EASTERN KENTUCKY ASSOCIATION OF REALTORS RESIDENTIAL INPUT FORM MLS (6) promatch complete Legal / List / $ List Date / / Exp Date / / Month Day Year Month Day Year PFX (Choose 1 ) Number (10) Unit # (10) E N S W City (See List) NE NW SE SW List Price $ (8) Street (30) KY State SFX(2) Zip Bath Boyd Breathitt Carter Fayette Floyd Greenup Harlan Johnson Knott County (Choose 1) Lawrence Morgan Lee Other Leslie Perry Letcher Pike Logan, WV Powell Magoffin Rowan Martin Wayne, WV Menifee Wolfe Mingo, WV Wyoming, WV Country (Choose 1) X USA Canada Internal ID (12) Listing Agent Co-List Agent Buyer Agt Comp %. (2.3) Sub Agt Comp %. (2.3) Trans Broker Comp %. (2.3) Agency (Choose 1) Excl Agency Excl Right To Sell Buyer Agt Comp $ (6) Sub Agt Comp $ (6) Trans Broker Comp $ (6) Association Fees _. _(4.2) Tax ID (20) Tax Total (6) Legal Owner of Record (50) REO (Choose 1) Yes Subdivision (50) No Elementary School (20) Middle School (20) High School (See List) Zoning (Choose 1) C2 C3 Commercial MIXED None R R1 R2 R3 Residential UKN Continued on Pg 2 54-R-0713-13
Residential Page 2 Acreage _. _(5.3) Lot Size (20) Site Flood (Choose 1) Yes No Lease (Choose 1) Yes No Lease Payment _. (6.2) Auction (Choose 1) Yes No Auction Type (Choose 1) Business Opport. Fee Simple Subj to Lease Prop Type (Choose 1) Condo Single Family Townhouse Sewer (Multiple Allowed) Aerator Holding Tank Only Public Available Public Installed See Agent Comments Septic System Water (Multiple Allowed) Drilled Well Public Public Available See Agent Comments See Agnt Com. Exterior Features (Multiple Allowed) Above Ground Pool Landscape Lighting Asphalt Drive None Barn Outside Bar-B-Q Concrete Drive Pool House Fenced Yard Security Lighting Garden Space Sprinkler System Guesthouse Storage Building In-ground Pool Underground Utilities Year Built (4) Total Rooms (2) Bedrooms (2) Baths. (2.2) Bldg Full Baths(2) 3/4 Baths(1) Half Baths(2) Style (Multiple Allowed) 1.5 Story 2 Story 2.5 Story A Frame Colonial Contemporary Double Wide Ranch Single Wide Split Foyer Tri-Level Tudor Exterior (Multiple Allowed) Aluminum/Metal Block Brick Concrete Lap Log Masonite Stone Stucco Vinyl Wood Windows (Multiple Allowed) Dbl Pane Insulated Metal NONE Screens Single Pane Storm Windows Vinyl Wood Roof (Multiple Allowed) Metal Roll Rubber Shingle Slate Tar & Gravel Tile Wood Shakes Porches/Patios (Multiple Allowed) Covered Deck Deck Front Covered Front Porch None Rear Patio Rear Patio Covered Rear Porch Rear Porch Covered Screened Porch Stoop Sun Room Wrap Around Porch Below Grade (Multiple Allowed) Crawl Space Finished Full None Outside Entrance Partial Slab Unfinished Attic (Multiple Allowed) Access Only Attic Fan Eave Storage Finished Floored None Partially Floored Permanent Stairs Pull Down Stairs Continued on Pg 3 54-R-0713-14
Residential Page 3 Bldg Cooling (Multiple Allowed) Central None See Agent Comments Wall Units Window Units Heating (Multiple Allowed) Baseboard Coal Electric Floor Furnace Forced Warm Air Gas Heat Pump Hot Water Radiant See Agent Comments Space Heater Wall Furnace Wood Flooring (Multiple Allowed) Brick Carpet Concrete Hardwood Laminate Slate Subfloor Only Tile Vinyl Interior Features (Multiple Allowed) 1st Floor Bedroom Bonus Room Cable/DSL Available Cathedral Ceilings Ceiling Fans Den/Office Garden Tub Hot Tub None Security System See Agent Comments Vacuum System Walk In Closet Wet Bar Wheelchair Access Whirlpool Bath Window Treatments Appliances (Multiple Allowed) Cook Top Dishwasher Disposal Dryer Electric Gas Island Microwave Negotiable None Refrigerator Stove Trash Compactor Wall Oven Washer Car Storage (Multiple Allowed) 1 Car Carport 1 Car Garage 2 Car Carport 2 Car Garage 3 Car Carport 3 Car Garage Attached Built In Detached None Car Storage Sq. Ft. (4) Sq. Ft. Below Grade (5) Sq. Ft. 1st Level (5) Sq. Ft. 2nd Level (5) Sq. Ft. 3rd Level (5) Tot AG SqFt (5) Living Sq. Ft. (5) Room Remarks Continued on Pg 4 54-R-0713-15
Residential Page 4 Rooms Room Name 1/2 Baths 3/4 Baths Bedrooms Dining Room Family Room Fireplaces Full Baths Kitchen Living Room Other Utilities Room Name Below Grade(3) 1st Level(3) 2nd Level(3) 3rd Level(3) Misc/Show Possession (Multiple Allowed) 30 Days 60 Days At Closing Lease/Option to Buy Negotiable Other-See Agnt Com. Subject to Lease Documents Available (Multiple Allowed) Association By-Laws Deed Deed/Subdivision Restrictions Easements Elevation Certificate Plat Map/Survey Power of Attorney Sellers Disclosure Zoning Map Lock Box (Choose 1) Yes No Deed Restrictions (Choose 1) Yes No Occupancy (Choose 1) New Owner Tenant Vacant Internet Display (Choose 1) Yes No Address Display (Choose 1) Yes No Allow AVM (Choose 1) Yes No Allow Blogging (Choose 1) Yes No Showing Instructions Public Remarks (550) Continued on Pg 5 54-R-1210-16
Residential Page 5 Misc/Show Confidential Remarks (500) Directions (550) Latitude.(2.9) Longitude _. (2.9) Virtual Tour URL (100) 54-R-1210-17