Equal Housing
Please complete the following form and select "continue to STEP 2" when finished.
All areas with (R) are REQUIRED and must be completed
Sections with have additional information when clicked.
Owner Name(s): (R) Add'l Owner(s): Property Address: (R)
City: (R)
State: FL (R)
Zip: (R)
What county is your property in? (R) Pasco Pinellas Hillsborough
What would you like your List price($) to be? (R)
How is your property zoned (R)
What year was your structure built? (R) Year 1850 1851 1852 1853 1854 1855 1856 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
What is the size of your lot (R)
What is the heated Sq. Ft. of your structure (a.k.a. living area)
Where did you find the heated Sq. Ft. information? Tax Records (Must be the actual figure stated in the public records or "Measured" must be selected) I Measured Appraisal Builder
What is the Legal Description of your property (R)
What is the Subdivision number of your property?
What is the Block number of your property?
What is the Lot number of your property?
How many bedrooms does your property have? (R) Choose one 1 2 3 4 5 6 7 8 9 10 11 12
How many bathrooms does your property have? (R) Choose one 1 2 3 4 5 6 7 8 9 10 11 12
How many half-bathrooms does your property have? (R) Choose one 0 1 2 3 4 5 6 7 8 9 10 11 12
Type of Ownership (R) Condo Co-op Fee Simple Land Lease Condo-Hotel
Is your property a Planned Unit Development (R) Yes No
Property Codes (R) Single Family Condo-Hotel Condo Townhouse Villa Manufactured-Modular
If you have an annual CDD fee what is it (Community Development District) (If the fee is included in your taxes please separate the figures)
Is there a required Homeowners/Condo Association? (R) Yes No How much is the Homeowners/Condo Association fee? --- check box if it's included in the monthly maintenance fee
How often is the Homeowners/Condo Association fee paid? Annual Monthly Quarterly Semi-Annual
Do you claim a Homestead Tax Exemption on your property? (R) Yes No
How much are your annual real estate taxes? (R) Tip: The amount must be the UNDISCOUNTED amount which is also the March figure.
What year was the tax figure from? (R) Year 2008 2009 2010
How much commission are you willing to offer a REALTOR that brings you a buyer? (R) It can be a % of the sales price -OR- a flat fee. (NO VARIABLE COMMISSIONS ALLOWED)
How many floors are in your building? (For condos only)
What is the total number of units in your building? (For condos only)
What is the Land Lease Fee (if any)? (For condos only)
What is the maximum weight allowed for a pet? (R) lbs. (If pets are allowed, and there is no max pet weight, enter 999. If pets are not permitted enter 00.)
What is the minimum amount of time your property can be leased? (R) days. (If you are not allowed to lease your property, enter 00. Enter 999 if there is no minimum.)
Are there any community or association monthly maintenance fees in addition to any Homeowners Association fees? (R) Yes No
If there are community or association monthly maintenance fees, how much are they?
What is the Legal Subdivision Name of your property (R)
When would you like your listing to expire (R) CAUTION: Setting a long expiration date can backfire on you! read more Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2011 2012
Contact phone number(s) to appear in your MLS listing: 1st phone number (R) Include AREA code 2nd phone number
Property Description (R) One Story Two Story Three Story Ground Floor Unit 1st Floor Multi-Story 2nd Floor Multi-Story 3rd Floor + above Multi-Story End Unit Elevated Penthouse Townhouse 2-3 Floors Tri Level Split Level Stilt Home
Architectural Style (6 max) Bungalow Cape Cod Colonial Contemporary Courtyard Custom Dutch Provincial Elevated Florida French Provincial Historical Key West Patio Ranch Spanish Traditional Tudor Victorian Other
Acreage Information (R) Non-Applicable Zero Lot Line Up to 10,889 Sq. Ft. 1/4 Acre to 21,779 Sq. Ft. (1/2 Acre) 1/2 Acre to 1 Acre One+ to Two Acres Two+ to Five Acres 5 to 10 Acres 10 to 20 Acres 20+ Acres 50+ Acres 100+ Acres 200+ Acres 500+ Acres
Location Coastal Construction Control Line Conservation Area Corner Lot / Unit Cul-De-Sac End Unit Gated Community Golf Course Frontage Historic District In City Limits In County Key Lot Level Oversized Lot Pasture/Agriculture Park View Pool View Sidewalk Street Brick Street Dead-End Street One-Way Street Paved Street Private Tennis Court View Tip Lot Unpaved Street Unincorporated Wooded View Zoning Permits Horses
Which direction does the front of your property face? (R) East North Northeast Northwest South Southeast Southwest West
What type of construction best characterizes your structure? (R) Asbestos Block Brick Log Metal Frame Mobile On Piling Other Siding Stone Stucco Wood Frame
What kind of foundation does your property have? Basement Crawlspace Slab
Does your property have any of the following energy features? Geothermal HVAC Low Flow Toilet Solar Power Solar Hot Water
Exterior Features Balcony/Sun Deck Barn Detached In-Law Apt. Detached Workshop Fenced French Doors Fruit Trees Greenhouse Gutters/Downspouts Handicapped Modified Hot Tub/Spa Hurricane Shutters Irrigation System Mature Landscaping Oak Trees Other Outdoor Grill Outdoor Kitchen Outdoor Lights Outdoor Shower Parking-RV / Boat Porch / Patio / Deck Covered Porch / Patio / Deck Open Porch / Patio / Deck Screened Rental Apartment Satellite Dish Sauna Screened/Covered Enclosure Sliding Doors Stables Storage Trees/Landscaped Utility Shed Wheelchair Accessible Xeriscape
What type of Roof does your property have?(R) Built Up Membrane Metal Other Shake Shingle Slate Tile
What kind of Garage / Carport does your property have? (R)
None - No Garage or Carport Carport: 1 Car Carport 2 Car Carport 3 Car Carport 3+ Car Carport 4 Car Carport 5+ Car Carport RV Carport
Garage: 1 Car Garage 2 Car Garage 3 Car Garage 3+ Car Garage 4 Car Garage 5+ Car Garage RV Garage
What kind of Garage / Carport features does your property have? (R) None Assigned Parking Attached Bath in Garage Circular Drive Detached Door Opener Golf Cart Guest Parking Open Parking Oversized Parking Pad Secured Parking Side Rear Entry Street Parking Tandem Parking Under Building Parking Washer / Dryer Hookup Workshop
Air Conditioning-cooling only(R) Central Humidistat None Wall Unit(s) Window Unit(s) Zoned/Multiple
Heating (R) Central Electric Gas Oil Heat Recovery Unit None Radiant Solar Space Heater Wall Furnace Wall Units / Window Units Zoned/Multiple
What type of flooring do you have? Brick / Stone Ceramic Tile Laminate Marble Other Parquet Quarry Tile Slate Terrazzo Vinyl Wall to Wall Carpet Wood
Utilities Data Broad Band/High Speed Internet Available Cable Canal/Lake for Irrigaton Fire Hydrant (w/i 1000 ft) Gas Public Municipal Water Private Municipal Water Private Municipal System Septic Sewer Sprinkler Meter Sprinkler Well Sprinkler Reclaimed Well Underground
Does your property have a Security Alarm System? (R) Yes No
What Community Features are available ONLY TO OWNERS in your subdivision? (R) Tip: The Community Features are private and paid for by the residents. (NOT Public) (12 max.) None-N/A Airport Runway Association Recreation Lease Association Recreation Owned Boat Slip Community Boat Ramp Community Heated Pool Community Hot Tub/Spa Community Pool Dock Deed Restrictions Elevators Fees Required Fishing Pier Fitness Center Gated Golf Course Handicapped Modified HOA Optional HOA Required Horse Stables Laundry Facility Optional Additional Fees No Truck/RV/Motorcycle Park Playground Pool View Private Boat Ramp Racquet Ball Recreation Building Runway Security Shuffleboard Storage Tenants No Pets Tennis Court Water Access Waterfront Complex
What type of Maintenance is included in your maintenance fee? (R) Not Applicable Building Exterior Cable Electric Escrow Reserves Gas Insurance Building Internet Lawn/Ground Maintenance Maintenance/Repairs Manager Pest Control Private Road Recreational Facilities Roof Security Trash Removal Water / Sewer
Layout - Interior Bonus Room Breakfast Room Separate Eating Space in Kitchen Family Room Florida Room Formal Dining Room Separate Formal Living Room Separate Great Room Plan In-Law Rental Apartment Kitchen / Family Room Combo Laundry Room-Separate "L" Dining Living / Dining Room Combo Master Bedroom Downstairs Open Plan Split Bedroom Study / Den / Library
Interior Extras Attic Attic Ventilator Blinds / Shades Cathedral / Vaulted Ceiling Ceiling Fan(s) Central Vacuum Corridor Access Crown Molding Drapes/Window Treatment Dry Bar Dumb Waiter Elevator Furnished Handicapped Modified Hot Tub/Spa Inside Utility Intercom System Medical Alarm Other-See Remarks Radiant Barrier Rods Sauna Solid Surface Counters Solid Wood Cabinets Skylights Smoke Alarm(s) Stone Counters Storage Room Thermal Windows Thermostat Attic Fan TV Antenna Volume Ceilings Walk in Closet Washer/Dryer Hook-Up Wet Bar Wheelchair Accessible Whole House Reverse Osmosis System
Fireplace Yes No
Fireplace Description Electric Fireplace Family Room Gas Fireplace Living Room Master Bedroom Wood Burning Fireplace Other Room
Master Bath Features - MBR= Master Bedroom Bidet Dual Sinks Garden Bath Handicap Accessible MBR Bath - Shower No Tub MBR Bath - Tub w/ Shower MBR Bath - Tub with Separate Shower Stall MBR Bath - w/ Whirlpool MBR Bath with Spa/Hydro Other - Specify in Remarks
Kitchen Breakfast / Snackbar Closet Pantry Cooking Island Desk Built In Pantry Walk-in Pantry
What Appliances are you going to include in the sale of your property? Built In Oven Compactor Compactor Dishwasher Disposal Dryer Exhaust Fan Freezer Gas Appliances Hot Water Electric Hot Water Gas Kitchen Reverse Osmosis System Microwave Range Range Hood Refrigerator Solar Hot Water Tankless Water Heater Washer Water Softener Wine Refrigerator
Do you have a private or community pool? (R) Tip: A community pool is usually located in the actual subdivision or condo complex and should not be confused with a public city/county pool. Yes there is a pool No there is no pool
If you OWN your pool what type is it? (Not for community pools) No Seller Owned Pool Above Ground Pool Automatic Cleaner Child Safety Fence Diving Board Fiberglass Gunite/Concrete Heated Hot Tub/Spa Heated Pool Infinity Edge In Ground Other Water Feature Pool Sweep Salt Water Screen Enclosure Solar Heated Pool Spa Tile Pool Vinyl Pool
Water Frontage(R) "Yes" should be used only when the subject property touches water, and can be clearly defined by the "Water Frontage Description" features below. Yes No
Water Frontage Description Bay/Harbor Beach - Private Beach - Public Canal - Freshwater Canal - Saltwater Creek Gulf/Ocean Gulf/Ocean to Bay Intracoastal Waterway Lagoon Lake Lake - Chain of Lakes Marina Pond River
Water Access (R) "Yes" should be used only when the subject property has deeded access to one or more of the "Water Access" features below. Note: The availability of off-site Water Access facilities provided by an association membership DOES NOT qualify under this heading, please enter that information under Community Features. Yes No
Water Access Description Bay/Harbor Beach - Private Beach - Public Beach-Access Deeded Canal - Freshwater Canal - Saltwater Creek Gulf/Ocean Gulf/Ocean to Bay Intracoastal Waterway Lagoon Lake Lake - Chain of Lakes Marina Pond River
Water View (R) "Yes" should be used only when the subject property has a view of the water, that can be clearly defined by selecting one or more of the "Water View" features below. Yes No
Water View Description Bay/Harbor - Full Bay/Harbor - Partial Beach Canal Creek Gulf/Ocean - Full Gulf/Ocean - Partial Gulf/Ocean to Bay Intracoastal Waterway Lagoon Lake Lake - Chain of Lakes Marina Pond River
Water Extras (R) Yes No
Water Extras Boat Ramp - Private Boathouse Boats - None Allowed Bridges - No Fixed Bridges Dock - Slip 1st Come Dock - Slip Deeded Off-Site Dock - Slip Deeded On-Site Fishing Pier Lift - Davits Locks Private Lake Dues Required Sailboat Water Seawall - Concrete Seawall - Other Skiing Allowed Riprap
Water Name
Waterfront Feet
Rules (R) Not Applicable Association approval not required Association approval required Condo Disclosure Available Condo Documents Available HOA Disclosure Available No Pets Allowed Not OK to Lease OK to Lease Optional Association Owner is a REALTOR and/or real estate licensee Pets Allowed Required Association Retirement 55 Retirement 62 Special Assessments Subdivision Restrictions Tenant Approval
What type of Financing will you permit a buyer to use when making an offer? (R) Assumable-Must Qualify Assumable-Non Qualify Cash Conventional Loan Exchange / Trade FHA Loan Flood Insurance Required Lease Option Lease Purchase Other Owner / PMM Seller Financing Special Funding VA Loan
REALTOR Aids (R) Bonus to Selling Office Brochure Available Corporate Owned Environmental Report Available 3rd Party Approval Required FIRPTA Fixer-Upper Floor Plan Available Go to Site Home Warranty No Sign Owner Occupied Owner-Assist w/Closing costs Owner-Consider Financing Pet on Premises Sold As-is Survey Available Tenant Occupied Termite Warranty Vacant Seller Property Disclosure Tenant Approval
Do any of the following Financially Distressed Property situations apply? (R) Pre-Foreclosure Short Sale REO/Bank Owned In Foreclosure None of the Above
Showing Instructions (R) Gate/Lobby Coded Call Owner Call Tenant Under Construction
Photo Instructions (R) I will e-mail you photos - send to: (10 photos max.) At least 1 photo is REQUIRED within 3 days of listing a property in the MLS!
If you require your photos to be loaded in any specific order you MUST specify the actual name of the image file and the order in which they are to be loaded prior to us loading the photos into the MLS. The first photo is required by MLS rules to be a front exterior photo or artist's rendering of elevation. If you cannot e-mail photo(s) you may:
Driving Directions (R) - Tip: Start from a well known intersection
PLEASE NOTE: While we edit remarks for legal violations and MLS rule infractions, we WILL NOT correct spelling, grammar and punctuation. If your remarks exceed your allowed character limit they will be cut off.
**No contact information is allowed in the public remarks by MLS rule.**
Public marketing remarks section--This is where you can present your "sales pitch" to all REALTORS and the general public. (1150 characters allowed including blank spaces)
REALTOR remarks--only REALTORS will be able to view these remarks. (180 characters allowed including blank spaces)
Contact Person: (R) (Enter Corporation, Trust, POA, etc. contact person here.) Address: (R)
State: State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY (R)
Contact Phone Number: (R) Include AREA code Contact Phone Number 2:
Fax:
E-mail: (R)
How would you like to receive a copy of your listing? (R) E-mail - will be sent as a .pdf to the e-mail address above Fax - please be sure to fill # in above Mail - will be sent to the address above
How did you hear about us? Postcard Search engine Google search Google Ad Word of mouth Investors club Referral - from whom? Website Sign E-mail Phonebook Repeat customer Other - specify:
The Owner has reviewed the information entered on this Profile Sheet and acknowledges that the foregoing information is believed to be true and correct and by reference hereto becomes a part of the Listing Agreement. Owner agrees to promptly notify Broker if there is any material change in such information during the term of this Listing. The Owner agrees to indemnify and hold harmless the Suncoast MLS and its 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's 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 Profile Sheet, the Suncoast MLS may electronically transfer information about Owner's property to Internet Web Sites to aid in the marketing of the Property for sale. Seller authorizes Broker, the MLS and/or Association of Realtors® to use and/or license the Active listing and sold data. Suncoast MLS assumes no responsibility or liability to Owner for errors or omissions on this Data Entry Form or in the MLS computer system or reciprocal computer systems. The owner(s) also acknowledges that they must notify Jack Keller Inc., REALTORS within 48 hours of signing a sales contract AND within 48 hours of closing.
I agree (R)
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© 1997, Jack Keller Inc
