Form 502b - Maryland Dependents' Information - 2014
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1
22014
Dependents' Information
MARYLAND
FORM
(Attach to Form 502, 505 or 515.)
502B
Social Security Number
Spouse's Social Security Number
Your first name
Initial Last name
Spouse’s first name
Initial Last name
Summary
1. Enter the total number of boxes checked below for Regular dependents (4) . . . . . . . . . . . . . . . . . . . .
1. ________________
2. Enter the total number of additional boxes checked below for dependents 65 or over (5) . . . . . . . . . . .
2. ________________
3. Total dependent exemptions (Add lines 1 and 2 and enter the total here and on line (C) of the
Exemptions area of Form 502, 505 or 515.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. ________________
Dependents (If a dependent listed below is age 65 or over, please check both boxes 4 and 5.)
1.
First name
Initial
Last name
2.
3.
Social Security Number
Relationship
4.
Regular
5.
65 or over
1.
First name
Initial
Last name
2.
3.
Social Security Number
Relationship
4.
Regular
5.
65 or over
1.
First name
Initial
Last name
2.
3.
Social Security Number
Relationship
4.
Regular
5.
65 or over
1.
First name
Initial
Last name
2.
3.
Social Security Number
Relationship
4.
Regular
5.
65 or over
1.
First name
Initial
Last name
2.
3.
Social Security Number
Relationship
4.
Regular
5.
65 or over
COM/RAD-026
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Parent category: Financial