Form Mw506r - Certification Of Exemption From Withholding Upon Disposition Of Maryland Real Estate Affidavit Of Residence Or Principal Residence - 2012

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Certification of Exemption from Withholding Upon
2012
Disposition of Maryland Real Estate
M RYL ND
ffidavit of Residence or Principal Residence
FORM
Based on the certification below, Transferor claims exemption from the tax withholding
requirements of §10-912 of the Tax-General
rticle,
nnotated Code of Maryland. Section
10-912 provides that certain tax payments must be withheld and paid when a deed or other
instrument that effects a change in ownership of real property is presented for recordation. The
requirements of §10-912 do not apply when a transferor provides a certification of Maryland
residence or certification that the transferred property is the transferor’s principal residence.
1. Transferor Information
Name of Transferor
2. Reasons for xemption
Resident
I, Transferor, am a resident of the State of Maryland.
Status
Transferor is a resident entity as defined in Code of Maryland Regulations (COM R)
03.04.12.02B(11), I am an agent of Transferor, and I have authority to sign this document
on Transferor’s behalf.
Principal
lthough I am no longer a resident of the State of Maryland, the Property is my principal
Residence
residence as defined in IRC 121 and is recorded as such with the State Department of
ssessments 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. ntity Transferors
Witness/ ttest
Name of Entity
By
Name
Title
11-49

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