Form Mw506ae - Application For Certificate Of Full Or Partial Exemption - 2015 Page 2

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Application for Certificate of Full or Partial Exemption

MARYLAND

page 2

FORM

MW506AE

2015

Transferor/Seller’s Name ______________________________________________________

Your Social Security Number/FEIN _____________________________

Special Situations

Check the box in the “Special Situations” column that applies to your situation, if any. If none apply, your exemption will be based

only on the amount on the worksheet on page 1. See instructions for required documentation.

Principal Residence.

Transfer is pursuant to an installment sale under §453 of

the Internal Revenue Code.

Principal Residence – Active-duty Military, Certain

Transfer of inherited property is occurring within 6 months

Government Employees.

of date of death.

Tax-Free Exchange for purposes of §1031 of the Internal

Transfer/seller is the custodian of an individual retirement

Revenue Code.

account (IRA).

Transferor/seller is receiving zero proceeds from this

Transfer is pursuant to a specific Internal Revenue Code

transaction because proceeds are going to another seller/

section. Please see addendum.

owner (ex. cosignor).

Address of Settlement Agent to Mail Certificate if Issued (See instructions.)

Name of contact person and company

Street Address

City

State

ZIP code

Telephone number

Fax number

Email Address

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.

Your signature

Date

Preparer’s PTIN (required by law)

Signature of preparer other than taxpayer

Spouse’s signature

Date

Address of preparer

Telephone number

Telephone number of preparer

Check here

if you authorize

us to contact you by email.