Maryland State Department of Assessments & Taxation Ground Rent Registry of Residential Properties Subject to Ground Leases (Please Read Instructions Before Completing this Form) REPORTING FORM FOR CHANGES OR CORRECTIONS 1.SDAT Real Property Tax Identification Number of the Property Subject to the Ground Lease:1-A (Maryland Counties) County Code Identification Number (See Instructions) 1-B (Baltimore City) For Baltimore City Only 2.Premise Address of the Property Subject to the Ground Lease: MD Street Address City State Zip N/A 3.Change of the Name/Address of Ground Lease Tenant: Name (First, M.I., Last) Street Address City State Zip N/A 4.Change of the Name/Address of Ground Lease Holder: Name Street Address City State Zip *(Optional) Telephone Number: Email Address Office Use Only Co unty Co de 03 Ward Sect ion Block Lot American LegalNet, Inc. www.FormsWorkFlow.com N/A 5.Change of the Name/Address of the Person or Entity to Whom Ground Rent Payment is Made Payable and Mailed: Name Street Address City State Zip *(Optional) Telephone Number: Email Address N/A 6.Corrections or Changes to Original Filing or Previous Amendment A.Range of Years in Which the Ground Lease was Created: Prior to April 8, 1884; Between April 6, 1888 and July 1, 1982; or Between April 8, 1884 and April 5, 1888; July 2, 1982 or later B.Total Annual Ground Rent Amount: $ . C.Rent Payment Due Dates: Annually on:Quarterly on: Semi-Annually on: Other: D.Corrected Deed Reference Information for the Current Ground Rent Deed: Book Page Clerk222s Initials Year Recorded 7.Name and Address of Person or Entity Reporting Change(s) or Correction(s): Name Street Address City State Zip 8.Date this Form was Prepared: //20 9.See Instructions for the mailing address to submit this form reporting the redemption of a ground lease. American LegalNet, Inc. www.FormsWorkFlow.com NOTE: REAL PROPERTY ARTICLE, 247 8 226 706, REQUIRES THAT A GROUND LEASE HOLDER PROMPTLY NOTIFY THIS DEPARTMENT OF CHANGES TO CERTAIN INFORMATION IN A PREVIOUSLY FILEDREGISTRATION. THIS FORM LISTS THOSE CHANGES WHICH MUST BE REPORTED. IN ADDITION, SOME OTHER ITEMS OF INFORMATION HAVE TO BE REPORTED IN ORDER TO INDEX THE CHANGES WITH THE EARLIER REGISTRATION. A GROUND LEASE HOLDER WITH CHANGES TO A LARGE NUMBER OF GROUND LEASES SHOULD CONSIDER CONTACTING THE DEPARTMENT TO OBTAIN A 223FILE FORMAT224 DESCRIPTION FOR SUBMITTING THE CHANGE FORMS ON A COMPACT DISK (CD). ITEM 1 226 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 Department222s website for Real Property. If using the Department222s website, the account number displayed must be preceded by the two-digit county/city code listed below. Item 1-A is used for all Maryland jurisdictions with the exception of Baltimore City. Item 1-B is to be used exclusively for Baltimore City properties only. This item is required. Allegany - 01 Calvert - 05 Charles - 09 Harford - 13 Prince George222s - 17 Talbot - 21 Anne Arundel - 02 Caroline - 06 Dorchester - 10 Howard - 14 Queen Anne222s - 18 Washington - 22 Baltimore City - 03 Carroll - 07 Frederick - 11 Kent - 15 St. Mary222s - 19 Wicomico - 23 Baltimore Co. - 04 Cecil - 08 Garrett - 12 Montgomery - 16 Somerset - 20 Worcester - 24 ITEM 2 226 PREMISE ADDRESS: Enter the correct street number and full address of the property subject to the ground lease. This item is required. ITEM 3 226 CHANGE NAME/ADDRESS OF GROUND LEASE TENANT TO: If a change to the name or the address of the tenant has occurred, enter the new information here. If there has been no change to this item, check the N/A box. ITEM 4 226 CHANGE NAME/ADDRESS OF GROUND LEASE HOLDER TO: Enter a full and complete name and address for the holder of the ground lease if either information has changed. If there has been no change to this item, check the N/A box. Telephone number/email address are helpful but optional entries. ITEM 5 226 CHANGE NAME/ADDRESS WHERE GROUND RENT PAYMENT IS MAILED: Enter the full and complete name of the person or entity to whom the ground rent check is made payable and the address where a tenant is required to send the ground rent payment if either information has changed. If there has been no change to this item, check the N/A box. Telephone number/email address are helpful but optional entries. ITEM 6 226 CHANGE TO GROUND LEASE INFORMATION: Use this section to report changes or corrections to a previously reported deed and rent payment information. . If there has been no change to this item, check the N/A box. ITEM 7 - NAME AND ADDRESS OF PERSON OR ENTITY REPORTING THE CHANGE(S): Enter the full and complete name and address for the person or entity reporting the change(s). This item is required. ITEM 8 226 DATE THIS FORM WAS PREPARED: The filer should enter the actual date this change form was prepared for submission to the Department. ITEM 9 226 MAILING ADDRESS: The completed form(s) or CD submission should be mailed to the Department of Assessments and Taxation, Ground Rent Division, 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