Maryland Sheet Form – Fill Out and Use This PDF

State of Maryland Land Instrument Intake Sheet

Validation

Baltimore City

County:

Information provided is for the use of the Clerk’s Office, State Department of

Assessments and Taxation, and County Finance Office Only.

Recording

(Type or Print in Black Ink Only─All Copies Must Be Legible)

Clerk

1

Type(s)

( Check Box if addendum Intake Form is Attached.)

of Instruments

Deed

Mortgage

Other _________

Other _________

Court

Deed of Trust

Lease

_______________

_______________

Circuit

2

Conveyance Type

Improved Sale

Unimproved Sale

Multiple Accounts

Not an Arms-

Check Box

Arms-Length [1]

Arms-Length [2]

Arms-Length [3]

Length Sale [9]

for

Reserved

3

Tax Exemptions

Recordation

(if applicable)

State Transfer

Space

Cite or Explain Authority

County Transfer

4

Consideration Amount

Finance Office Use Only

Transfer and Recordation Tax Consideration

Purchase Price/Consideration

$

Consideration

Any New Mortgage

$

Transfer Tax Consideration

$

Balance of Existing Mortgage

$

X (

) %

=

$

and Tax

Other:

$

Less Exemption Amount

−

$

Calculations

Total Transfer Tax

=

$

Other:

$

Recordation Tax Consideration

$

X (

) per $500

=

$

Full Cash Value:

$

TOTAL DUE

$

5

Amount of Fees

Doc. 1

Doc. 2

Agent:

Recording Charge

$

$

Surcharge

$

$

Tax Bill:

Fees

State Recordation Tax

$

$

State Transfer Tax

$

$

C.B. Credit:

County Transfer Tax

$

$

Other

$

$

Ag. Tax/Other:

Other

$

$

6

Description of

District

Property Tax ID No. (1)

Grantor Liber/Folio

Map

Parcel No.

Var. LOG

(5)

Property

Subdivision Name

Lot (3a)

Block (3b)

Sect/AR (3c)

Plat Ref.

SqFt/Acreage (4)

SDAT requires

submission of all

Location/Address of Property Being Conveyed (2)

applicable information.

A maximum of 40

Other Property Identifiers (if applicable)

Water Meter Account No.

characters will be

indexed in accordance

with the priority cited in

Residential

or Non-Residential

Fee Simple or Ground Rent

Amount:

Real Property Article

Partial Conveyance?

Yes No

Description/Amt. of SqFt/Acreage Transferred:

Section 3-104(g)(3)(i).

If Partial Conveyance, List Improvements Conveyed:

7

Doc. 1 – Grantor(s) Name(s)

Doc. 2 – Grantor(s) Name(s)

Transferred

From

Doc. 1 – Owner(s) of Record, if Different from Grantor(s)

Doc. 2 – Owner(s) of Record, if Different from Grantor(s)

8

Doc. 1 – Grantee(s) Name(s)

Doc. 2 – Grantee(s) Name(s)

Transferred

To

New Owner’s (Grantee) Mailing Address

9

Other Names

Doc. 1 – Additional Names to be Indexed (Optional)

Doc. 2 – Additional Names to be Indexed (Optional)

to Be Indexed

10

Contact/Mail

Instrument Submitted By or Contact Person

Return to Contact Person

Information

Name:

Firm

Hold for Pickup

Address:

Phone: (

)

Return Address Provided

Yes

No

Will the property being conveyed be the grantee’s principal residence?

Assessment

Yes

No

Does transfer include personal property? If yes, identify:

Information

Yes

No

Was property surveyed?

If yes, attach copy of survey (if recorded, no copy required).

Validation

Assessment Use Only – Do Not Write Below This Line

Terminal Verification

Agricultural Verification

Whole

Part

Tran. Process Verification

Transfer Number

Date Received:

Deed Reference:

Assigned Property No.:

County

Year

20

20

Geo.

Map

Sub

Block

Land

Zoning

Grid

Plat

Lot

Buildings

Use

Parcel

Section

Occ. Cd.

for

Total

Town Cd.

Ex. St.

Ex. Cd.

REMARKS:

Space Reserved

Distribution:

White – Clerk’s Office

Canary – SDAT

AOC-CC-300 (5/2007)

Pink – Office of Finance

Goldenrod – Preparer