Account Number______________________District _____ Map_____ Block____
Parcel ______
Owner’s Name _________________________________________________________________
Location ______________________________________________________________________
______________________________________________________________________________
Name of Active Member(s) Residing on Farm _________________________________________
I (We),_______________________________________________________________
the active member(s) of __________________________________________________
which owns the farm located at__________________________________________________________________
and described as ________________________________________________________________
hereby attest that my (our) principal residence is located on this
property.
I (we) declare, under the penalties of perjury, that this declaration
(including any accompanying forms and statements) has been examined
by me (us) and the information contained herein, to the best of
my (our) knowledge, information, and belief, is true, correct, and
complete.
Signature________________________________________________ Date___________
Rev. 6/1/2005
| This form seeks information for the purposed
of an application by an Agricultural Limited Liability Entities
for Homestead Tax Credit. 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 State Government Article, §10-624. 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.
Additionally, if your property would be used by the State Department
of Assessments and Taxation as a comparable for establishing
the value of another property in a hearing before the Maryland
Tax Court, the requested information, or a portion thereof,
may have to be provided to the owner of that other property.
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