Form 502h - Historic Property And Heritage Area Preservation Page 2
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2PART A SUBTRACTION
DOCUMENTATION OF HISTORIC REHABILITATION
(expenses prior to January 1, 1997)
Property name (if any) __________________________ Approximate date of construction ______________
Address _________________________________________________________________________________
Is your property listed in the National Register? ______________________ Date entered ________________
Is your property within a National Register Historic District? ________________________________________
Name of district ___________________________________________ Date entered_________________
Is your property within a locally designated historic district? ________________________________________
Name of district ___________________________________________ Date entered ________________
Did your rehabilitation work require Historic District Commission concurrence?_________________________
Date approved ________________________________________________
Is your property designated as an individual historic site by a certified local government?_________________
Date designated _______________________________________________
Is the property described above your legal residence? ____________________________________________
NOTE: IF “NO”, YOU DO NOT QUALIFY FOR THIS SUBTRACTION
Do you rent all or part of the property? _________________________________________________________
Do you operate a business on this property? ____________________________________________________
Attach a detailed description of rehabilitation work and a summary of expenses.
Have you consulted early pictures, written descriptions or research on similar buildings in your area, or otherwise
attempted to ascertain the accuracy and adequacy of your rehabilitation? ____________________________
“BEFORE AND AFTER” PHOTOGRAPHS OF THE REHABILITATED PORTION(S)
OF THE STRUCTURE MUST BE ATTACHED.
Do not submit photographs with your tax return
Under the penalties of perjury, I declare that I have examined this form, including accompanying additional
documentation, and to the best of my knowledge and belief it is true, correct, and complete.
________________________________________ ________________________________________
Your signature and date
Spouse’s signature and date
(if subtraction applies to a joint return)
Certification by Maryland Historical Trust
________________________________________
Expenses approved as submitted.
Administrator of Project Review and Compliance
_______________________________________
Expenses modified as detailed in attachment.
Chief of Office of Preservation Services
COM/RAD-015
Rev. 9/012
338
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