Residential (SF) Data Input Form Connecticut Multiple Listing Service 1

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Lewis Rich
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1 Connecticut Multiple Listing Service 1 Agent ID: Agent Name and Information: - - Agent Information - - Office Name and Information: Team Agent 1 Name: Team Agent 2 Name: Team Agent 1 Phone: Team Agent 2 Phone: Where My Listings Go: Homefinder Homes.com Realtors.com Trulia Zillow ne Co-List Agent ID: Agent Name and Information: Office Name and Information: Sign: Owners Name: Showing Instructions: Showing Time Showing Instructions: Listing Type (Select One) Exclusive Agency Exclusive Agency w/reserved Prospect Exclusive Agency w/variable Rate Compensation Exclusive Right to Sell/Lease Listing Agreement Exclusive Right to Sell/Lease with Reserved Prospect Exclusive Right to Sell/Lease w/variable Rate Compensation Listing Type Descriptions (Select One) Entry Only Full Service Limited Service NA Lockbox Description (Select One) CMLS CTMLS DAR GRW NC WAT ne Lockbox Type (Select One) CLB Combo Elec Other N/A Buyer Agent Comp Buyer Agent Comp Type (Select One) $ % Other - - Property Information - - Parcel Number: Street Number: Street Name: County: Town: Neighborhood: Zip: Zip + 4: Area: State: Subdivision Name: List Price: List Date: Expiration Date: Elementary School: Middle School: Jr. High School: Senior High School: Display Property Address on Internet: Assessed Value: Mill Rate Override: Tax Year: Other Taxes: Other Taxes: Tax Phase In:

2 Connecticut Multiple Listing Service 2 Acres: Acres Source: Lot SqFt: Zoning Code: Flood Zone: SqFt Includes Below Grade: Flood Zone Code: Elevation Certificate: Style: 1/2 Duplex Chalet Hi-Ranch Raised Ranch Split Level A-Frame Colonial Log Ranch Townhouse Antique Contemporary Mediterranean Rooming House Tudor Barn Cottage Mobile Home Row House Victorian Bungalow Farming House Other Saltbox Cape Cod Georgian Prefab Single Detached Year Built Description: Appraiser Estimate Measured Owner Town Records Completed Historic Model To Be Built Under Construction SqFt Source: Agent Owner Town Records Total Rooms: Color of House: Year Built: New Constructions: Total SqFt: Total Beds: Full Baths: Half Baths: # of Fireplaces: Direct Waterfront: Adult 55: Waterfront Description: Access Brook Mooring Sound Assoc Mandatory Dock Ocean View Assoc Optional Frontage Other Walk To Beach Harbor Pond Beach Rights Lake River Gated Community: Horse Property: Seasonal Property: Home Warranty: Lease Purchase: Potential Short Sale: Foreclosure by Market Sale: Possession Terms: days Immediate Over 90 days days Negotiable Short Sale Comments: Foreclosure By Market Sale Comments: REO: Easements Right of Way: Exclusions: - - Additional Property Information - - Lot Description: Corner Fence - Partial Horse Property Rear/Flag Lot View Cul-De-Sac Fence - Privacy Level Topography Rolling Water Frontage Easements Fence - Rail Lightly Wooded Secluded Water View Farm Land Fence - Stone Neighborhood Sloping Wooded Fence - Chain Link Fence - Water Open Some Wetlands Zero Lot Line Fence - Full Golf Course Frontage Possible Subdivide Subdivision Fence - Invisible Golf Course View Prof. Landscaped Treed

3 Basement Type: Apartment Full Basement Interior Access Partially Finished Bulkhead Full Basement With Hatchway Liveable Space Shared Basement Concrete Floor Full Basement With Walk-Out ne Storage Cooled Fully Finished Partial Basement Sump Pump Crawl Space Garage Access Partial Basement With Hatchway Unfinished Dirt Floor Heated Partial Basement With Walk-Out Walk-out Attic YN: Attic : Crawl Space Floored Heated Pulldown Stairs Walkup # of Garage Spaces: Driveway Type: Finished Hatch Opening Partially Finished Storage Space Park Garage Type: Assigned Car Port Lot Open RV/Boat Pad Under House Attached Covered Garage ne Parking Gar. Security Unit Garage Barn Detached On-Street Reserved Tandem Unpaved Asphalt Circular Dirt Heated Other Private Cement Crushed Stone Gravel ne Paved Shared Pool Descripton: Pool YN: Above Ground Above The Ground Heated In - Ground In Ground Heated Indoor Deck Dimensions: Exterior Siding: Deck Type Descripton: Covered Ground Level Deck Patio Upper Level Wrap Around Aluminum Clapboard Poured Concrete Stucco Asbestos Concrete Redwood Vertical Block Frame Shake Vinyl Siding Brick Log Shingles Wood Cedar Metal Steel Siding Cement Block Other Stone Exterior Features: Area Amenities: Bus Library Private Rec Facilities Public Pool Shopping/Mall Commuter Bus Medical Facilities Private School(s) Public Rec Facilities Tennis Courts Golf Course Park Private Trash Pickup Public Transportation Health Club Playground Professional Use Public Trash Pickup HOA Y/N: HOA Fee: Awnings French Doors Hot Tub Patio Sprinker System Balcony Fruit Trees Invisible Fencing Paved Drive Stable Barn Garden Area Kennel Porch Stone Wall Breezeway Gas Grill Lighting Porch-Enclosed Storage Area Cabana Gazebo ne Porch-Heated Tennis Court Deck Greenhouse Other Porch-Screened Terrace Fence Guest House Outbuilding(s) Porch-Wrap Around Underground Utilities Fenced Area Gutters Outdoor Kitchen Shed Fenced Yard Horses Permitted Paddock Sidewalk Connecticut Multiple Listing Service 3

4 HOA Fee Includes: Residential (SF) Data Input Form Connecticut Multiple Listing Service 4 Association Insurance Heat Other Taxes Central Air Hot Water Security Trash Removal Grounds Maintenance Management Snow Removal Water Amenities Included: Basketball Court Golf Course/Putting Green Paddle Tennis Shuttle Service Bocci Court Guest Parking Park Squash Club House Handball Court Playground/Tot Lot Stable\Riding Court Lake Pool Tennis Exercise Room/Health Club ne Racquet Ball Court Trails Gardening Area Other Security Services Association Fee Amount: Association Fee Desc Monthly Anually Other Association Fee Includes: Accounting/Legal Grounds Maintenance Lake/Beach Access Pest Control Air Conditioning Heat Management Plowing Club House Hot Water ne Pool Service Flood Insurance Insurance Payroll Handicap Accessible: Handicap Features: 32 Min Doors Exterior Curb Cuts Low Counters Ramps 60 Turn Radius Hallways 36+ Wide Modified Range Remote Devices Appliances Low/Secure Hard/Low Nap Floors Multiple Entrances Roll-In Shower Bath Kitchen Other Roll-under Sink(s) Bath Grab Bars Lever Door Handles Parking Scald Control Faucets Chair Lift Lever Faucets Raised Dishwasher Special Needs Transport Closet Bars Low Cabinetry Raised Toilet Interior Features: Air Filter Elevator Network Smoke Detector(s) Audio System Fireplace Open Floor Plan Sprinkler System Auto Garage Door Opener Generator Other Wine Cellar Cable - Available Humidifier Roughed-in Bath Wired for Multi-Line Phones Cable - Pre-wired Intercom Satellite Dish Workshop Central Vacuum Internet - Available Sauna Dehumidifier Internet - Pre-wired Security System Additional MLS Numbers: Hubbard Y/N: PUD

5 Connecticut Multiple Listing Service 5 **For Room Type(s), Level(s), Description(s) and their Selections, refer to the list found on Rooms Information Page** - - Rooms - - Laundry Info: Basement Common Laundry Area First Floor Lower Level ne Upper Level In Law Y/N: In Law Access: Detached Possible First Floor Second Floor Lower Level Separate Entry Over Garage

6 Connecticut Multiple Listing Service 6 Fuel Type: - - Utilities - - Above Ground Electric Kerosene Oil Solar Bottle Gas Geothermal Natural Gas Other Wood Coal In Ground Fuel Propane Estimate Annual Heat Cost: Underground Oil Tank: Fuel Tank Description: Above Ground Tank In Ground Tank n Applicable In Basement In Garage Water Source: Water Sewer Lien: Water Private Well Shared Well Well Required Both Other Public Water Available Spring Neither Private Water System Public Water Connected Well Available Sewer Hot Water Fuel: Water Domestic Natural Gas Oil Propane Sewer Annual Assess: Electric Hot Water Other Solar Assisted Heat Type: Baseboard Heat Steam Gas Other Wall Unit Gas on Gas Radiant Warm Air Heat Pump Radiator Wood/Coal Stove Hot Air Solar Zoned Hydro Air Space Heat Sewer Usage Fee: Sewer Annual Fee: Sewage System: Cesspool Other Public Sewer Connected Septic Available Shared Septic Sewer Public Sewer Available Septic Septic Required Cooling System: AC Avail. In Some Units Central Air Heat Pump ne Wall Unit Zoned Attic Fan Combo Individual Unit(s) Other Window Unit Electrical: 100 Amps 110 Volts 150 Amps 220 Volts 440 Volts Circuit Breaker Fuses 200+ Amps 3 Phase 60 Amps or Less Energy Features: Active Solar Geothermal Heat Partial Thermopane Windows Attic Fan Heat Recovery Unit Passive Solar Built Green Certification Home Energy Rating Radiant Heat Ceiling Fan(s) Humidistat Ridge Vents Day/Night Thermostat Multi Zone Heat Solarium Energy Star Rated Screens Storm Doors Extra Insulation Storm Windows Storm Windows Fireplace Insert ne Tankless Hot Water Full Screens Other Thermopane Windows Full Storm Windows Partial Screens Whole House Fan Generator Partial Storm Windows Wood/Coal Stove Radon Mit System Air: Radon Mit System Water:

7 Connecticut Multiple Listing Service 7 Appliances Included: Allowance Dryer Gas Range Other Wall Oven Compactor Electric Cooktop Hood Oven/Range Washer Counter Grill Electric Range Instant Hot Water Tap Refrigerator Wine Chiller Dishwasher Freezer Microwave Stove Top Disposal Gas Cooktop ne Subzero Public Remarks: - - Remarks Characters Please use proper case when entering in Remarks. Agent to Agent Remarks: 500 Characters Office Remarks: Please use proper case when entering in Remarks. 250 Characters Directions to Property: Please use proper case when entering in Remarks. 255 Characters REALTOR Signature Date Seller Signature Date

8 Room(s) Information Page Connecticut Multiple Listing Service Room Type: Bathroom Extra Storage In-Law Apt Nursery Bedroom Family Room Kitchen Studio Apt Bonus Room Formal Dining Room Laundry Room Other Study Breakfast Room Foyer Library Partial Bath Sun Room Breezeway Full Bath Living Room Playroom Utility Den Game Room Porch Wine Cellar Dining Area Great Room Master Bedroom Recreation Room Workshop Dining Room Greenhouse MBR Suite Sauna Eat-Inn Kitchen Half Bath Media Room Sewing Room Exercise Room Mudroom Sitting Room Level: Lower Main Other Upper Description: Combination Liv/Din Rm Floor - Laminate Galley Steam/Sauna Atrium Counters - Corian Floor - Limestone Great Room Stove - Pellet Balcony Counters- Granite Floor - Marble Half Bath Stove - Wood Bay Window Country Floor - Parquet Hot Tub Studio Beams Double-sink Floor - Plywood Hydro-tub Sunken Bedroom Suite Dressing Room Floor - Slate Interior Balcony Upper Level Book Shelves Dry Bar Island Vaulted Ceiling Breakfast Bar Eating Space Kitchen Floor - Stone L-Shaped Walk-In Closet Breakfast ok Entertainment Center Floor - Tile Lower Level Wet bar Built-In Hutch Fireplace Floor - Travertine On 3rd Floor Whirlpool Built-Ins Fireplace - Gas log Floor - Vinyl Pantry Windows - 2-Story Carpet First Floor Floor - Wide board Remodeled Windows - Palladian Cathedral Ceiling Floor - Composite Formal Skylight Cedar Closet Floor - Concrete French Door(s) Slider Ceiling Fan(s) Floor - Hardwood Full Bath Stall Shower

Residential For Rent Data Input Form Connecticut Multiple Listing Service 1

Residential For Rent Data Input Form Connecticut Multiple Listing Service 1 Connecticut Multiple Listing Service 1 Agent ID: Agent Name and Information: - - Agent Information - - Office Name and Information: Team Agent 1 Name: Team Agent 2 Name: Team Agent 1 Phone: Team Agent