Form SDATRP_EX4B "Application for Exemption for Surviving Spouses of a Disabled Veterans" - Maryland

What Is Form SDATRP_EX4B?

This is a legal form that was released by the Maryland Department of Assessments and Taxation - a government authority operating within Maryland. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2019;
  • The latest edition provided by the Maryland Department of Assessments and Taxation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SDATRP_EX4B by clicking the link below or browse more documents and templates provided by the Maryland Department of Assessments and Taxation.

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Download Form SDATRP_EX4B "Application for Exemption for Surviving Spouses of a Disabled Veterans" - Maryland

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MARYLAND STATE DEPARTMENT OF ASSESSMENTS & TAXATION
APPLICATION FOR EXEMPTION FOR SURVIVING SPOUSES OF A DISABLED VETERANS
To be filed with the Supervisor of Assessments at the appropriate office; a list of offices is attached.
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 a “personal
record” as defined in General Provisions Article, §4-501. 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.
Full Name of Titled Owner: _______________________________________________________________________________
Address of property:______________________________________________________________________________________
County:
Account Number:
Baltimore City
Ward
Section
Block
Lot
Description:
Date Property Acquired:
Veteran’s Name:
Veteran’s Date of Death:
Veteran’s Social Security Number:
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.
Signature of Survivor: ______________________________________________________Date _____________________________
Print Name: _________________________________________________ Email: _________________________________________
Full Address:
Phone
Attach a copy of the Veteran’s Honorable Discharge or a copy of DD-Form 214 as required by law. (Maryland
Annotated Code, Tax-Property Article, § 7-208)
Attach a copy of the most recent rating decision of the veteran by the U.S. Department of Veterans Affairs (“V.A.”) or a
document from the V.A. indicating that the veteran is 100% permanently and totally disabled or 100% permanently
unemployable. Include disability effective date.
TO BE COMPLETED BY THE VETERANS ADMINISTRATION
The United States Veterans Administration The United States Veterans Administration hereby certifies that the above named veteran,
prior to or after his/her death, was declared by the Veterans Administration to have a service-connected disability, which was not
incurred through misconduct; that the said disability was________% disabling, permanent in character, and reasonably certain to
have continued throughout the life of the said veteran; had been receiving disability payments as allowed for reasons of _________ %
disability, or _______% unemployability.
The character of the disability is as follows:
Effective Date of Disability____________________________
Adjudication / Service Officer ________________________________________________ Date __________________________
Print Name ___________________________________________________ Phone __________________________________
Full Address___________________________________________________________________________________________
THIS APPLICATION IS NOT OPEN FOR PUBLIC INSPECTION
FOR ASSESSMENT OFFICE USE ONLY
Comments
Disapproved [ ]
Code No._________________
Effective ________________________
Approved [ ]
Date _______________________________
Supervisor’s Signature______________________________________________________________
SDATRP_EX4B
January 2019
http://dat.maryland.gov
MARYLAND STATE DEPARTMENT OF ASSESSMENTS & TAXATION
APPLICATION FOR EXEMPTION FOR SURVIVING SPOUSES OF A DISABLED VETERANS
To be filed with the Supervisor of Assessments at the appropriate office; a list of offices is attached.
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 a “personal
record” as defined in General Provisions Article, §4-501. 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.
Full Name of Titled Owner: _______________________________________________________________________________
Address of property:______________________________________________________________________________________
County:
Account Number:
Baltimore City
Ward
Section
Block
Lot
Description:
Date Property Acquired:
Veteran’s Name:
Veteran’s Date of Death:
Veteran’s Social Security Number:
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.
Signature of Survivor: ______________________________________________________Date _____________________________
Print Name: _________________________________________________ Email: _________________________________________
Full Address:
Phone
Attach a copy of the Veteran’s Honorable Discharge or a copy of DD-Form 214 as required by law. (Maryland
Annotated Code, Tax-Property Article, § 7-208)
Attach a copy of the most recent rating decision of the veteran by the U.S. Department of Veterans Affairs (“V.A.”) or a
document from the V.A. indicating that the veteran is 100% permanently and totally disabled or 100% permanently
unemployable. Include disability effective date.
TO BE COMPLETED BY THE VETERANS ADMINISTRATION
The United States Veterans Administration The United States Veterans Administration hereby certifies that the above named veteran,
prior to or after his/her death, was declared by the Veterans Administration to have a service-connected disability, which was not
incurred through misconduct; that the said disability was________% disabling, permanent in character, and reasonably certain to
have continued throughout the life of the said veteran; had been receiving disability payments as allowed for reasons of _________ %
disability, or _______% unemployability.
The character of the disability is as follows:
Effective Date of Disability____________________________
Adjudication / Service Officer ________________________________________________ Date __________________________
Print Name ___________________________________________________ Phone __________________________________
Full Address___________________________________________________________________________________________
THIS APPLICATION IS NOT OPEN FOR PUBLIC INSPECTION
FOR ASSESSMENT OFFICE USE ONLY
Comments
Disapproved [ ]
Code No._________________
Effective ________________________
Approved [ ]
Date _______________________________
Supervisor’s Signature______________________________________________________________
SDATRP_EX4B
January 2019
http://dat.maryland.gov
MARYLAND STATE DEPARTMENT OF ASSESSMENTS & TAXATION
REAL PROPERTY DIVISION
Listed below are the mailing addresses for local assessment offices
ASSESSMENT OFFICE MAILING ADDRESSES
PHONE
FAX
EMAIL
Allegany County Assessments 112 Baltimore Street, 3rd Floor, Cumberland, MD 21502
(301) 777-2108
(301) 777-2052
sdat.alle@maryland.gov
Anne Arundel County Assessments 45 Calvert St., 3rd Floor, Annapolis, MD 21401
(410) 974-5709
(410) 974-5738
sdat.aa@maryland.gov
Baltimore City Assessments Wm. Donald Schaefer Tower, 6 Saint Paul Street, 11th Floor, Baltimore, MD 21202
(410) 767-8250
(410) 333-4626
sdat.baltcity@maryland.gov
Baltimore County Assessments Hampton Plaza, 300 E Joppa Road, Suite 602, Towson, MD 21286
(410) 512-4900
(410) 321-4148
sdat.blco@maryland.gov
Calvert County Assessments State Office Bldg. 200 Duke Street, Room 1200, Prince Frederick, MD 20678
(443) 550-6840
(443) 550-6850
sdat.calv@maryland.gov
Caroline County Assessments Denton Multi-Service Center, 207 South 3rd St, Denton, MD 21629
(410) 819-4450
(410) 819-4441
sdat.crln@maryland.gov
Carroll County Assessments 15 E Main Street, Suite 229, Westminster, MD 21157
(410) 857-0600
(410) 857-0128
sdat.carl@maryland.gov
Cecil County Assessments District Court Multi-Service Center, 170 East Main Street, Elkton, MD 21921
(410) 996-2760
(410) 996-2770
sdat.cec@maryland.gov
Charles County Assessments Southern Maryland Trade Center, 101 Catalpa Drive Suite 101A, LaPlata, MD 20646
(301) 932-2440
(301) 932-2189
sdat.char@maryland.gov
Dorchester County Assessments 501 Court Lane, PO Box 488, Cambridge, MD 21613
(410) 228-3380
(410) 228-3704
sdat.dor@maryland.gov
Frederick County Assessments 5310 Spectrum Dr, Suite E, Frederick, MD 21703
(301) 815-5350
(301) 663-8941
sdat.fred@maryland.gov
Garret County Assessments County Courthouse 317 East Alder St., Room 106, PO BOX 388, Oakland, MD 21550
(301) 334-1950
(301) 334-5018
sdat.gar@maryland.gov
Harford County Assessments Mary E.W. Risteau District Court Multi-Service Center, 2 South Bond Street, Suite 400, Belair, MD 21014
(410) 836-4800
(410) 838-5914
sdat.harf@maryland.gov
Howard County Assessments District Court Multi-Service Center, 3451 Court House Dr, Ellicott City, MD 21043
(410) 480-7940
(410) 480-7960
sdat.how@maryland.gov
Kent County Assessments 114-A Lynchburg Street, Chestertown, MD 21620
(410) 778-1410
(410) 778-1525
sdat.kentco@maryland.gov
Montgomery County Assessments 30 W. Gude Drive, Suite 400, Rockville MD 20850
(240) 314-4510
(301)424-3864
sdat.mont@maryland.gov
Prince George's County Assessments 14735 Main Street, Suite 354B, Upper Marlboro, MD 20772
(301) 952-2500
(301) 952-2955
sdat.princeg@maryland.gov
Queen Anne's County Assessments Carter M. Hickman District Court Multi-Service Center, 120 Broadway Suite 7, Centreville, MD 21617
(410) 819-4160
(410) 819-4170
sdat.qaco@maryland.gov
St Mary's County Assessments Carter Building, 23110 Leonard Hall Drive, Room 2059, PO Box 1509 Leonardtown, MD 20650
(301) 880-2900
(301)475-4856
sdat.stm@maryland.gov
Somerset County Assessments 11545 Somerset Avenue, Princess Anne, MD 21853
(410) 651-0868
(410) 651-1995
sdat.som@maryland.gov
Talbot County Assessments 29466 Pintail Drive, Suite 12, Easton, MD 21601
(410) 819-5920
(410) 822-0048
sdat.talb@maryland.gov
Washington County Assessments 3 Public Square, Hagerstown, MD 21740
(301) 791-3050
(301) 791-2925
sdat.wash@maryland.gov
Wicomico County Assessments Salisbury District Court Multi-Service Center, 201 Baptist Street, Box 8 Salisbury, MD 21801
(410) 713-3560
(410) 713-3570
sdat.wic@maryland.gov
Worcester County Assessments One West Market Street, Rm. 1202, Snow Hill, MD 21863
(410) 632-1196
(410) 632-1366
sdat.wor@maryland.gov
ALL ASSESSMENT OFFICES ARE OPEN MONDAY - FRIDAY 8:00 AM – 4:30 PM,
EXCEPT BALTIMORE CITY WHICH IS OPEN 8:00 AM – 5:00 PM
For a complete list of office locations visit http://dat.maryland.gov/realproperty/Pages/Maryland-Assessment-Offices.aspx
Revised: 8/20/18
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