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Owner/Agents Name _________________________________________ Property Being Sold:

Park/ Community Name _______________________________________

Property/Park Address _________________________________________________________

Lot# _____ City _____________________ State ________ Zip ________

Owners Address ______________________________________________________________

Lot# _____ City _____________________ State ________ Zip ________

Contact to Show _____________________________________________

Phone #1 (____)________________ Phone #2 (____)________________

E Mail Address ________________________

Home:

Price $______________ Bedrooms ____ Baths _____ Sq ft ___________

Yr Built ______ Manufacturer ___________________ Size _____x_____

Taxes ___________ Tags ___________ Ad Valorium Tax ____________

Type of Roof ____________ Siding ____________ Carport ___________

Awn __________ Shed size _____x_____ Skirting _________

Air Condition: CHA _____________ Wall _______ Heat ____________

Size of Elec Service _______ amps. Breakers________ Fuses _______

Rooms: size Features

Living Room ______________ _________________________________

Dining Room ______________ _________________________________

Kitchen ______________ _________________________________

Family Room ______________ _________________________________

Screen Room ______________ _________________________________

Bedroom 1 ______________ _________________________________

Bedroom 2 ______________ _________________________________

___________ ______________ _________________________________

___________ ______________ _________________________________

___________ ______________ _________________________________

Selling Furnished ____________ Part Furn __________ Unfurn ________

Leaving (circle) Refrigerator Stove/Oven Dishwasher Microwave

Garbage Disposal Trash Compactor Washer Dryer Bread Maker

Other ______________________________________________________

Community: Senior 55+ _______ Adult ________ Family ________

Type - Resident Owned ________ Rental _________ Other ___________

Explain _____________________________________________________

Lot Size ______x______ Maintenance Fee $_________ Rent $_________

Fees include (Y/N) or add cost in space:

water & sewer ______ trash _____ lawn ______ cable _____ other _____

Clubhouse ____ Swimming Pool ______ Heated ____ Spa/Hot Tub _____

Shuffleboard _________ Golf Course _________ Exercise Room ______

Pets/Size __________________ May you rent out home ______________

Other Amenities ______________________________________________

____________________________________________________________

Manager Name & Phone _______________________________________

Terms: Cash ___ Owner Financing _______________________________

Write a special ad for your home: ________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

Owners Authorization:

I, ______________________________________ (print name) as legal owner/agent

for owner hereby give authorization to you to place any and all above information

and/or photos on the internet.

Sign _____________________________________________

Date _____________

Contact (727) 709 9060 or Mail to:

WITH Photos, Form and a check for $29.95 to Payable to & C/O:

John Frejeris

XpectA, Inc.

795 C.R.1, Unit #69

PalmHarbor, Fl. 34683

If you would like the Photos Taken by us for only an additional $20.00 Call (727) 709 9060

Get Your Private Page with your own DOT-COM add $20.00 for 1 year (renew if home not sold)

www.HomePromo.info ™

2001 - 2007XPECTA, INC.

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