Wasatch Front Regional MLS Listing Input Form RES Single Family, Condo, Mobile, Recreational, P.U.D. Fields marked with an * are required Property Location Pricing Information List Price* $ Previous MLS# _________________________ Address Information Non-Standard Address (See Directions) o House Number* Street Name or Number * Street Type Unit Number Quadrant* o NW o NE o SW o SE Zip* City* County* State* Project / Subdivion Zoning HOA Information HOA Fee / Month* HOA Contact HOA Contact Phone o Project Restrictions o Senior Community o Maintenance Fee Short Sale* o Not Short Sale o Price Subject to 3rd Party Approval o Price Previously Approved by 3rd Party o Offer Under 3rd Party Review School Information School District* Elementary School* Junior High School* High School* Private School Other School Site Location Tax / Parcel Information o Assigned Parcel # OR* Taxes $ Tax Parcel Number* Style*o 2-Story o Bungalow/Cottage o Mobile o Tri/Multi-Level o A-Frame o Cabin o Rambler/Ranch o Tudor o Condo, High Rise o Condo, Top Level o Condo, Main Level o Condo, Middle Level o Townhouse, Row-Endo Townhouse, Row-Mido See Remarks Parking Garage Parking Carport Parking Capacity R.V. Parking Height BEDROOMS (MASTER) Level 4 (❏) Level 3 (❏) Level 2 (❏) Level 1 (❏) (❏) (4th Floor) (3rd Floor) (2nd Floor) (Main Floor) Basement o Voice o TDD F BATH T H Capacity R.V. Parking Length Lot Dimensions Acres* Frontage Frontage Facing o N o S o E o W o NE o SE o NW o SW Side Back o Irregular Shape Deck Patio o Basement o Manufactured o Split-Entry/Bi-Level o Victorian Basement Information Basement Type* o None/Crawl Space o Daylight o Entrance o Full o Partial o Shelf o Slab o Walkout o See Remarks Basement Finished* Effective Year Built APPROXIMATE SQ FT North / South East / West Construction Status* o Built/Standing o Under Construction o To Be Built Water Shares o P.U.D. Property Type* o Single Family o Condominium o Mobile (w/o land) o Recreational o Townhouse o Twin Year Built* oNoSoEoW oNoSoEoW FAMILY DEN FORMAL LIVING ROOM K KITCHEN/DINING B F S LAUNDRY FIREPLACE Totals (System Entered) Listing Office Location Listing Date* Expiration Date* Owner Name o REO / Foreclosure / Bank Owned o HUD Owned o Owner / Agent Contact Type o Agent o Owner o Secretary Contact for Appointments & Access Contact Phone 1 o Voice o TDD Contact Phone 2 o Voice o TDD Listing Type* o EAL o ERS Photo Instructions* o Please Take o Under Construction o I Will Provide o To Be Built Dual/VAR Rate* o Yes o No Compensation Offered* BAC Possession o Publicly Searchable Seller’s Initials Seller’s Initials REV 06/10 GSW Date Listing Agent Information Agent Public ID* BAC Based on* o Gross o NET Co-Agent Public ID* Agent Name Co-Agent Name Office License ID# Office Name The information in gray will be supplied by the WFR Membership Database (Completion Optional) Date Form B - Res Page 1 of 4 Accessibility Features Driveway / Access Floor Coverings Inclusions / Exclusions o 32" wide doorways o 36" wide hallways o Access to elec. Outlets o Audible alerts o Ceiling lift system o Elevator o Frnt-cntrld stove / oven o Fully accessible o Grab bars o Ground level o Modified kitchen o No-step entry o Porch lift o Ramp o Roll-in shower o Single level living o Stair lift o Universal design o Visible alerts o Visitable o Wheelchair access o See remarks o Asphalt o Circular o Common Drive o Concrete o Dirt o Gravel o See Remarks o Bamboo o Carpet o Cork o Hardwood o Laminate o Linoleum o Marble o Natural Rock o Slate o Tile o Travertine o Vinyl o See Remarks Include Exclude Recommended Maximum 8* Recommended Maximum 2* Environmental Certs Recommended Maximum 3* o Built Green o Energy Star o Home Energy Rating o Leed o See Remarks Amenities Exterior Special Features o Cable Tv Available o Cable Tv Wired o Clubhouse o Electric Dryer Hookup o Exercise Room o Gas Dryer Hookup o Gated Community o Home Warranty o Park / Playground o Sauna / Steam Room o Swimming Pool o Tennis Court o Workshop o See Remarks o Atrium o Attic Fan o Awnings o Balcony o Barn o Basement Entrance o Bay Box Windows o Deck, Covered o Double Pane Windows o Entry (Foyer) o Greenhouse Windows o Horse Property o Out Buildings o Outdoor Lighting o Patio, Covered o Porch, Open o Porch, Screened o Secured Building o Secured Parking o Skylights o Sliding Glass Doors o Stained Glass Windows o Storm Doors o Storm Windows o Triple Pane Windows o Walk Out o See Remarks Recommended Maximum 5* Animals Pick Only 1 o None o Pets < 20 Lbs. o Pets 20 - 75 Lbs. o Pets > 75 Lbs. o Livestock o See Remarks Seller’s Initials REV 06/10 GSW Recommended Maximum 4* o 2 Car Deep (Tandem) o Attached o Built-in o Detached o Extra Height o Extra Length o Extra Width o Heated o Opener o Parking, Covered o Parking, Uncovered o RV Parking o Storage Above o Workbench o Workshop o See Remarks Recommended Maximum 3* o Central Air, Electric o Central Air, Gas o Evap. Cooler, Roof o Evap. Cooler, Window o Geothermal o Heat Pump o Natural Ventilation o Refrig. Air, Window o Seer 16 Or Higher o Solar - Active o Solar - Passive o See Remarks Recommended Maximum 2* Garage / Parking Exterior o Aluminum / Vinyl o Asbestos Shingles o Asphalt Shingles o Brick o Cedar / Redwood o Cement Board o Cinder Block o Clapboard / Masonite o Composition o Concrete / Glass o Container o Frame o Insulated Concrete Forms o Log o Sips Panel o Stone o Straw Bale o Stucco o See Remarks Air Conditioning Recommended Maximum 3* Heating Recommended Maximum 3* o 95% Efficiency Or Higher o Electric o Electric, Baseboard o Electric, Radiant o Forced Air o Gas, Central o Gas, Radiant o Gas, Stove o Geothermal o Gravity Heater o Heat Pump o Heat Recovery o Hot Water o Hydronic o Oil o Propane o Solar - Active o Solar - Passive o Space Heater o Steam o Wall Heater o Wood Burning o See Remarks Recommended Maximum 10* Date Seller’s Initials Pick Up To 10* o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o o Alarm System o Basketball Standard o Ceiling Fan o Compactor o Dishwasher, Portable o Dog Run o Dryer o Electric Air Cleaner o Fireplace Equipment o Fireplace Insert o Freezer o Gas Grill / Bbq o Gazebo o Hot Tub o Humidifier o Microwave o Play Gym o Projector o Range o Range Hood o Refrigerator o Satellite Equipment o Satellite Dish o Storage Sheds o Swing Set o Trampoline o Tv Antenna o Washer o Water Softener, Own o Water Softener, Rent o Window Coverings o Wood Stove o Workbench o See Remarks Date Form B - Res Page 2 of 4 Interior Special Features Lot Facts Show Instructions Utilities o Accessory Apartment o Alarm, Fire o Alarm, Security o Bar, Dry o Bar, Wet o Basement Apartment o Bath, Master o Bath, Sep. Tub / Shower o Central Vacuum o Closet, Walk-in o Den / Office o Dishwasher, Built-in o Disposal o Floor Drains o French Doors o Gas Log o Granite Countertops o Great Room o Instantaneous Hot Water o Intercom o Jetted Tub o Kitchen, Second o Kitchen, Updated o Laundry Chute o Low Voc Finishes o Mother-in-law Apt. o Oven, Double o Oven, Gas o Oven, Wall o Range, Countertop o Range, Down Vent o Range, Gas o Range / Oven, Built-in o Range / Oven, Free Stdng. o Silestone Countertops o Theater Room o Vaulted Ceilings o See Remarks o Additional Land Available o Adjacent to Golf Course o Corner Lot o Cul-de-sac o Curb & Gutter o Drip Irrigation, Auto-full o Drip Irrigation, Auto-part o Drip Irrigation, Manual-full o Drip Irrigation, Manual-part o Fenced, Full o Fenced, Part o Greywater Collection o Pervious Paving o Private o Rainwater Collection o Road, Paved o Road, Unpaved o Secluded Yard o Sidewalks o Sprinkler, Auto-full o Sprinkler, Auto-part o Sprinkler, Manual-full o Sprinkler, Manual-part o Terrain, Flat o Terrain, Grad Slope o Terrain, Hilly o Terrain, Mountain o Terrain, Steep Slope o View, Lake o View, Mountain o View, Valley o Wooded o See Remarks o Agent Has Key o Appt / Use Key Box o Call / Use Key Box o Call Agent / Appt o Call Owner / Appt o Call Tenant / Appt o Key At List Office o Key Box, Electronic o Key Box, Mechanical o Knock / Use Key Box o Vacant o See Agent Remarks o Gas, Available o Gas, Connected o Gas, Not Available o Gas, Not Connected o Power, Available o Power, Connected o Power, Not Available o Power, Not Connected o Sewer, Available o Sewer, Connected o Sewer, Not Available o Sewer, Not Connected o Sewer, Private o Sewer, Public o Sewer, Septic Tank o Water, Available o Water, Connected o Water, Not Available o Water, Not Connected o See Remarks Recommended Maximum 10* Landscaping Recommended Maximum 5* o Fruit Trees o Landscaping, Full o Landscaping, Part o Mature Trees o Pines o Scrub Oak o Stream o Terraced Yard o Vegetable Garden o Waterfall o Xeriscaped o See Remarks Seller’s Initials REV 06/10 GSW Recommended Maximum 10* Recommended Maximum 3* Storage Recommended Maximum 3* o Basement o Carport o Garage o Patio o Shed o See Remarks Telecommunications Recommended Maximum 4* o Broadband Cable o DSL o Ethernet, Wired o Fiber Optics o Isdn o Multiple Phone Lines o T-1 Line o Wireless Broadband o See Remarks Terms Pool Features Recommended Maximum 10* Recommended Maximum 3* o Assumption, Qualify o Assumption, Simple o Available T o Rent o Cash o Commercial Fin. Req. o Conventional o Down Payment Assist. o Exchange $ Equity For Exchange Only o Fha o Lease Option o Monthly o Yearly o Owner 2nd o Seller Finance o Seller Will Subordinate o Va o See Remarks o Above Ground o Concrete / Gunite o Electronic Cover o Fenced o Fiberglass / Vinyl o Heated o In Ground o Indoor o With Spa o See Remarks Roof Recommended Maximum 2* o Aluminum o Asbestos Shingles o Asphalt Shingles o Bitumen o Composition o Fiberglass o Flat o Metal o Pitched o Pvc o Rolled-silver o Rubber (Epdm) o Stone o Tar / Gravel o Tile o Wood Shake Shingles o See Remarks Date Seller’s Initials Recommended Maximum 5* Water Recommended Maximum 3* o Culinary o Irrigation o Irrigation, Pressure o Private o Rights, Owned o Rights, Rented o Secondary o Shares o Spring o Well o See Remarks Window Coverings Recommended Maximum 3* o Blinds o Draperies o Full o None o Part o Plantation Shutters o Shades o See Remarks Zoning Recommended Maximum 3* o Agricultural o Commercial o Indust. / Manufact. o Res. - Multi Family o Res. - Single Family o See Remarks Date Form B - Res Page 3 of 4 Remarks Agent Remarks Directions / Non-Standard Address Exclusions Remarks HOA Remarks The Undersigned is the owner of the real property described in this Listing Input Form (“Owner”) and hereby acknowledges receipt of completed copies of this document, (Form B, 4 pages) and the Exclusive Right to Sell Listing Agreement. Owner acknowledges that Wasatch Front Regional Multiple Listing Service, Inc. (“WFRMLS”) maintains a multiple listing service database for brokers and agents, and others (the “MLS Database”), and a database of listings which is available to the public (the “IDX Database”). Owner consents to WFRMLS including all of the information included in this Listing Input Form (the “Listing”) in the MLS Database and the IDX Database, and any modifications of the MLS Database and IDX Database, the licensing of the MLS Database and IDX Database to any third party, disclosure and public display of the Listing, and any other lawful use of the Listing by WFRMLS. Owner hereby irrevocably assigns and transfers to WFRMLS all right, title, and interest in and to any copyright rights and other intellectual property rights, and any actions and causes of action related to the foregoing, and any damages, profits and other recoveries related thereto, which Owner may have or acquire in and to the Listing and any and all photographs, images, graphics, video recordings, virtual tours, drawings, written descriptions, remarks, narratives, pricing information, and other copyrightable elements relating to the property that are associated with the Listing and any changes thereto (“Listing Content”). Owner represents and warrants to WFRMLS that the information contained herein is correct and that the Listing, Listing Content, and the assignment of rights to WFRMLS set forth above does not violate or infringe upon the rights, including any intellectual property rights, of any person or entity. Owner agrees to indemnify and hold harmless WFRMLS against all damages, costs and liabilities, including reasonable attorney fees, arising from any claim that the Listing, Listing Content, or any portion thereof infringes the rights of any third party. Owner’s Signature REV 06/10 GSW Owner’s Signature Form B - Res Page 4 of 4
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