Highlighting Indicates the Field Or Section Requires Entry

MLS ENTRY FORM

INSTRUCTIONS:

· Complete this form for each property. All entry fields are highlighted in grey ¨¨.

· Highlighting ¨¨ indicates the field or section requires entry.

· The [TAB] key moves you to next input field. The [SHIFT][TAB] combination moves you to the previous input field.

· Do NOT use the [ENTER] key while entering data.

· Clicking on any drop-down box entry will allow selection of just one item in that list. Click again to reselect another choice.

· You can click as many “check box” items per group as instructed. Clicking a second time will unselect that item.

· Some versions of Microsoft Word may display a security warning. Simply enable the active content as per its instructions.

· Save a copy. Print a copy. Email your final version to or fax to 804-521-5602.

· If any questions or suggested improvements, please contact Gary Duda at 804-521-5601.

A. SUBMITER INFORMATION (person inputting data should complete this section):

COMPANY
SALES REP NAME
PHONE # / () -
EMAIL ADDRESS
SUBMISSION DATE

B. PROPERTY INFORMATION (this data covers the property in question):

# / INFORMATION / ENTER YOUR RESPONSES BELOW / FORMAT /
1 / Subdivision
2 / Property Type / <select one from drop-down>Single FamilyTownhome - interior unitTownhome - end unitCondo - interior unitCondo - end unit / Select one
3 / Spec or TBB / <select one from drop-down>SpecTBB / Select one
4 / Approximate Completion Date / mm/dd/yyyy
5 / Floor Plan
6 / Listing Date / mm/dd/yyyy
7 / Expiration Date / mm/dd/yyyy
8 / List Price / In whole dollars
9 / County/City
10 / Area
11 / Full Street Address
12 / Zip Code / nnnnn-nnnn (zip+4)
13 / Tax ID
14 / Lot / Block / Section / Lot
Block
Section
15 / Commission
16 / Elementary School
17 / Middle School
18 / High School
19 / Directions
20 / Lot Size
21 / HOA (Y/N) / <select one from drop-down>YesNo / Select one
22 / Monthly Fee / In whole dollars
23 / Finished Square Footage / In whole square feet
24 / Unfinished Square Footage / In whole square feet
25 / # of Rooms
26 / # of Bedrooms
27 / # of Levels
28 / Basement (Y/N) / <select one from drop-down>YesNo / Select one
29 / Garage (Y/N) / <select one from drop-down>YesNo / Select one
30 / Garage # of Cars / Include decimal
31 / # of Fireplaces
32 / Pool (Y/N) / <select one from drop-down>YesNo / Select one
ROOM DIMENSIONS
33 / Living Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
34 / Dining Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
35 / Kitchen / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
36 / Family Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
37 / Foyer / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
38 / Great Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
39 / Office/Study / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
40 / Rec Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
41 / Florida Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
42 / Laundry/Utility Room / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
43 / Master Bedroom / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
44 / Bedroom #2 / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
45 / Bedroom #3 / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
46 / Bedroom #4 / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
47 / Bedroom #5 / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
48 / Extra Room #1 / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
49 / Extra Room #2 / Dimensions (round to nearest foot): Length X Width
Level: <select one from drop-down>B1234
Description:
FULL BATHS (REQUIRED)
50 / Basement / Select a Full Bath type for each one found on the Basement level:
FB #1: <select one from drop-down>TubShowerTub/Shower
FB #2: <select one from drop-down>TubShowerTub/Shower
FB #3: <select one from drop-down>TubShowerTub/Shower
51 / Level 1 / Select a Full Bath type for each one found on Level 1:
FB #1: <select one from drop-down>TubShowerTub/Shower
FB #2: <select one from drop-down>TubShowerTub/Shower
FB #3: <select one from drop-down>TubShowerTub/Shower
52 / Level 2 / Select a Full Bath type for each one found on Level 2:
FB #1: <select one from drop-down>TubShowerTub/Shower
FB #2: <select one from drop-down>TubShowerTub/Shower
FB #3: <select one from drop-down>TubShowerTub/Shower
53 / Level 3 / Select a Full Bath type for each one found on Level 3:
FB #1: <select one from drop-down>TubShowerTub/Shower
FB #2: <select one from drop-down>TubShowerTub/Shower
FB #3: <select one from drop-down>TubShowerTub/Shower
HALF BATHS (REQUIRED)
54 / Half Baths / Select how many Half Baths are found on each level:
Level B: <select one from drop-down>12
Level 1: <select one from drop-down>12
Level 2: <select one from drop-down>12
Level 3: <select one from drop-down>12
55 / Year Built / yyyy
56 / Public Remarks
(permits as much data to be input as MLS will allow)
57 / Agent Remarks
(permits as much data to be input as MLS will allow)

C. PROPERTY FEATURES (see each feature for selection instructions; highlighting ¨¨ indicates required):

MLS ENTRY FORM

58. LOT DESCRIPTION

(select 0 to 3 choices)

CORNER

CUL-DE-SAC

DEAD END STREET

LEVEL

ON GOLF COURSE

PARK LIKE

SLOPING

STEEP SLOPES

STREET LIGHTS

WATERFRONT

WATERVIEW

WOODED

ZERO LOT LINE

59. SIDING

(select 1 to 2 choices)

BRICK

BRICK VENEER

CEDAR

CEDAR SHAKE

CEMENT LAPBOX

CLAPBOARD

GLASS

HARDBOARD

HARDIPLANK

SHINGLE

STONE

STUCCO

SYNTH STUCCO

VINYL

WOOD

60. WATER TYPE

(select 0 to 5 choices)

BAY FRONTAGE

BEACH

CREEK FRONTAGE

HARBOR FRONT

LAKE

LAKE FRONTAGE

OCEAN/BAY FRONTAGE

POND

RIVER

RIVER FRONTAGE

WALK TO WATER

WATER ACCESS

61. ROOF

(select 1 to 3 choices)

ASPHALT

COMPOSITION

DIMENSIONAL

METAL

SHINGLED

SLOPED

62. ATTIC

(select 1 to 3 choices)

ACCESS PANEL

EXPANDABLE

FINISHED

NO ATTIC

PART FINISHED

PULL DOWN

WALK-IN

WALK-UP

63. STYLE

(select 1 to 3 choices)

2-STORY

CAPE

COLONIAL

CONTEMPORARY

COTTAGE / BUNGALOW

CUSTOM

GREEN CERTIFIED HOME

MEDITERRANEAN / SPANISH

OTHER

PATIO HOME

RANCH

ROWHOUSE

SALT BOX

TRANSITIONAL

64. FLOORING

(select 0 to 4 choices)

CARPET - PART

CARPET - W - W

LAMINATE

LINOLEUM

SLATE

TILE - CERAMIC

VINYL

WOOD

WOOD - PART

65. FIREPLACE

(select 0 to 4 choices)

BRICK

DIRECT VENT

GAS

NON-VENTED

STONE

WOOD BURNING

66. BASEMENT

(select 1 to 3 choices)

BASEMENT - FULL

BASEMENT - PART

CRAWL SPACE

DIRT

FINISHED - COMPLETE

FINISHED - PARTIAL

FLOORED

HEATED

LOCKED STORAGE

OTHER

SLAB

UNFINISHED

WALK - OUT

WORKSHOP

67. APPL/EQP

(select 0 to 15 choices)

ATTIC FAN

CENTRAL VAC

COMPACTOR

COUNTERTOP RANGE

DISHWASHER

DISPOSAL

DOUBLE OVEN

DOWNDRAFT RANGE

DROP - IN RANGE

DRYER

ELECTRIC AIR CLN

ELECTRIC COOKING

EXHAUST FAN

GAS COOKING

INTERCOM

MICROWAVE

OVEN

REFRIGERATOR

SELF / CON CLEAN

SMOKE ALARM

STACK WASHER / DRYER

STOVE

STOVE HOOD

SUMP PUMP

WALLOVEN

WASHER

68. INTERIOR

(select 0 to 10 choices)

1ST FLOOR BEDROOM

1ST FLOOR MASTER BEDROOM

1ST FLR BDRM W/ FULL BATH

9’+ CEILINGS

BAY / BOW WINDOW

BEAMED CEILING

BREAKFAST NOOK

BREEZEWAY

BUILT-IN CABINET / BOOKCASES

BUTLER’S PANTRY

CABLE TV

CATHEDRAL CEILING

CEILING FAN

DINING AREA

DOUBLE VANITY

DRYER HOOKUP

EAT-IN KITCHEN

FIRE SPRINKLER

FORMAL DINING ROOM

FRENCH DOORS

ISLAND

JETTED TUB

LOFT

MBR BATH

PANTRY

RECESSED LIGHTING

ROUGHIN BATH

SECURITY SYSTEM

STACK WASHER/DRYER HOOKUP

SUNKEN TUB

TRAY CEILING

WALK-IN CLOSET

WASHER HOOKUP

WET BAR

69. EXTERIOR

(select 0 to 10 choices)

INSULATED DOORS

IRRIGATION SYSTEM

OUT BUILDING

OUTDOOR LIGHTING

PALLADIAN WINDOWS

PRIVATE STORAGE

PUBLIC PARK

SCREENS

SLIDING DOOR

STORAGE SHED ATTACHED

TENNIS COURT

THERMAL WINDOWS

70. AMENITY

(select 0 to 10 choices)

ASSOCIATION

BASKETBALL

CLUBHOUSE

COMMON AREA

COMMON LAUNDRY

COMMUNITY ROOM

CONTROLLED ACCESS

DOCK

ELEVATOR

EXERCISE ROOM

EXTRA STORAGE

GATED COMMUNITY

GOLF COURSE

HOT TUB

JOGGING PATH

KIDDIE POOL

LANDSCAPING

LIFEGUARD

MARINA

MAINTENANCE FREE

ON BUS LINE

PLAYGROUND

PROFESS MGMT

PUTTING GREEN

RESIDENT MANAGER

ROAD MAINT

SAUNA

SECURITY GUARD

TENNIS COURT

71. POOL

(select 0 to 5 choices)

COMMUNITY / OFF-SITE

CONCRETE

COVERED

FENCED

HOT TUB

IN GROUND

INDOOR

LAP POOL

MEMBERSHIP REQUIRED

OTHER

OUTDOOR

POOL EQUIPMENT

POOL HOUSE

WITH SPA

WITHIN YARD

72. FENCED

(select 0 to 3 choices)

ALL FENCED

COMBINATION

DECORATIVE

FRONT ONLY

NO FENCING

PART FENCED

PRIVACY

REAR ONLY

WALL

WROUGHT IRON

73. PORCH

(select 0 to 2 choices)

BALCONY

DECK

FRONT

FRONT COUNTRY

FRONT FULL

GLASS

PATIO

REAR

SCREENED

SIDE

SLEEPING PORCH

STOOP

WRAP AROUND

74. HEAT FUEL

(select 1 to 3 choices)

ELECTRIC

MULTI-FUEL SYSTEM

NATURAL GAS

NONE

OTHER

PROPANE GAS

75. HEATING

(select 1 to 3 choices)

2 ZONED HEAT

3 OR MORE ZONES

BASEBOARD

ELECTRIC

FORCED HOTAIR

HEAT PUMP

HOT WATER

HOT WATER COIL

OTHER

RADIANT

TIMER THERMOSTAT

76. COOLING

(select 1 to 3 choices)

2 ZONED AC

3 OR MORE ZONES

CENTRAL AIR

ELECTRIC

GAS A/C

GEOTHERMAL

HEAT PUMP

WHOLE HOUSE FAN

77. WATER HEATER

(select 0 to 2 choices)

ELECTRIC

INSTANT HOT

INSULATED

NATURAL GAS

OFF FURNACE

PROPANE GAS

TANK

TANKLESS

78. WATER / SEWER

(select 1 to 2 choices)

COMMUNITY WELL

OTHER

PUBLIC SEWER

PUBLIC WATER

SEPTIC

WELL

79. PARKING

(select 0 to 3 choices)

ASSIGNED

CARPORT

CIRCULAR DRIVE

COMMON DRIVE

DOUBLE WIDTH

NO PARKING

OFF STREET

ON STREET

OPEN LOT

PAVED DRIVEWAY

UNDERGROUND

UNPAVED DRIVEWAY

80. GARAGE

(select 1 to 6 choices)

APARTMENT

ATTACHED

AUTO DOOR OPENER

DETACHED

DIRECT ENTRY

FINISHED

HEATED

NO GARAGE

OTHER

OVERSIZED

STORAGE ABOVE

UNFINISHED

WORKSHOP

81. DISABILITY EQUIP

(select 0 to 5 choices)

ADAPTED

BARRIER FREE

ELEVATOR

ENTRY RAMP

GRAB BARS

LOWER CABINET / COUNTER

OTHER

RAMP

ROLL IN SHOWER

SENSORY

SHOWER SEAT

STAIR LIFT

WHEELCHAIR ADAPTED

WIDE DOORWAYS

82. FEE

(select 0 to 2 choices)

COMMUNITY ASSOCIATION

CONDO ASSOCIATION

COOPERATIVE

OWNERS ASSOCIATION

ROAD MAINTENANCE

83. RESTRICTIONS

(select 0 to 5 choices)

AGE-RESTRICTED COMMUNITY

ARCHITEC DEC

ASSOC RESTRC

BLDG MORATOR

BLDG RESTRICTION

FLOOD INSURANCE

FLOOD PLAIN

SUBDIV RESTR

WATERFRONT REST

WETLANDS

ZONING RESTRICTED

84. SALE TERMS

(select 1 to 7 choices)

CASH

CONVENTIONAL

FARM HOME ADM

FED MTG HSAD

FEDERAL LAND

FHA

VHDA

85. FEE INCLUDES

(select 0 to 10 choices)

CLUBHOUSE

COMM AR MNT

COMMUNITY UTILITIES

EXTERIOR MAINTENANCE

INSURANCE

MGMT FEES

POOL

RECREATIONAL FACILITIES

SECURITY

SEWER

SNOW REMOVAL

TRASH REMOVAL

WATER

WATER ACCESS

YARD MAINTENANCE

MLS ENTRY FORM