Residential Input Form: BeachesMLS, Inc. Local Real Estate Brokerage | Broker James M. Arena | BK3608150 Address Information Address Address 1 Address 2 City State/Province Zip/Postal Code Country Unit # Parcel ID Area GEO Contract Information Listing Date MM DD YYYY Go Active Date MM DD YYYY Expiration Date MM DD YYYY Auction Yes No List Price $ Owner Name First Name Last Name Owner Phone (###) ### #### Negotiable Seller Concessions Yes No Listing Type Ex Right w/Limited Service List Office Agency Transaction Broker General Property Description Structure Type * Cabana Co-Ownership Condo Coop Mobile/Manufactured Single Family Detached Townhouse Villa Governing Bodies * Condo Coop HOA None W/D Allowed Yes No Number Main Level Bedrooms Total Bedrooms Main Level Bathrooms Baths - Full Baths - Half Property Condition * New Construction Pre Construction Resale Under Construction Property Completion Date MM DD YYYY Builder Lot/ Unit # Community Development District How Paid Amount Annually $ Year Built MM DD YYYY Builder Name Builder Model SQFT - Total SQFT - Living SQFT Source Appraisal Developer Floor Plan Other Owner Tax Rolls Guest House Yes No SQFT Guest House Gated Community Yes No Garage Spaces Carport Spaces Open Parking Spaces Year Roof Installed MM DD YYYY Homeowners Association * Mandatory None Voluntary HOA/POA/COA (Monthly) $ Application Fee $ Association Deposit * $ Association Contact Phone (###) ### #### Association Website http:// Membership Fee Required * Yes No Membership Fee $ Capital Contribution * Yes No Capital Contribution Amount $ Development Name Lot SQFT Lot Dimensions Waterfront * Yes No Waterfrontage Dock Yes No Front Exposure Private Pool * Yes No Spa * Yes No Building # Unit Floor # Pets Allowed * No Restricted Yes Pet Fee $ Maximum Number of Pets Total Weight Limit (Pets) Pets on Premisies * Yes No Total Floors/ Stories Total Units in Building Total Assessed Value $ Total Units in Complex Directions * Subdivision * Legal Description * Location, Tax & Legal Zoning Tax Year Tax Amount $ Special Assessment * Option 1 Option 2 Short Sale * No Yes Short Sale A/U * Approved Unapproved N/A Short Sale Addendum * No Yes Multiple Offers Accepted * Yes No Hardship Package * Complete Incomplete Submitted REO * Yes No Minimum Credit Score HOPA * No Hopa Yes-Unverfied Yes-Verified MIddle School * High School * Elementary * Remarks & Misc. Public Remarks Broker Only Remarks Office Remarks Seller Opt Out: Seller Directs Listing to be excluded from Internet Seller Directs Address to be excluded from internet Seller Directs Listing to Not be used in AVMs on Internet Seller Directs Listing to Not Allow comments on Internet Publish this listing to: Show Address in VOWs Show street Name on IDX My Condo Plans Realtor.com Portal Realtor.com Sold Data Realtor.com coming soon Co-Ownership Fractional Share Property Management Property Management Phone (###) ### #### Property management Email Co-Ownership Description Lease Info Land Lease Recreation Lease Minimum Days to Lease Lease Times p/Year Mobile/Manufactured Home Info Brand Name Decal # Mobil Home Size Serial # Design < 4 Floors A-Frame Coach House Duplex/Triplex/Row Contemporary French Key West Mediterranean Multi-Level Patio Home Quad Rustic Stilt Traditional Victorian Western 4+ Floors Art Deco Colonial Courtyard European Georgian Log Mid Century Old Spanish Plantation Ranch Spanish Townhouse Tudor Villa Other Arc Unit Description Corner Exterior Catwalk Interior Hallway Multi-Level Penthouse Efficiency Garden Apartment Lobby On Golf Course Construction (1 to 3 Required) Aluminum Siding Brick Concrete Fiber Cement Siding Hollow Tile Manufactured Mixed Piling Pre-Fab Stucco WoodSide Block CBS Elevated Frame Log Metal Modular Pre-cast Stone Vinyl Siding Other Mobile Home Features 220v No Stock Certificate Skirt - Aluminium Skirt - None Stock Certificate Tie Down Wheels Dryer Hookup Screened Skirt - Brick Skirt - Other Skirt - Stone Slab Storage Shed Utility Room View Bay City Garden Intracoastal Lake Ocean Pool River Other Canal Clubhouse Golf Lagoon Marina Pond Preserve Tennis Waterfront Details (1 to 5 Required) None Basin Creek Fixed Bridges Intracoastal Lake Marina No Fixed Bridges Oceanfront Point Lot Riprap Seawall Canal Width 81 -120 Bay Directly on Snad Interior Canal Lagoon Mangrove Navigable Ocean Access One Fixed Bridge Pond River Canal Width 1 - 80 Canal Width 121+ Private Pool Description Above Ground Autoclean Concrete Fiberglass Gunite Heater Lease Inground Salt Chlorination Solar Heat Vinyl Lined Auto Chlorinator Child Gate Equipment Included Freeform Heated Indoor Ocean Water Screened Spa Pool Size : (W x L) Spa Features Above ground Fiberglass Gunite In Ground Heated Lot Description East Of US-1 < 1/4 Acre 1/4 to 1/2 Acre 1/2 to < 1 Acre 1 to < 2 Acres 2 to < 3 Acres 3 to < 4 Acres 4 to < 5 Acres 5 to < 10 Acres 10 to < 25 Acres 25 to < 50 Acres 50+ Acres Corner Lot Dirt Road Freeway Interior Lot Paved Road Public Road Sidewalks Zero lot West of Us-1 Air Strip Cul-De-Sac Flood Zone Golf Front Irregular Lot Private Road Shell Rock Road Treed Lot Exterior Features Auto Sprinkler Built-In Grill Covered Balcony Custom Lighting Extra Building Fruit Trees Hangar Manuel Sprinkler Open Patio Outdoor Shower Screen Porch Screened Patio Shutters Summer kitchen Utility Barn Wrap porch Zoned Sprinkler Awnings Cabana Covered Patio Deck Fence Green House Lake/Canal Sprinkler Open Balcony Open Porch Room For Pool Screened Balcony Shed Solar Panels Tennis Court Well Sprinkler Wrap-Around Balcony NONE Interior Features Bar Closet Cabinets Custom Mirror Dome Kitchen Entry Level Living Area Fireplace(s) French Door Laundry Tub Pull Down Stairs Second/Third Floor Concrete Split Bedroom Upstairs Living Area Walk-in Closet Wet bar Built-In Shelves Cathedral/ Vaulted Ceilings Decorative Fireplace Elevator Fire Sprinkler Foyer Kitchen Island Pantry Roman Tub Sky Light(s) Stack Bedrooms Volume Ceiling Watt Wise None Porch/Patio/Balcony Balcony Patio Porch ADA Compliant Handicap Access Accessible Elevator Installed Emergency Intercom Handicap Convertible Level Ramped Main Level Wide Doorways Wheelchair Accessible Door Levers Entry Kitchen Modification Other Bath Modification Roll-In Shower Wide Hallways Master Bedroom/ Bath 2 Master Baths Bidet Dual Sinks Master Bedroom -Sitting Separate Shower Spa Tub & Shower 2 Master Suits Combo Tub/Shower Master Bathroom - Ground Master Bedroom - Upstairs Separate Tub Whirlpool Spa None Furnished Furnished Partially Furnished Turnkey Furniture Negotiable Unfurnished Rooms Atrium Cabana Bath Cottage Family Garage Apartment Glass Porch Laundry - Garage Laundry - Utility/ Closet Maid/ In-law None Recreation Storage Utility-Garage Attic Convertible Bedroom Den/Office Florida Garage Converted Great Laundry-Inside Loft Media Pool Bath Sauna Studio Bedroom Workshop Parking 2+ Spaces Carport - Attached Covered Drive - Circular Driveway Garage - Building Golf Cart Open Slab Strip Special Rent Under Building Vehicle Restrictions Assigned Carport - Detached Deeded Drive - Decorative Garage - Attached Garage - Detached Guest RV/Boat Special Purchase Street Unpaved Other - See Remarks Subdivision Amenities Airpark Basketball Beach Club Available Bike Storage Boating Business Center Cafe/Restaurant Common Laundry Courtesy Bus Elevator Fitness Center Game Room Horse Trails Indoor Pool Library Manager on Site Pickle ball Pilot House Pool Putting Green Runaway Unpaved Shuffleboard Soccer Field Street Lights Trash Chute Workshop Ball Field Beach Access By Easement Bike - Jog Billards Bocce Ball Cabana Clubhouse Community Room Dog Park Extra Storage Fitness Trail Golf Course Horses Permitted Internet Included Lobby Park Picnic Area Playground Private Beach Pavilion Runaway Paved Sauna Sidewalks Spa-Hot Tub Tennis Whirpool None Maintenance Fee Included A/C Maintenance Cable Common Real Estate Tax Elevator Gas Hot Water Insurance-Building Insurance-Other Laundry Facilities Legal/Accounting Maintenance-Interior Manager None Pest Control Recreational Facility Roof Maintenance Sewer Water Other Assessment Fee Common Areas Electric Fidelity Bond Golf Impact Fee Insurance-Interior Janitor Lawn Care Maintenance Fees Master Antenna/TV Parking Pool Service Reserve Funds Security Trash Removal Water Treatment Pet Restrictions Cats Only No Aggressive Breeds No Dogs Number Limit Other Pet Restrictions Horses Allowed No cats No Restrictions Size Limits Restrict Buyer Approval Daily Rentals OK Interview Required Lease OK w/Restrict No Boat No Lease No Lease First Two Years No RV Tenant Approval Other Commercial Vehicles Prohibited Historic Designation Lease OK Maximum # Vehicles No Corporate Buyers No Lease 1st Year No Motorcycle No Truck None Security Burgular Alarm Entry Card Gate - Manned Lobby Private Guard Security Light Security System Leased TV Camera NONE Doorman Entry Phone Gate - Unmanned Motion Detector Security Bars Security Patrol Security System Owned Wall Membership Club Membership Required Golf Equity Available Golf Purchase Other membership Included Social Membership Available Tennis Membership Included Equity Purchase Required Golf Equity Included Other membership Available Social Membership Tennis Membership Available No membership Available Flooring Carpet Clay tile Laminate Marble Slate Tile Wood Floor Ceramic Tile Concrete Linoleum Parquet Floor Terrazzo Floor Vinyl Floor Other Heating Central Central Individual Gas Heat Strip Oil Solar Wall Furnace Zoned Central Building Electric Heat Pump Reverse No Heat Radiant Space Window/Wall Other Cooling Air Purifier Ceiling Fan Central Building Electric Gas Paddle Fans Ridge Vent Wall-Win A/C None Attic Fan Central Central individual Exhaust Humidistat Reverse Cycle Thermal Fan Zoned Other Equipment/Appliances Included Auto Garage Open Compactor Dishwasher Dryer Freezer Generator Hookup Hookup Intercom Microwave Range - Electric Refrigerator Satelite Dish Solar Water Heater TV Antenna Washer Water Heater- Electric Water Softener- Owned None Central Vacuum Cooktop Disposal Fire Alarm Gas Lease Generator Wheel House Ice Maker Lead Cert Purifier Range - Gas Reverse Osmosis Water Treatment Smoke Detector Storm Shutters Wall Oven Washer/Dryer Hookup Water Heater - Gas Water Softener - Rented Laundry Appliances Included Washer and Dryer Dryer Only Washer Only Washer / Dryer Hookup None Dinning Area Breakfast Areas Dining Family Dining Florida Dining Living Dining/ Kitchen Eat in Kitchen Formal Snack Bar Roof Aluminum Barrel Comp Rolled Concrete Tile Flat Tile Manufactured Mixed Roofover Slate Tar/Gravel Wood Shake Other Bahama Built-Up Comp Shingle Fiberglass Mansard Metal Pre-Stressed S-Tile Steel Joint Wood Joist Wood Truss/Raft Guest house 1 Bath 2 Baths Carport Garage Living Room Screened Porch 1 Bedrooms 2 Bedrooms Efficiency Kitchen Patio Boat Services Private Dock Commoon Dock Up to 20 ft boat Up to 30 ft boat Up to 40 ft boat Up to 50 ft boat Up to 60 ft boat Up to 70 ft boat Up to 80 ft boat Up to 90 ft boat Up to 100 ft boat Over 101 ft boat Lift Hoist/Davit Boathouse Electric Available Water Available Fuel Marina Yacht Club Attended Full Service Restroom Sew Pump Available Overnight Live Aboard Ramp Exclusive Use No Wake Zone Wake Zone Dock Available Equestrian Services Boarding Allowed Bridle Path/ Trails Center Asile Community Stalls Covered Ring Feed room Fly System Grass Field Grooms Quarters Lounge Mirror Office Owners Apartment Paddocks Regulation Dressage Ring Shed Row Stable Tack Room Wash Racks Water & Electric Number of Barns Number of Stalls Terms Considered Assumable-Qualify Cash Conventional Exchange FHA203k Lease purchase Owner Financing USDA Will Rent Assume-NON Qualify Contract For Deed Cryptocurrency FHA Lease otion Owner 2nd Seller Financing VA Minimum % Down Minimum % Down Required By Auction Terms Auction Date MM DD YYYY Absolute NON Published Reserve Subject To Sellers Confirmation Online Website http:// Terms and Conditions List Price is the required deposit to bid on the property Yes No Pre-Auction Yes No Live Auction Date MM DD YYYY Post Auction Period Auction Contact Name First Name Last Name Auction Contact Phone (###) ### #### Utilities Cable Gas Bottle Lake Worth Drain District No Telephone Public Sewer Septic Water Available Electric Gas Natural No Electric Oil Public Water Underground Well Water None Window Treatments Arched Bay Window Casement Double Hung Wood Electric Shutters Impact Glass Picture Single Hung Metal Sliding Thermal Awning Blinds Double Hung Metal Drapes Hurricane Windows Jalousie Plantation Shutters Single Hung Wood Solar Tinted Verticlas Storm Protection Current Owner Wind Mitigation Certification Available Electric Panel For Portable Power Safe Room None According Shutters Electric Power Shutters Panel Shutters Roll Down Shutters Impact Glass Other Protection Permanent Generator Special Info Abstract CDD Addendum Required Deed Restrictions Foreign Seller Home Warranty Non-Conforming Use Sold As-Is Title Insurance Bank Owned Corporate Owned Disclosure Handyman Institution Owned Potential Tear Down Survey Taxes Agricultural City/County County Only Disability Exemption Homestead Land Only New Construction No Homestead Widow Exemption Other Exemption Possession At Closing Before Closing Funding Lease Back Long Closing Preferred Negotiable Post Closing Quick Closing Subject to Lease Other Room Information Room Name 1 Add Room Name | Length | Width | Level | Remarks Room Name 2 Add Room Name | Length | Width | Level | Remarks Room Name 3 Add Room Name | Length | Width | Level | Remarks Room Name 4 Add Room Name | Length | Width | Level | Remarks Room Name 5 Add Room Name | Length | Width | Level | Remarks Room Name 6 Add Room Name | Length | Width | Level | Remarks Room Name 7 Add Room Name | Length | Width | Level | Remarks Room Name 8 Add Room Name | Length | Width | Level | Remarks Room Name 9 Add Room Name | Length | Width | Level | Remarks Room Name 10 Add Room Name | Length | Width | Level | Remarks Room Name 11 Add Room Name | Length | Width | Level | Remarks Room Name 12 Add Room Name | Length | Width | Level | Remarks Room Name 13 Add Room Name | Length | Width | Level | Remarks Room Name 14 Add Room Name | Length | Width | Level | Remarks Room Name 15 Add Room Name | Length | Width | Level | Remarks Room Name 16 Add Room Name | Length | Width | Level | Remarks Room Name 17 Add Room Name | Length | Width | Level | Remarks Room Name 18 Add Room Name | Length | Width | Level | Remarks Seller Name * Digital Authorization and Consent for MLS Listing Input By typing your full name in the designated field below, you hereby certify that all information you have provided in this form is true and accurate to the best of your knowledge. You further authorize and consent to the use of this information by the listing broker and/or listing agent for the purpose of preparing and submitting your property listing into the Multiple Listing Service (MLS). Your typed name shall serve as your valid and legally binding digital signature on behalf of all owners of this property, indicating your formal approval of the information provided and your consent to its use in connection with marketing and listing your property. You acknowledge that this authorization is given voluntarily and with full understanding of its effect. First Name Last Name Date Seller Signed * The seller that signed and date this form has done so on behalf of all owners of this property. MM DD YYYY Limitation of Liability and Indemnification By submitting this form and authorizing the use of the information provided herein, you acknowledge and agree that the listing broker and listing agent are relying on the accuracy and completeness of the information you have supplied. You agree that the listing broker and listing agent shall not be held liable for any errors, omissions, misrepresentations, or inaccuracies in the information you provide. You further agree to indemnify, defend, and hold harmless the listing broker, the listing agent, and their affiliated companies, officers, agents, and employees from and against any and all claims, losses, damages, liabilities, costs, or expenses (including reasonable attorneys' fees) arising out of or related to any inaccurate, incomplete, or misleading information you submit or your failure to disclose material facts about the property. This clause shall survive the termination or completion of any listing agreement or MLS entry. Thank you!