GEORGIA MLS Page 1 of 4 TypeRSD SINGLE FAMILY DETACHED (SD) INPUT SHEET Property Address ______Listing Number ______List Date/Expire Date ______City State Zip Office Name ______Agent Name ______Office Name (2) ______Agent Name (2)______

Location

StateR_ _ CountyR______AreaR____

Street NumberR______Street NameR______Quadrant _ _ (NE,NW,SE,SW)

R Unit/Lot Number ______City ______ZipR_____-____ (Zip 4) SubdivisionR______Subdivision or complex name. If no subdivision enter NONE

Terms

R R Listing Agreement Type List DateR__/__/____ Expire DateR__/__/____ List Price $______ - Exclusive Agency (mm/dd/yyyy) (mm/dd/yyyy)  - Exclusive Right to Sell List Agent IDR______List BrokerR______Listing broker code List Agent 2 ID______Co-listing Agent. Must be valid Georgia MLS agent ID Owner Name ______Owner of record Owner Phone _ _ _ -___-____

Variable Rate CommissionR_ R  $ Commission ______.__ Is the commission variable? (Y/N)  %

Tax/Legal

Tax IDR______TaxesR______Tax YearR____ Tax ID number assigned by county. Also known as Parcel ID or PIN Total taxes (County & City) Year of taxes shown

Land Lot ____ District ____ Section _ _ _ _ Block _ _ _ _ Lot _ _ _ _ Unit _ _

Plat Book ______Plat Page ______Deed Book ______Deed Page ______

R Construction StatusR_ Year Built ____ Acreage______Acreage_SourceR  Actual year built - see seller’s statement New Construction  To Be Built  - Acreage not entered Estimated total acres  Resale  Under Construction  - Agent OwnershipR  - Appraiser  - Fee Simple  - Other (see remarks) Lot Dimensions ______ - Owner / Seller  - Leased Land  Start with street frontage and move clockwise separating dimensions with an ‘X’ - Public Record Schools

ESR______MSR______HSR______ES Bus _ MS Bus _ HS Bus _ Is property on ES bus route? (Y/N) Is property on MS bus route? (Y/N) Is property on HS bus route? (Y/N)

R denotes required field R21-032316 Address______Page 2 of 4 Bed/Bath LowerR _ _ Bedrooms MainR _ _ Bedrooms UpperR _ _ Full Baths LowerR _ _ Full Baths MainR _ _ Full Baths UpperR _ _ System will calculate totals Half Baths LowerR _ _ Half Baths MainR _ _ Half Baths UpperR _ _

Interior Energy Related R (continued) Heating TypeR Equipment R Accessibility  - Insulation -  - Baseboard  - Convection Oven  - 32”  - LEED Certified  - Electric  - Cooktop - Separate  - Bath Access Wheelchair  - None  - Central  - Dishwasher  - Access Wheelchair  - Programmable Thermostat  -  - Double Oven  - Van Access  - Vent Fans  - Floor Radiant  - Garbage Disposal  - Low Handles  - Storm Doors  - Forced Air  - Icemaker Line  - Low Kitchen Counters  - Storm  - Heat Pump  - Indoor Grill  - Low Switches  - Tankless Water Heater  - No Heating  - Microwave - Built In  - Other (See Remarks)  - Water Heater - Electric  - Other (See Remarks)  - None  - Ramps  - Water Heater - Gas  - Space Heater  - Other (See Remarks)  - Shower Access Wheelchair  - Water Heater -  - Steam / Hot Water  - Oven -  - Stepless Entry  - Zoned / Dual  - Range / Oven  - Wide  - Refrigerator R Equipment Interior  - Stainless Steel Appliances  - Expandable R  - Alarm - Burglar  - Trash Compactor  - Bookcases   - Alarm - Carbon Monoxide - Bath Finished  - Cable In Street   - Alarm - Smoke / Fire - Bath Stubbed  - Cable TV Connection Laundry Location   - Central Vacuum - Block  - Carpet  - Basement   - Dryer - Boat Door  - 9' Plus  - Garage   - Electric Air Filter - Concrete  - Ceilings - Trey  - Hall   - Fire Sprinkler - Crawlspace  - Ceilings - Vaulted  - Kitchen Area   - Generator - Daylight  - Double Vanity  - Mud   - Intercom / Radio - Earthen  - Elevator  - Other (See Remarks)   - Satellite Dish - Entrance - Inside  - Exposed Beams  - Upstairs   - Washer - Entrance - Outside  - Foyer - 2 Story   - Water Softener - Finished  - Foyer - Entrance  - Full Laundry Type  - Garden Tub   - Partial -  - Gas Logs   - Pier R - No Laundry  - Handicap Access   - Slab / None __ - Other (See Remarks) Total number of fireplaces  - Hardwood Floors  - Room  - Laminate Flooring R Cooling Source Location  - Other (See Remarks)  - Electric  - In Basement  - Pull Down Attic  - Gas R  - In Great /  - Rear Stairs Rooms  - Other (See Remarks)  -  - In  - Recently Renovated  - Solar  -  - In Master  -  - Dining Rm / Living Rm Combo  - Other (See Remarks)  - Separate Shower  - Dining Rm - L Shaped Cooling TypeR  - Outside  - Skylight  - Seats 12+  - Ceiling Fan  - Tile Bath  - DR-Separate  - Central  - Tile Floors  - Exercise Room  - Heat Pump Fireplace Type  - Walk-in Closet  - Family Room  - No Cooling  - Factory Built  -  -  - Other (See Remarks)  - Gas Starter  - Whirlpool Bath  - In-Law Suite or Apartment  - Whole Fan  - Masonry  - Library / Office  - Units  - Metal  -  - Zoned / Dual  - Wood Stove Kitchen / Breakfast  - Breakfast Area  - LR Separate R  - Breakfast Bar  - Master on Main Level Energy Related R  - Certified Earthcraft Heating Source  - Breakfast Room  - Other (See Remarks)  - Certified Energy Wise  - Electric  - Country Kitchen  - Rec Room  - Certified EnergyStar  - Gas  - Island  - Roommate Plan  - Certified Good Cents  - Oil  - Keeping Room  - Solarium / Sun Room  - Double Pane / Thermo  - Other (See Remarks)  -  - Split Bedroom Plan  - Geothermal  - Propane  - Second Kitchen  - Stubbed Bath  - HERS Rated  - Solar  - Solid Surface Counters  - Theater / Media Room  - Insulation - Ceiling  - Wood  - Walk-in Pantry  - Water Feature Name Boathouse/Dock  Water Description - Boathouse - 1 Slip ______ - Corps of Engineers Controlled  - Boathouse - 2 Slip  - Deep Water Access  - Boathouse - 3 plus Name of lake/river/other  - Lagoon  - Covered Dock - 1 Slip   - Covered Dock - 2 Slip - Lake Access  - Marsh  - Covered Dock - 3 plus Waterfront FT  - Dock Approval Required _____  - Pond  - Dock Rights Estimated length  - Private  - Floating Dock  - Stream / Creek / River  - No Dock or Boathouse Property Setting  - Tidal  - No Dock Rights  - Borders US / State Park  - Utility Company Controlled  - Seawall  - Creek  - Water View  - Shared Dock  - Lake  - Waterfront  - Stationary Dock  - Mountain  - Uncovered - No Slip  - Ocean / Gulf  - Verbal Appr Dock Permit  - River R denotes required field R21-032316 Address______Page 3 of 4 Exterior R Construction R Exterior (continued) Parking R Style  - Aluminum / Vinyl  - Screen  - 1 Car  - A-Frame  - Brick / Frame  - Sprinkler System  - 2 Car  - Adirondack  - Brick 3 Sided  - Stables  - 3 Car or More  - / Cottage  - Brick 4 Sided  - Tennis Court  - Assigned Space  - Cabin  - Brick Front  - Veranda  - Attached  - Cape Cod  - Concrete Siding  - Water Feature  - Auto Garage Door  - Cluster  - Log  -  -  - Colonial  - Other (See Remarks)  - Detached  - Contemporary   - Press Board Siding R  - Drive Under / Basement - Country / Rustic  - Rough-Sawn Siding Lot Description   - Craftsman  - City View - Garage  - Steel Frame   - European  - Corner - Guest Parking   - French Provincial - Stone  - Cul De Sac  - Kitchen Level Entry   - Stone / Frame  - Golf Course  - None - Mediterranean   - Stucco EIFS  - Greenbelt  - Off Street - Mobile  - Stucco Real  - Level Lot  - Parking Pad  - Modular Home  - Stucco Unspecified  - Mountain View  - Parking Shed Must be permanently attached to  - Tabby  - None  - RV / Boat Parking land and sold as real estate  - Wood Siding  - Open Land  - Side / Rear Entrance  - Other (See Remarks)  - Private  - Storage  - Ranch  - Seasonal View  - Traditional Exterior  - Sloping Roof Type  - Tudor  -   - Valley View - Composition  - Victorian  - Barn   - Wooded - Concrete  - /  - Copper  - Dog Run / Pen  - Metal / Steel Water/Sewer R  - Fenced Yard  - Other (See Remarks)  - Community Well R  - Garden Area Lot Size  - Slate  - Low Flow Fixtures  - Gas Grill  - Less than 1/3 Acre  - Tar / Gravel  - Private Sewer  - Gazebo  1/3 - 1/2 Acre  - Tile  - Private Water  - Green House -  - Tin  - Public Water   - 1/2 - 1 Acre - Hot Tub   - Septic Tank  - Wood Shingle - Other (See Remarks)  - 1 - 2 Acres  - Sewer Connected  - Out StoriesR  - 2 - 5 Acres  - Sewer in Street  - Outdoor Kitchen  - 1 Story  5 - 10 Acres  - Well  - Pool - Above Ground -  - 1.5 Stories  - Pool - In Ground  - 10 - 20 Acres  - 2 Stories Owner Initials ______ - Pool House  - 20 - 50 Acres  - Over 2 Stories  - Pool Screened / Enclosed  - 50 - 100 Acres  - Multi-Level  - Porch   - 100 Plus Acres - Split Foyer  - Split Level Other Possible Financing (continued) R (continued) Special Conditions Date of Possession R Neighborhood Amenities  - FHA  - None  - Agent Owned  - 3-7 Days after Closing  - FNMA Apprv  - Park  - Agent/Seller Relationship  - At Closing  - FNMC Apprv  - Physical Fit Facilities  - Bank Owned  - Negotiable  - GHFA Loan (GRFA)  - Playground  - Corporate Relocation  - Other (See Remarks)  - Lease Purchase  - Pool  - Covenants/Restrictions  - Not Valid Option  - Racquetball  - Estate Owned Fee Amount $  - Other (See Remarks) _____  - Retirement Community  Annual association fees - see below  - Owner 1st - Fixer Upper  - Security  - Owner 2nd  - Foreclosure R  - Sidewalks Fees Include  - Owner Financing  - Government Owned  - Stables  - Bldg. & Liability Insurance  - Release of Liability  - Historic  - Street Lights  - Exterior Maintenance  - USDA  - Investor Owned  - Swim Team  - Facilities Fee  - VA  - Pre-Foreclosure  - Tennis Courts  - Garbage Pickup  - Wrap Around  - Recently Renovated  - Grounds Maintenence  - Tennis Team  - Rental  - Heating / Cooling  - Undergound Utilities  - Short Sale   - Walk to Marta - Management Fee Showing InstructionsR   - Walk to Schools - None  - 24 Hour Access   - Walk to Shopping - Other (See Remarks)  - 9AM to 10PM  - Pest Control / Termite  - Appt. Agent  Above Grade Finished - Private Roads  - Appt. Owner System  Photo R ______SQ FT - Reserve Fund  - Appt. Tenant will   - Broker Will Provide Photo Estimated finished area at or above - Security  - Call Agent Only calculate  ground level - Sewer  - No Photo Desired By Seller  - Caution Alarm estimated  Total - Swimming  - Caution Pet  Owner Initials______Below Grade Finished Finished - Tennis  - Courtesy Call - Leave Msg  ______SQ FT Area - Water  - Under Construction  - Day Sleeper  - Key in Office Estimated finished area partially or R Home Warranty _  - Lockbox GAMLS Compatible completely below ground level Possible Financing  Does seller offer a home warranty? (Y/N)  - 100 PCT. Financing - Lockbox Non - GAMLS Compat  - 1031 Exchange (See Private Remarks) Below Grade Unfinished  Initiation Fee $_____  - Assume - See Remarks ______SQ FT  - Special Hours Association initiation fee in dollars  - Cash Estimated unfinished area partially or   - Conventional - Under Construction completely below ground level R Neighborhood Amenities   - Vacant - Credit Report Required R  - Airstrip  - Exchange Considered Square Footage Source  - Boat / Camper / Van Prkg (Please select only one)  - Clubhouse External References (ER)  - Agent  - Gated Community If this listing is referenced elsewhere you may enter source and reference ID here  - Appraiser  - Golf Course ER1 Source______ER1 ID______ - Builder Plans  - Guest Lodging  - Other (See Remarks)  - Lake ER2 Source______ER2 ID______ - Owner / Seller  - Marina  - Public Record  - Neighborhood Association  - Sq Ft Not Entered External Reference Source External Reference ID R denotes required field R21-032316 Address______Page 4 of 4 Comments

R Public Remarks Comments directed to the general public (768 character max). ______

Private Remarks Confidential comments viewable only to members (320 character max). ______

Private URL Additional web address viewable only to members (200 character max). ______

Office Remarks Confidential comments viewable only to members in your office (192 character max). ______

R Directions (256 character max) ______

Vow_Address _ (Y/N) Vow_Avm _ (Y/N) Vow_Comments _ (Y/N) Vow_Included _ (Y/N)

SELLER’S STATEMENT: Seller herein certifies that the property Seller is offering for sale through the broker was built in the year specified in this document, and Seller has been informed by the broker of the lead-based paint disclosure requirements under The Residential Lead- Based Paint Hazard Reduction Act of 1992, 42 U.S.C. §4851-4856 (the “Act”). Seller agrees to sign all the necessary disclosure forms, of which copies are attached hereto and made a part hereof by reference in order to abide by this Act; and, to disclose in writing to the broker and to prospective purchasers any other physical characteristics of the property that may adversely affect its value. Seller understands and agrees that all the information above will be provided to agents who may represent other parties. Seller hereby waives any claims arising out of disclosure of such information to other parties. Seller agrees above information is true and correct to the best of his/her knowledge.

Signature ______Date ______

Signature ______Date ______R denotes required field R21-032316