I will pay for MLS service:                Online              Mail Check
I wil send the signed listing agreement by:                 US Mail             FAX

MLS listing period:        2 Months          3 Months            4 Months           5 Months          6 Months   

                                       
Owners Full Name: __________________________________________               ___________________

2nd Owners Full Name:__________________________________________________________________

Street Address of Property For Sale:
Street:_______________________________________     City:__________________________________

Unit #:_______           State:                                          _ ____       Zip:_____________________________

Mailing Address:
Street:_______________________________________     City:__________________________________

Unit #:_______           State:                                          _ ____       Zip:_____________________________

U.S. COUNTY WHERE PROPERTY IS LOCATED:_______________________________________

Daytime Phone:                        ____________        Evening Phone:     _______                                 __       

Do you want both phone numbers on the MLS:       Yes     Just the day #      Just the night #       Other

EMAIL ADDRESS:___________________________________________________________________

FAX NUMBER:______________________________________     

Subdivision Name:___________________________     Development Name:______________________
Tax ID#                      ___     ___    Taxes $                     Tax Year                        Year Built____ ______

LEGAL DESCRIPTION:

Land Lot_______                   District___                 Section___                              Lot________________

Block                          Unit___                       Plat Book                                    Page___________________

# of Fireplaces                                       Are you Offering a Home Warranty   Yes  or  No    

Association Fees$                        Assoc. Fee is:      Optional     Required     IncludesSwim/Tennis   None

Elementary School:_____________________________________________________________________

Middle School:_________________________________________________________________________

High School:___________________________________________________________________________

Number of Bedrooms on each level:___Upper Level ___Main Level ___Lower Level       Total # _____

Number of Full Baths on each level:___Upper Level ___Main Level ___Lower Level       Total # _____

Number of Half Baths on each level:___Upper Level ___Main Level ___Lower Level      Total # _____

PROPERTY DESCRIPTION (up to 180 characters):

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DIRECTIONS: (from a major road or intersection):

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Amount of commission being offered to real estate agents:    2%       2.5%      3%      3.5%     4%    4.5%

CHECK ALL OFF THE FOLLOWING THAT APPLY TO YOUR PROPERTY

NAME  ______________________________________________  {Signature} ____________________________________________________

NAME  ______________________________________________  {Signature} ____________________________________________________

DATE____________________