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

LISTING TAB-STATUS AND LISTING INFORMATION

**Entered WhereOffice

**List Date **Expiration Date

BOM Date

**List Price Original List Price

Previous List Price

Range Price Y/N

Yes

Seller Represented

**Listing TypeExclusive Right to Sell

Limited Service

Seller Not Represented

Yes

No

Lease Rate Lease Price Per Acre

Lease Terms (5)

3 to 5 Years 6+ Years

Renewal OptionPurchase Options

Price Per Acre

Availability

**Office Primary Board ID(H) Central Pasco

(E) East Pasco

(J) For Future Use

(G) Lake/Sumter

(M) Manatee

(S) Osceola

(C) Port Charlotte

(R) Other

(N) Venice

(A) Sarasota

(T) Tampa

(V) West Volusia

**Special Sale Provision

REO/Bank Owned Short Sale None

**Special Listing Type

Exclusion Not ApplicableOther

ADDRESS

**Street Number **Street NameStreet Type

Street Dir Post

Page 1

Association

Representation

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

**CountyFloor Number Building # Floors

Building Name/Number Floors in Unit

No

VRange Price Low

(B) Bartow

(D) Englewood

(L) Lakeland

(U) PinellasSuncoast

(W) West Pasco

(F) DeSoto

(X) Interealty Usage

Indicates a Multiple Choice Field

SCHOOLS

Elementary School Middle or Junior School

High School

AUCTION

**Auction Y/N

Yes No

Auction Date

Auction Time

L.S. / Exclusive Agency

Exclusive Right to Lease

Exclusive Agency

L.S. / ExclusiveRight to Sell

Sold Data /Entry Only

**For Lease Y/N

1 to 2 Years Annual Rate Increase

Pass ThroughsGross Lease

Improvement Allowance

Variable Commission

Exclusion /Variable

Street Dir Pre

(O) OrlandoRegional

(K) LakeWales

(P) EastPolk

Billboard Site

Dude Ranch

Four UnitsUse

Land Fill

Multi-Family

Ranchland

Timberland

Well Field

Working Ranch

Trans/Cell Tower

Tree Farm

Triplex Use

**Property Style

Business

Duplex Use

Groves

Mining

Other

ResidentialDevelopment

Commercial

Farmland

Home &Income Housing

Mixed Use

PlantNurserySingle FamilyUse

Crop ProducingFarm

Fish Farm

Industrial

MobileHome Use

PUD

Sod Farm

Front Exposure

N

S

E

W

NE

NW

SE

SW

Frontage Description (10 Max)

City Road

County Road

Easement Access

InterchangeNo Current Access

Private Road

State Road

US Highway

BusinessDistrict

Interstate

**Location (10 Max)Close to Bus Line

Cul de Sac

Greenbelt

Hunting Lease

Level

Lot – Oversized

Partially WoodedRoom For PoolStreet Dead-End

CDD

Historic District

Key Lot

Lot - Key

Reclaimed Land

Street Brick

Brownfield

Conservation Area

Envr. Restr. Area

Hilly

In County

Lot - Irregular

Near Airport

Preserve Area

Sidewalk

Street Paved

Street Private

Street Unpaved

Wetlands

Wooded

Billboard Lease

Flood Plain

In City Limits

Lot – Flag

Lot - Tip

Zoning Permits Horses

Coastal ConstrCtrl Line

HighwayFrontage

Pasture/Agriculture

RuralService Area

Corner Lot/Unit

Golf Course Frontage

Near Railroad Siding

Street One Way

Trans/Cell Tower Lease

Urban Service Area

Wildlife Sanctuary

Easements

Road FrontageNumber of Add parcelsFences (3 Max)

Chain Link

Cross

Other

Partial

Hedge

Stone

Wire

WoodMasonry / Masonry Brick

Current Adjacent Use (2)

Church Commercial Industrial Multi-Family

ParkProfessional Office

Residential

Retail

School Vacant

Mobile Home Park

Page 2

**Utilities (10)

City Water

Gas-LP None

Public Utilities

Telephone

Sewer Available Street Lights

Well Required Well + Pump

Sprinkler Well

Water AvaiableUnderground

Sprinkler Meter Sprinkler Recycled

Sold As IsStreet Lights Trees

Site Improvements (25)

Cleared

Corral

Flat Level SiteFilled

WoodedStocked FishPonds

On Site Fuel Storage/Handling Equip

BB/HS Internet Avail County Water

Gas-Natural

Private Municipal Water Public Water

Well

Sewers Nearby Septic SystemRequired

Cable Available

Electric Avail on Site

Fire Hydrant

Private or Subdivision

Cable Connected

Fiber Optics

Other PrivateSystem

Water Nearby

Billboard Buildable Boundary Fencing

Caretakers/SecurityGuard Residence

Compact Soil

Central Business District

Commercial Park

Cross Fencing Demucked

Curb & Gutters

DrainageEasement

Existing Bldg incidental to land value

Feeding Stations

Fill may be needed

Fish BreedingPonds

Flood Insurance may be required

Fruit Trees Irrigation System

Int. All Weather Parking

Loading Pens Int. All Weather Roads

Security Lighting

Stables

Retention Pond

Security Fending/Lighting/Alarms

Barn

LAND AND TAX TAB - LEGAL**Tax ID Alt Key/Folio **Taxes **Tax Year

**Zoning Zoning Compatible Y/N

**Legal Description

**Section **Township **Range **Plat Book/Page **Subdivision Number

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

Yes No

SW Subdiv Sub Condo Number SW Subdv Community Name

Yes No **Additional Parcel Y/N

Complex/Community Name/NCCB

LOT INFORMATION

**Lot Size Sq Ft **Lot Size Acres **Front Footage

**Total AcreageUp to 10,889Sq. Ft

1/2 acre to 1 acre

Two + toFive acres

10 to less than 20

50 to less than 100

200 to less than 500

Zero Lot LineOne+ to Two acres

20 to less than 50

500+ acres Non-Applicable

**Lot Dimensions

1/4 Acre to 21,779 SqFt

5 to less than 10

100 to less than 200

**Legal Subdivision Name

Millage Rate

**CDD Y/NYes

No

Annual CDD Fee Future Land Use State Land Use Code

State Property Use Code County Land Use Code County Property User Code

WATER/GREEN TAB - WATER ACCESS

Water Access Y/N

Yes

No

Water AccessBeach – Private

Beach – Public

Canal – Freshwater

Canal – Saltwater Gulf/Ocean

Gulf/Oceanto Bay Lagoon Lake Limited

AccessMarina River

Bay/HarborBeach – Access Deeded Creek

Intracoastal Waterway

Lake – Chain of Lakes

Pond

Water View Y/N

Yes

No

Water ViewBeach– Private

Beach Gulf/Ocean- Full

Gulf/Ocean- Partial

Lagoon Lake Marina Pond

Bay/Harbor – Full Creek

IntracoastalWaterway

LimitedAccess

Canal Gulf/Ocean to Bay

Lake -Chain of Lakes River

Water Frontage Y/N

Yes

No

Water Frontage Beach – Private

Beach –Public Creek Gulf/Ocean

Lagoon Lake Pond River

Bay/Harbor Canal – Saltwater

Intracoastal Waterway Marina

Canal – Freshwater

Gulf/Ocean to Bay

Lake – Chain of Lakes

Water Extras Y/N

Yes

No

Water Extras

Boat Ramp – Private

Dock – Slip1st Come

Dock – Slip Deeded Off-Site

Lift

Boats-None Allowed

Private Lake Dues Required

Boathouse Davits

Fishing Pier Lock

Dock – Slip Deeded On-Site

Bridges – No Fixed Bridges

Sailboat Water

Seawall – Concrete

RiprapSkiing Allowed

Seawall – Other

Water Name Waterfront Feet

OWNER TAB - OWNEROwner Name

Owner Phone

Fannie Mae Secured

Yes

No

**Ownership (1)

Fee Simple Currently Leased

Deed Restrictions

HOA Optional

HOA Required

Not Applicable

Contract For Deed

Land Lease PUD

Page 3

COMMUNITY TAB - ASSOCIATION INFORMATION

**HOA/COMM ASSN

None Required

HOA FeeHOA Payment Schedule Association Fee Includes (6)

Community Features (25)

Boat Slip Card Entry Dock

Gated Community

Horse Stables

Maintenance Free

Playground Racquet Ball

Shuffleboard Water Access

Annual

Monthly

Quarterly

SemiAnnual

Common Area Taxes

Pool Maintenance

Common Electric

Security

Lawn/Landscaping

Management/Maintenance

Airport/Runway Association Recreation - Owned

Deed Restrictions

Fitness Handicap Modified

Laundry Facility

None Public BoatRamp

Security Tennis Courts

Association Recreation - Lease

Community Boat Ramp

Fees Required Golf Community

Horse Allowed

No Deed Restrictions Pool

Recreation Building

Storage Waterfront Complex

Optional

PETS

Pets Allowed Y/N

Yes

No

Pet Restrictions Y/N

Yes

No

Pet Restrictions

REALTOR INFORMATION TAB – REALTOR INFORMATION

Financing Available (10)

Assumable - Must Qualify

CDD Addendum required

Docs Available

Seller Financing

Realtor Information (25)

Condominium Disclosure Avail

Lease Purchase Special Funding

Assumable Mortgage

Corporate Owned Relo

Other USDA

BrochureAvailable

Flood Insurance Required

Owner/PMM VA

Assoc Approval Req

Conventional Lease Option

Fannie Mae Approved Pilot

Exchange/Trade

Engineering Report Fixer-Upper

Assumable - Non Qualify

FHA

Environmental Disclosure

Floor Plan Available

Cash Flood Insurance Required

Environmental Report Available

Foreign Seller Home Warranty

Lead Paint Disclosure

HOA/PUD/Condo Disclosure

Lease RestrictionsIn Foreclosure

No Sign

Land Sales Disclosure

Other Other Disclosures-Contact Agent

Remediation Accomplished

Remediation in Progress

See AttachmentsOwner/Agent

Phase 1 Environmental Report

Phase 2 Environmental Report

Scrub Jay-checkwith county Seller May Build Seller Must Build Seller Related

To AgentSeptic/Sewer Addendum Required

SignSeller PropertyDisclosure

Special Assessments Subject to Zoning Survey Available Will Sell 1 Lot

Realtor Info (Confidential) (7)

VacantPre Foreclosure

Variable Rate Commission

Tenant Approval

Tenant Occupied

Bonus to Selling office Go To Site Pet on

PremisesInForeclosure

Bonus toLease office

Lease Available

Contract for Deed

OwnerOccupied

AGENT/OFFICE**Agent ID Agent Name Agent EmailAgent Direct Phone Agent Pager/Cell

Agent Home PageAgent Fax Team Name List Agent 2 ID List Agent 2 name

List Agent 2 Email List Agent 2 Phone

OFFICEOffice ID Office Name Office Phone Agent Office Extension Office Fax

List Office 2 ID Office 2 Name Interoffice Info

COMPENSATION**Single Agent Comp **Non Rep Comp **Trans Broker Comp Bonus Y/N

Yes NoBonus Amount Bonus Expiration Date

Page 4

SHOWING INFORMATION

Call Center Phone Number Showing Time Secure Remarks Showing Time

**Showing Instructions(16)

IDX/VOW

**Internet Y/N

Yes

No

**Show Prop on Address on Internet Y/N

Yes

No

**IDX Y/N

Yes

No

**Realtor.com Y/N

Yes

No

Third Party Y/N

Yes

No

Set Appointment

View Instructions

24 Hour Notice Call Listing Agent Call Owner

Gate Code Required

Lock Box - Combination

No Call Box

Under Construction (Go to site)

Appointment Only Call List Agent 2 Call Tenant

Key-Listing Broker Office

Lock Box - Electronic

Pet on Premises Use Request Showing Button

Call Before Showing Call Listing Office

Contact Call Center

Listing Agent Must Accompany

Lock Box Coded

See Remarks MARKETING LINKS and INFORMATION

Yes No**Create Automatic Virtual Tour Y/N

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