Additional Rooms (9)

Bonus Room Breezeway

Den / Library / Office Family Room

Florida Room Foyer

Game Room Inlaw / Rental Apt

Inside Utility

**Air Conditioning (2)

Central Humidistat

No Air Wall/Window Units

Zoned/Multiple

**Heating and Fuel (6)

Central Fuel - Electric

Fuel – Oil Heat Pump

Other

Partial

Solar Space Heater

Zoned / Multiple

Fuel - Gas Bottled

Fuel - Gas Natural

Heat Recovery Unit No Heat

Raiant / Baseboards Raiant / Ceiling

Wall Furnace

Wall / Window Units

**Appliances Included (13)

Dishwasher

Gas Appliances

Other

Solar Hot Water Rented

Compactor

Freezer

None

Solar Hot Water Owned

Disposal

Hot Water Electric

Range

Washer

Dryer

Hot Water Gas

Range Hood

Water Softner Owned

Exhaust Fan

Microwave

Rifrigerator

Water Softner Rented

Page 4

Interior Layout (8)

Formal Dining Room Separate

L Dining

Master Bedroom Downstairs

Breakfast Room Separate

Formal Living Room Separate

Living/Dining Room Combo

Split Bedroom

Eating Space In Kitchen

Kitchen/Family Room Combo

Living Room/Great Room

Volume Ceilings

**Interior Features (14)

Attic Fan

Central Vacuum

Hot Tub/Spa

Radiant Barrier

Smoke Alarm(s)

Walk In Closet

Cathedral/Vaulted Ceiling

Furnished

Medical Alarm

Sauna

TV Antenna

Wet Bar

Attic

Ceiling Fan(s)

Handicapped Modified

Pest Guard System

Skylights

Volume Ceilings

Wheelchair Accessible Window Treatment

Blinds/Shades

Corridor Access

Intercom System

Rods

Solid Stone Counters

Washer/Dryer Hookup

Other

Master Bath Features (4)

Bath with Whirlpool

Dual Sinks

Handicapped Accessible

Tub w Separate Shower Stall

Other - Specify in Remarks

Bath w Spa/Hydro Massage Tub

Bidet

Garden Bath

Shower - No Tub

Tub w Shower

**Floor Covering (6)

Carpet

Cork [G]

Marble

Other

Recycled/Composite Flooring [G]

Terrazzo

Bamboo [G]

Ceramic Tile

Forestry Stewardship Certified [G]

Marmoleum [G]

Quarry Tile

Salvaged Flooring [G]

Vinyl

Brick/Stone

Concrete [G]

Laminate

Parquet

Reclaimed Wood [G]

Slate

Wood

Security System

Leased Owned

**Fireplace

Yes No

Fireplace Description (2)

Family Room

Living Room

Other Room

Electric Fireplace

Gas Fireplace

Master Bedroom

Wood Burning FP

Kitchen Features (5)

Closet Pantry

Cooking Island Desk Built In

Breakfast/Snack Bar

Pantry Walk In Pantry

SPACE

**Efficiencies-Number of 1 Bed/1 Bath # 1 Bed/1 Bath Avg Rent Num of Add Parcels

2 Bed/1 Bath # 2 Bed/1 Bath Avg Rent 2 Bed/2 Bath # 2 Bed/2 Bath Avg Rent

3 Bed/1 Bath # 3 Bed/1 Bath Avg Rent 3 Bed/2 Bath # 3 Bed/2 Bath Avg Rent

WATER/GREEN TAB - WATER ACCESS

Water Access

Yes

No

Water Access (10)

Beach – Private Canal – Freshwater Canal – Saltwater

Gulf/Ocean Gulf/Ocean to Bay Lagoon Lake

Limited Access Marina River

Water View

Yes

No

Water View (10)

Bay/Harbor – Partial Beach

Lagoon Lake

Pond River

Beach - Access DeededBay/Harbor

Creek

Lake - Chain of Lakes

Beach – Public

Intracoastal Waterway

Pond

Canal Gulf/Ocean - Full

Gulf/Ocean - Partial

Bay/Harbor - Full Creek

Intracoastal Waterway

Marina

Gulf/Ocean to Bay Lake - Chain of Lakes

Water Frontage

Yes

No

Water Frontage (10)

Beach – Private

Gulf/Ocean Lagoon Lake

Pond

Beach – Public

I r er y

River

.. y/H r r er

M r

l re er

G e y

Creek

e e

Page 5

Water Extras

Yes

No

Water Extras (10)

Water Name Waterfront Feet

Boathouse

Dock - Slip Deeded On-Site Fishing Pier Lock

Riprap Seawall - Other

Boat Ramp - Private

Dock - Slip Deeded Off-Site Lift

Boats - None Allowed

Sailboat Water Skiing Allowed

Davits Dock - Slip 1st Come

Private Lake Dues Required

Bridges - No Fixed Bridges

Seawall - Concrete

WATER/GREEN TAB - GREEN INFORMATION

Green Certifications (G) (4)

Energy Star HomeTM

FGBC Green Certified Home

Florida Friendly Yard Recognition

Geothermal HVAC

LEED Neighborhood Development

EPA Indoor Air Quality Plus

FGBC Remodel

Florida Water Star

LEED Certified Building

NAHB Certification

EarthCraft HouseTM

EPA WaterSense

Florida Certified Yard

FORTIFIED for Safer Living

LEED for Homes

Other – Specify in Remarks

Green Energy Features (G) (9)

Energy Star Refrigerator

Energy Star Windows

Heat Pump Water Heater

Hydronic Radiant Heating

Outdoor Lighting – Solar

Reflective Roofing Material

Solar Hydronic Radiant Heating

Sprayfoam Insulation – Attic

Energy Star Qualified Roof Product

Gas Tankless Appliances

Heat Recovery Unit

Humidistat

Programmable Thermostat

HVAC SEER 15+

Solar Power

Sprayfoam Insulation – Walls

Energy Star Dishwasher

Energy Star Washer

Geothermal Heat Pump

Hydro Power

Outdoor Lighting – None

Radiant Barrier

HVAC SEER 20+

Solar Water Heater

Wind

Green Water Features (G) (11)

Cistern

Dual Flush

High Efficiency Faucet/Fixtures

Irrigation – Low Volume

Irrigation – Reclaimed Water

Whole House Water Purification

Drip Irrigation

Grey Water Use (Whole House)

High Efficiency (Low Flow) Toilet

Irrigation - None

Rain Barrels w Spigot/Overflow

Green Landscaping (G) (4)

Non Toxic Fertilizer/Pesticides

Vegetable (Productive) Garden

Florida Friendly/Native Landscape

Rain Water Harvesting

Fire Resistant Exterior

Hurricane Insurance Deduction Qual.

Lightning Protection System

Above Flood Plain

Fire/Smoke Detection Integration

Hurricane Shutters/Windows

Safe Room

Disaster Mitigation (G) (7)

Indoor Air Quality (G) (15)

Bath Fans Vented to Outside

HVAC Filter MERV 8+

Non Toxic Pest Control

Range Hood Vented to Outside

Fireplace - Direct Vent

No/Low VOC Paint/Stain/Finish

HVAC Cartridge/Media Filter

Sealed Combustion

Fresh Air Ventilation System

No/Low VOC Flooring

HVAC UV/Electronic Filtration

Whole House Vacuum System

OWNER TAB - OWNER

Owner Name

Owner Phone

Tenant Name

Tenant Phone

Management

Management Contact Information **Ownership

Co-Op

Condominium

Fee Simple

Land-Lease

Fannie Mae Secured

Yes No

COMMUNITY TAB - ASSOCIATION INFORMATION

**HOA/COMM ASSN

OptionalNone

HOA Fee HOA Payment Schedule

MonthlyAnnual

Quarterly Semi Annual

Required

Monthly HOA Amount Condo Maintenance Fee Condo Maintenance Fee Schedule

Annual Monthly

Quarterly Semi AnnualMonthly Condo Fee Amount

COMMUNITY TAB - HOUSING FOR OLDER PERSONS

**HOUSING FOR OLDER PERSONS (2)

55+ 62+ N/A

FCHR Website

Yes No

Affidavit

Yes No

Expire Renewal Date

Page 6

Community Features (25)

Association Recreation -Owned

Dock

Golf Community

Maintenance Free

Park

Security

Tennis Courts

Airport/Runway

Community Hot Tub/Spa

Fitness

Irrigation By Reclaimed Water [G]

Optional Additional Fees

Racquet Ball

Special Community Restrictions

Association Recreation - Lease

Deed Restrictions

Gated Community

Laundry Facility

Playground

Recreation Building

PUD

PETS

Pets Allowed

Yes

No

Pet Restrictions

Yes

No

Number of Pets Pet Size Max Pet Weight

Pet Restrictions

Boat Slip

Elevators

Handicap Modified

No Truck/RV/Motorcycle Parking

Private Boat Ramp

Shuffleboard

Water Access

Buyer Approval Required

Fees Required

Horse Stables

None

Public Boat Ramp

Storage

Waterfront Complex

REALTOR INFORMATION TAB – REALTOR INFORMATION

Realtor Information (25)

3rd Party Approval Req

CDD Addendum required

Corporate Owned Relo

Environmental Report Available

Floor Plan Available

In Foreclosure

Lease Restrictions

Owner/Agent

Owner Will Consider Financing

Seller Must Build

Septic Sewer Addendum Req.

Special Assessments

Tenant Occupied

Assumable Mortgage

Condominium Disclosure Avail

Deed Restrictions

Fannie Mae Approved Pilot

Foreign Seller

In-Law Quarters

No Sign

Owner Occupied

Pre-Foreclosure

Seller Property Disclosure

Short-Term Rental Allowed

Subject To Zoning

Termite Bond / Warranty

Brochure Available

Contract for Deed

Docs Available

Fixer-Upper

Home Warranty

Lead Paint Disclosure

Other Disclosures-Contact Agent

Owner Will Assist w/ Closing Costs

Seller May Build

Seller Related To Agent

Sold As-Is

Survey Available

Will Sell 1 Lot

Realtor Info Confidential (7)

Bonus to Selling office

Go To Site

Lease Available

Pet on Premises

Tenant Approval

Vacant

Bonus to Lease office

Contract for Deed

In Foreclosure

Owner Occupied

Pre-Foreclosure

Tenant Occupied

Variable Rate Commission

Financing Available (10)

Assumable - Non Qualify

Conventional

Exchange/Trade

Flood Insurance Required

Lease Option

Other

Special Funding

VA

Assumable - Must Qualify

Cash

Energy Efficient Mortgage [G]

FHA

Green Financing Available [G]

Lease Purchase

Seller Financing

USDA

COMPENSATION

Single Agent Comp Non Rep Comp Trans Broker Comp

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

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

Team Name

SHOWING INFORMATION

Call Center Phone Number Showing Time Showing Time Secure Remarks

Page 7

**Showing Instructions (16)

24 Hour Notice

Call Listing Agent

Call Owner

Contact Call Center

Listing Agent Must Accompany

Lock Box Coded

See Realtor Remarks

Appointment Only

Call Agent 2

Call Property Manager

Gate Code Required

Lock Box - Combination

Lock Box No Call

Under Construction (Go to site)

Call Before Showing

Call Listing Office

Call Tenant

Key-Listing Broker Office

Lock Box - Electronic

Pet on Premises

Use Request Showing Button

IDX/VOW

**Internet

Yes

No

**Show Prop on Address on Internet

Yes

No

**IDX

Yes

No

**Realtor.com

Yes

No

**VOW AVM

Yes

No

**IDX/VOW Display Comments

Yes

No

Third Party

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