Form Sdat-4b1 - Application For Exemption For Surviving Spouses Of Disabled Veterans Receiving Dic Benefits

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RETURN TO:
STATE OF MARYLAND
Your local Assessment office; a list of
offices is attached.
DEPARTMENT OF ASSESSMENTS AND TAXATION
APPLICATION FOR EXEMPTION FOR SURVIVING
SPOUSES OF DISABLED VETERANS RECEIVING DIC
BENEFITS
To be filed with the Supervisor of Assessments in the appropriate local office.
This form seeks information for the purpose of an exemption for the surviving spouse of a disabled veteran on the indicated property. Failure to
provide this information will result in denial of your application. However, some of this information would be considered a "personal record"
as defined in State Government Article, §10-624. Consequently, you have the statutory right to inspect your file and to file a written request to
correct or amend any information you believe to be inaccurate or incomplete. Additionally, personal information provided to the State
Department of Assessments and Taxation is not generally available for public review. However, this information is available to officers of the
State, county or municipality in their official capacity and to taxing officials of any State or the federal government, as provided by statute.
Additionally, if your property would be used by the State Department of Assessments and Taxation as a comparable for purposes of establishing
the value of another property in a hearing before the Maryland Tax Court, the requested information, or a portion thereof, may have to be
provided to the owner of that other property.
Full Name of Titled Owner: __________________________________________________________________
Address of Property: ___________________________________________________________________
Description/Location of Property __________________________________________________________________
Account Number: ___________________________________
Section
Block
Lot
Baltimore City
Ward
District
Map
Block
Parcel
Counties
Date Acquired: ____________________________
Deed Reference: _____________________________
Subdivision: ______________________________________________________________________
Name of Veteran: ______________________________________________________________________
Social Security Number ___________________________ Claim number_____________________________
Date of Veteran’s Death _________________________
*Attach a copy of a Veteran’s Honorable Discharge or a Copy of DD-Form No. 214 as Required by Law. (Tax-Property Article §7-208).
I declare under the penalties of perjury, pursuant to Section 1-201, Tax Property Article, of the Annotated Code of Maryland, that this
return (including any accompanying schedules and statements) has been examined by me and to the best of my knowledge and belief is a true,
correct and complete return and that I am the unremarried spouse of the veteran. In affixing my signature to this application, I hereby grant
permission to the Veteran Affairs (VA) to release to the Department the medical and other record information requested below.
_________________________________________ _____________________
___________________
Signature of Surviving Spouse
Phone
Date
____________________________________________ ___________________________________________________________
Address
City
State
Zip Code
THIS APPLICATION IS NOT OPEN FOR PUBLIC INSPECTION
SDAT – 4B1 (10/08)
1

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