MARYLAND
FORM
502B
2018
Dependents' Information
(Attach to Form 502, 505
or 515.)
COM/RAD-026
111111111111
1111111111
111111111111111
111111111111111111
18502B049
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Print Using Blue or Black Ink Only
Your Social Security Number Spouse's Social Security Number
Your First Name MI
Your Last Name
Spouse's First Name MI
Spouse's Last Name
Summary
1. Enter the total number checked below for Regular dependents (4) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Enter the total number checked below for dependents 65 or over (5) . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Total dependent exemptions (Add lines 1 and 2 and enter the total here and on line (C) of the
1.
2.
Exemptions area of Form 502, 505 or 515.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.
Dependents (If a dependent listed below is age 65 or over, check both 4 and 5.)
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 1
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 2
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 3
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 4
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 5
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 6
2. 3. 4. 5.
MARYLAND
FORM
502B
2018
Dependents' Information
(Attach to Form 502, 505
or 515.)
COM/RAD-026
111111111111
1111111111
111111111111111
111111111111111111
18502B149
- -
- -
- -
- -
- -
- -
Page 2
NAME SSN
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 7
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 8
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 9
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 10
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 11
2. 3. 4. 5.
First Name MI Last Name
1.
Social Security Number Relationship Regular 65 or over
DEPENDENT 12
2. 3. 4. 5.