Ground Rent Registry of Residential Properties Subject to Ground Leases (Please Read Instructions Before Completing this Form) Office Use Only REPORTING BY THE LEASE HOLDER OF THE REDEMPTION OF A RESIDENTIAL GROUND LEASE 1. SDAT Real Property Tax Identification Number of the Property Subject to the Ground Lease: ____________ Co. Code (See Instructions) ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Identification Number (up to 14 digits) Code Ward Sect Block Lot 03 For Baltimore City Only 2. Premise Address of the Property Subject to the Ground Lease: ________________________________________ Street Address _____________________________________ City MD _______ State __________ Zip 3. Name and Address of Ground Lease Tenant: __________________________________________________________ Name (Last, First, M.I.) ________________________________________ Street Address _____________________________________ City _______ State __________ Zip 4. Name of County or Baltimore City where the Property is Located: ________________________________________ County Name 5. Deed Reference Information for the New Deed Recording the Redemption of the Ground Lease: ____________ Book ___________ ______________ Page Clerk’s Initials _______________ Year Recorded (4) 6. Name and Address of Ground Lease Holder: ______________________________________________________ Name ________________________________________ Street Address _____________________________________ City _______ State ___________ Zip _______ State ___________ Zip ______________________________________________________ Name (Second Lease Holder if applicable) ________________________________________ Street Address _____________________________________ City 7. Date this Form was Prepared: _____/_____/ 20____ 8. See Instructions for the mailing address to submit this form reporting the redemption of a ground lease. American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR REPORTING BY THE LEASE HOLDER OF THE REDEMPTION OF A GROUND LEASE FOR A PREVIOUSLY FILED GROUND RENT REGISTRATION REAL PROPERTY ARTICLE, § 8 – 706, REQUIRES THAT A GROUND LEASE HOLDER PROMPTLY NOTIFY THIS DEPARTMENT OF THE REDEMPTION OF A GROUND LEASE REPORTED IN A PREVIOUSLY FILED REGISTRATION. THIS FORM LISTS THE INFORMATION WHICH MUST BE REPORTED IN ADDITON TO SOME OTHER ITEMS OF INFORMATION, WHICH HAVE TO BE REPORTED IN ORDER TO INDEX THE REDEMPTION WITH THE EARLIER REGISTRATION. NOTE: ITEM 1 – REAL PROPERTY TAX IDENTIFICATION NUMBER OF THE PROPERTY SUBJECT TO THE GROUND LEASE: The identification number is composed of the two digit county code where the property is located, followed by an account number up to 14 characters in length. This information can be obtained for a property from an assessment notice or by going to the Department’s website for Real Property. If using the Department’s website, the account number displayed must be preceded by the two digit county/city code listed below. Allegany - 01 Anne Arundel - 02 Baltimore City - 03 Baltimore Co. - 04 Calvert - 05 Caroline - 06 Carroll - 07 Cecil - 08 Charles - 09 Dorchester - 10 Frederick - 11 Garrett - 12 Harford - 13 Howard - 14 Kent - 15 Montgomery - 16 Prince George’s - 17 Queen Anne’s - 18 St. Mary’s - 19 Somerset - 20 Talbot - 21 Washington - 22 Wicomico - 23 Worcester - 24 ITEM 2 – PREMISE ADDRESS: Enter the correct street number and full address of the property subject to the ground lease. ITEM 3 – NAME AND ADDRESS OF GROUND LEASE TENANT: Enter the name and address of the ground lease tenant to whom the ground rent bill is sent. The name should be entered last name, first name, and middle initial. ITEM 4 – COUNTY NAME: Enter the name of the County or Baltimore City where the property is located. ITEM 5 – NEW DEED INFORMATION: Provide the specific Book and Page references for the new deed recording the redemption of the ground lease. The clerk’s initials and the year the deed was recorded are helpful but optional entries. ITEM 6 – NAME AND ADDRESS OF GROUND LEASE HOLDER: Enter the full and complete name and address for the holder of the ground lease. ITEM 7 – DATE THIS FORM WAS PREPARED: The filer should enter the date this change form was prepared for submission to the Department. ITEM 8 – MAILING ADDRESS: The completed form(s) or CD submission should be mailed to the Department of Assessments and Taxation, 301 W Preston Street, 8th Floor, Baltimore, MD 21201. There is no fee for submitting a change to a previously filed residential ground rent registration. American LegalNet, Inc. www.FormsWorkFlow.com