Maryland Form Mw506ae Draft - Application For Certificate Of Full Or Partial Exemption - 2010 Page 2

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2010
MARYLAND FORM
Application for Certificate of Full or Partial Exemption
MW506AE
Page 2
Transfer/Sellers Name
Your Social Security Number/FEIN
Reason for Full or Partial Exemption from Withholding
(Attach documentation and calculation)
Amount of Total Payment Subject to Tax is:
Reason for Exemption
None (totally Exempt)
Only a portion
1.
Transfer is to a corporation controlled by transferor for purposes of IRC
$ ______________________
§351:
2.
Transfer is pursuant to a tax-free reorganization for purposes of IRC §351:
$ ______________________
3.
Transfer is pursuant to an installment sale under IRC §453 and the
transferor/seller will receive less than the full purchase price during the
$ ______________________
taxable year.
4.
Transfer is by a tax-exempt entity for purposes of IRC §501(a) and transfer
involves limited or no unrelated business taxable income under IRC §512:
$ ______________________
5.
Transfer is by transferor to a partnership, such that no gain or loss is
recognized on the transfer under IRC §721:
$ ______________________
6.
Transfer is treated as a transfer by a partnership for purposes of IRC §731:
$ ______________________
7.
Transfer is treated as a transfer by a real estate investment trust for purposes
of IRC §857:
$ ______________________
8.
Transfer is a tax-free exchange for purposes of IRC §1031 and is treated as:
simultaneous without boot,
simultaneous with boot, or
delayed, with funds in escrow for acquiring replacement property:
$ ______________________
9.
Transfer is pursuant to a condemnation and conversion into similar property
for purposes of IRC §1033.
$ ______________________
10.
Transfer is between spouses or incidents to divorce for purposes or IRC
§1041:
$ ______________________
11.
Transfer is treated as a transfer by an S corporation for purposes of IRC
IRC §1368:
$ ______________________
12.
Transfer is by transferor to a disregarded entity, classified as such under 26
CFR §301.7701-3, that is solely owned by the transferor:
$ ______________________
13.
Transfer is otherwise fully or partially exempt from the recognition of gain in
accordance with the attached explanation:
$ ______________________
Provide Brief Explanation of Your Reason for Requesting Exemption
Calculation of Tax to be Withheld
1. Enter the amount subject to tax .......................................................................................................................................
1
2. Enter tax rate, whichever applies.
a. If you are a business entity, enter 8.25%
...........................................................
2
.......................................
...........................................................
b. If you are an individual, enter 7.50%
3. Amount of tax to be withheld at closing. Line 1 multiplied by line 2. (This line MUST be completed.) ............................
3
Under the penalties of perjury, I declare that I have examined this application, including any schedules or statements
attached, and to the best of my knowledge and belief, it is true, correct and complete. If prepared by a person other
than taxpayer, the declaration is based on all information of which the preparer has any knowledge.
_____________________________________________
___________________________ ___________________________
Please
Signature
Applicants phone number
Date
_____________________________________________
___________________________ ___________________________
Sign
Signature
Applicants phone number
Date
_____________________________________________
___________________________ ___________________________
Here
Signature
Applicants phone number
Date
06-09

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