Certification Of Exemption From Withholding Upon Disposition Of Maryland Real Estate Affidavit Of Residence Or Principal Residence - 2014

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2014
Certification of Exemption from Withholding Upon
Disposition of Maryland Real Estate
MARYLAND
Affidavit of Residence or Principal Residence
FORM
Based on the certification below, Transferor claims exemption
ownership of real property is presented for recordation. The
from the tax withholding requirements of §10-912 of the Tax-
requirements of §10-912 do not apply when a transferor
General Article, Annotated Code of Maryland. Section 10-912
provides a certification of Maryland residence or certification
provides that certain tax payments must be withheld and paid
that the transferred property is the transferor’s principal
when a deed or other instrument that effects a change in
residence.
1. Transferor Information
Name of Transferor
2. Reasons for Exemption
Resident Status
I, Transferor, am a resident of the State of Maryland.
Transferor is a resident entity as defined in Code of Maryland Regulations (COMAR)
03.04.12.02B(11), I am an agent of Transferor, and I have authority to sign this document on
Transferor’s behalf.
Principal Residence
Although I am no longer a resident of the State of Maryland, the Property is my principal residence
as defined in IRC 121 and is recorded as such with the State Department of Assessments and
Taxation.
Under penalty of perjury, I certify that I have examined this declaration and that, to the best of my knowledge,
it is true, correct, and complete.
3a. Individual Transferors
Witness
Name
Signature
3b. Entity Transferors
Witness/Attest
Name of Entity
By
Name
Title
14-49

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