State of California s136

STATE OF CALIFORNIA REAL ESTATE SERVICES DIVISION

STATEWIDE PROPERTY INVENTORY BUSINESS OPERATIONS, PLANNING & POLICY BRANCH

Rev. RESD FORM 1010 (04/26/2004) (Page 1 of 2)

REAL PROPERTY DATA ENTRY FORM

1. Action type (Mandatory) Add Change Delete

AGENCY

2. UCM Agency Number: ______

3. Agency Name 1. ______

2. ______

4. Agency Acronym: ______

REAL PROPERTY

5. Real Property Number: ______

6. Real Property Name: ______(50 characters)

7. Agency Property Number: ______8. Billing Code: ______

9. Agency Region: ______10. Thomas Bros.: Map Book ______Page ______Grid __ __

11. Bond Funds: __ 12. Bond Amount: $_ __ __,______,______,______

13. Payments Per Year: __ __ 14. Payment Amount $_ __ __,______,______,______

15. Commence Term Date: __ __/__ __/______16. End Term Date: __ __/__ __ /______

17. Outstanding Dollar Amount: $_ __ __,______,______,______18. Balance Date: __ __/__ __/______

19. Real Property Description:

______

20. Estimated Value: $_ __ __,______,______,______21. Date of Estimate: __ __/__ __/______

22. Real Property (Estimate) Comments:

______

REAL PROPERTY CHARACTERISTIC(S)

23. Real Property Characteristic Code: ______24. Applicable Date: __ __/__ ___/______

25. Real Property Characteristic Comments:

______

23. Real Property Characteristic Code: ______24. Applicable Date: __ __/__ ___/______

25. Real Property Characteristic Comments:

______

STATE OF CALIFORNIA REAL ESTATE SERVICES DIVISION

STATEWIDE PROPERTY INVENTORY BUSINESS OPERATIONS, PLANNING & POLICY BRANCH

REAL PROPERTY DATA ENTRY FORM CONTINUED

Rev. RESD FORM 1010 (02/2004) (Page 2 of 2)

ADJOINING REAL PROPERTY CHARACTERISTIC(S)

26. Adjoining Property Characteristic Code: ______27. Applicable Date: __ __/__ __/______

28. Adjoining Property Characteristic Comments:

______

26. Adjoining Property Characteristic Code: ______27. Applicable Date: __ __/__ __/______

28. Adjoining Property Characteristic Comments:

______

REAL PROPERTY USE(S)

29. Land Use Code: ______30. Current Use Acres: ______,______, ______.__ __ 31. Surplus Flag: __

32. Estimated Value: $_ __ __,______,______,______33. Date of Estimate: __ __/__ __/______

34. Current Program Use Code: ______

35. Projected Program Use Code: ______36. Projected Program Use Date: __ __/__ __/______

37. Real Property Use Comments:

______

29. Land Use Code: ______30. Current Use Acres: ______,______, ______.__ __ 31. Surplus Flag: __

32. Estimated Value: $_ __ __,______,______,______33. Date of Estimate: __ __/__ __/______

34. Current Program Use Code: ______

35. Projected Program Use Code: ______36. Projected Program Use Date: __ __/__ __/______

37. Real Property Use Comments:

______