State of Maryland Land Instrument Intake Sheet
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.
(Type or Print in Black Ink OnlyAll Copies
Must Be Legible)
( Check Box if addendum Intake Form is Attached.)
Type(s)
of Instruments
Deed
Deed of Trust
Mortgage
Lease
Other _________
_______________
Other _________
_______________
Conveyance Type
Check Box
Improved Sale
Arms-Length [1]
Unimproved Sale
Arm
s-Length [2]
Multiple Accounts
Arms-Length [3]
Not an Arms-
Length Sale [9]
Recordation
State Transfer
Tax Exemptions
(if applicable)
Cite or Explain Authority
County Transfer
Space Reserved for Circuit Court Clerk Recording Validation
Consideration Amount
Purchase Price/Consideration $
Finance Office Use Only
Transfer and Recordation Tax Consideration
Any New Mortgage $ Transfer Tax Consideration $
Balance of Existing Mortgage $ X ( ) % = $
Less Exemption Amount
$
Other:
$
Total Transfer Tax = $
Recordation Tax Consideration $ Other:
$
X ( ) per $500 = $
Consideration
and Tax
Calculations
Full Cash Value: $ TOTAL DUE $
Amount of Fees Doc. 1 Doc. 2
Recording Charge $ $
Agent:
Surcharge $ $
State Recordation Tax $ $
Tax Bill:
State Transfer Tax $ $
County Transfer Tax $ $
C.B. Credit:
Other $ $
Fees
Other $ $
Ag. Tax/Other:
District Property Tax ID No. (1) Grantor Liber/Folio Map Parcel No. Var. LOG
(5)
Subdivision Name Lot (3a) Block (3b) Sect/AR (3c) Plat Ref. SqFt/Acreage (4)
Location/Address of Property Being Conveyed (2)
Other Property Identifiers (if applicable)
Water Meter Account No.
Residential or Non-Residential Fee Simple or Ground Rent Amount:
Partial Conveyance? Yes No
Description/Amt. of SqFt/Acreage Transferred:
Description of
Property
SDAT requires
submission of all
applicab
le information.
A maximum of 40
characters will be
indexed in accordance
with the priority cited in
Real Property Article
Section 3-104(g)(3)(i).
If Partial Conveyance, List Improvements Conveyed:
Doc. 1 – Grantor(s) Name(s) Doc. 2 – Grantor(s) Name(s)
Doc. 1 – Owner(s) of Record, if Different from Grantor(s) Doc. 2 – Owner(s) of Record, if Different from Grantor(s)
Transferred
From
Doc. 1 – Grantee(s) Name(s) Doc. 2 – Grantee(s) Name(s)
New Owner’s (Grantee) Mailing Address
Transferred
To
Doc. 1 – Additional Names to be Indexed (Optional) Doc. 2 – Additional Names to be Indexed (Optional)
Other Names
to Be Indexed
Instrument Submitted By or Contact Person
Contact/Mail
Information
Name:
Return to Contact Person
Firm
Address:
Hold for Pickup
Phone: ( )
Return Address Provided
IMPORTANT: BOTH THE ORIGINAL DEED AND A PHOTOCOPY MUST ACCOMPANY EACH TRANSFER
Yes No Will the property being conveyed be the grantee’s principal residence?
Yes No Does transfer include personal property? If yes, identify:
Assessment
Information
Yes No Was property surveyed? If yes, attach copy of survey (if recorded, no copy required).
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.:
Year 20 20 Geo. Map Sub Block
Land Zoning Grid Plat Lot
Buildings Use Parcel Section Occ. Cd.
Total Town Cd. Ex. St. Ex. Cd.
REMARKS:
Space Reserved for County Validation
1
2
3
4
5
6
7
8
9
10
11
Distribution: White – Clerk’s Office Canary – SDAT AOC-CC-300 (5/2007)
Pink – Office of Finance Goldenrod – Preparer
NOTE: As of 5/2007, the gray shading has been removed from the Intake Sheet to improve readability. The Intake Sheet is designed as an 8 1/2" x 14"
document. You may need to adjust your printer settings to accomplish this. The Clerk will only accept the Intake Sheet in full 8 1/2" x 14" page size.
This form is fillable and
can be completed using
your PC. You can save the
form to your PC for reuse
but the information you
input will not save (unless
you have installed Adobe
Acrobat or Adobe Approval
software on your PC). For
this reason, you should
print the form once it is
completed and make the
appropriate number of
copies - at least 4 copies.
PRINT FORM on 8 1/2 x 14
RESET FORM
Submit 4 copies
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