MARYLAND STATE DEPARTMENT OF ASSESSMENTS & TAXATION
APPLICATION FOR EXEMPTION FOR 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 a disabled veteran’s exemption on the indicated property. Failure to provide
this information will result in denial of your application. However, some of this information would be considered a "personal
record" as defined in General Provisions Article, §4-501. Consequently, you have the statutory right to inspect yourfile 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 of Property:
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.
Signature of Veteran: Date:
Print Name: Social Security Number:
Mailing Address:
Phone: Email Address:
•
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.
•
Applicant must be a Maryland resident. Driver’s license, voter’s registration or income taxes may be
required as proof.
TO BE COMPLETED BY THE VETERANS ADMINISTRATION
The United States Veterans Administration hereby certifies that the above named veteran has been declared by the
Veterans Administration to have a service-connected disability, which was not incurred through misconduct; that the said
disability is % disabling. Is the disability permanent in character? _. Is thedisabilityreasonably certain to continue
for
the life of the veteran? _ _. Is the veteran 100%permanently unemployable? . Is the said veteran receiving
disability payments as allowed for reasons of _% disability, or % unemployability.
The character of the disability is asfollows:
Effective Date
of Disability
Adjudication/Service Officer
Address:
Phone:
Comments
Date:
THIS APPLICATION IS NOT OPEN FOR PUBLIC INSPECTION
FOR ASSESSMENT OFFICE USE ONLY
Approved [ ] Re-Application [
Supervisor’s Signature
] Disapproved [ ] Code No. __________
Date
Effective ________________
