INOTli Aa of 5/ 2007, the gray ah■dlng ha• been remoNd from the Intake Sheet to lmpron reaclabfllty.

The Intake Sheet.18 d.....,ecl •• ■n e 112• x 1,•

document. You may need to ■ djmt your prlntw Nttlnp to acc:ompllah thla. Th• awk wm only ■cc:ie,t the Intake 9heet In tun a 11 2· x 1,· paga .tze.

State of Maryland Land Instrument Intake Sheet

I This form Is fillable and
can be completed using
el Baltimore City □ County· i your PC. You can save the
Information provided is for the use of the Clerk's Office, State Department of i> form to your PC for reuse
Assessments and Taxatio11, and County Fina11ce Office O11/y.

-1.J Type ==
of lnstrumen
(Type or Print in Black Ink Only-All Copies Must Be Legible)
( Check Box if addendum Intake Form is Attached.)
I
~
but the Information you
Input wlll not save (unless
you have Installed Adobe
Acrobat or Adobe Approval
X Deed Mortgage Other X Other UCC
x Deed of Trust
-
Lease
- - ] software on your PC). For
i-1 TypeConveyance
Check Box
Improved Sale
- Anns-Length [1 J -
Unimproved Sale
Arms-Length [2] - Multiple Accounts
Arms-Length [3] - Not an Arms-
Length Sale [9J
i1! this reason, you should
print the form once It Is
.., completed and make the
...!J Tax Exemptions Recordation
(if applicable) State Transfer
I
a::
appropriate number of
copies - at least 4 copies.
Cite or Explain Authority !!
{j;
County Transfer

w Consideration Amount
Purchase Price/Consideration
Finance Office Use Only
Transfer and Recordalion Tax Consideration
$ 300,000.00
Any New Mortgage $ Transfer Tax Consideration $
Consideration
Balance of Existing Mortgage $ X( )% = $
and Tax
Other: $ Less Exemption Amount - $
.
-...
Calculations .......
Total Transfer Tax = $ as
Other: $ Recordation Tax Consideration $
--
en
""
-.....
X( ) oer $500 = $
Full Cash Value: $ 0.00 TOTAL DUE $ k.. en ::,
w Amount or Fees
Recording Charge
Doc. I Doc. 2 Agent:
01!1
......
c::, a:
~
-.. -
$ 40.00 $ 40.00 I:
C-,.,,, • · ~ -
Surcharge $ 0.00 $ Tax Bill: c::, N ,.,:a:
Fees
State Recordation Tax
State Transfer Tax
$ 0.00
$ 0.00
$
$
~
c::, >- -
-q
·- -
- a
J

C.B. Credit: ~ z -.. C

County Transfer Tax $ 0.00 $ C,J

-
C

Other $ $ Ag. Tax/O~

Other $ $

L!J Description of
District I Property Tax ID No. (1) I Grantor Liber/Follo Map Parcel No. ) Var. LOG

Property
SDAT requires
submission of all
applicable 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) .
I I I • (5)
Subdivision Name I Lot (Ja) Block (Jb) I Sect/AR (Jc) Plat Ref. I SqFt/Acreage
I (4>
I I
Location/Address or Property Being Conveyed (2)
4512 bonner road
Other Properly Identifiers (if applicable) Water Meter Account No.
Residential ■ or Non-Residential ,r I Fee Simple ,r or Ground Rent ■ Amount: I
Partial Conveyance? ■ Yes ,r No I Description/Amt. ofSqFt/Acreage Transferred : 6 12 468 Square Feet
If Partial Conveyance, List Improvements Conveyed:

2J Doc. 1 - Granlor(s) Name(s) Doc. 2 - Grantor(s) Name(s)

United States for America United State s Emminent Doma in
Transferred
From
Doc. 1 - Owner(s) or Record, if Different from Granlor(s) Doc. 2 - Owoer(s) or Record, if Different from Grsnlor(s)

.JU Doc. 1 - Granlee(s) Name(s) Doc. 2 - Granlee(s) Name(s)

Aaron Lamont Mincey Booke r , fiduciary, trustee United States Public Trust
Transferred
To
New Owner's (Grantee) Malling Address ~
-
.,, :, conner Koaa , tsatllmore, Mary1ana, urntea :;tales Tor Amenca
Doc. 1 - Additional Names lo be Indexed (Optional) Doc. 2 - Additional Names to be Indexed (Optional)
...!J other Names
to Be Indexed

(21
UQJ Contact/Mail Instrument Submitted By or Contact Person Return to Contact Person
Information Name: Aaron Lamont Mincey Booke r, Chief Justice
Firm United States P ublic Trust □ Hold for Pickup
Address: c/o 4512 bonne r road apartment d near baltimore marv's land
Phone: ( ) □ Return Address Provided
11
___.
I IMPORT ANT: BOTH THE ORIGINAL DEED AND A PHOTOCOPY MUST ACCOMPANY EACH TRANSFER

□ Yes
Yes
t?J No
No
Will the property being conveyed be the grantee's principal res,dence0
Does transfer include personal property" If yes, identify:
Assessment
Information
f;1l ves n No Was property surveyed? lf yes, attach copy of survey (if recorded, no copy required).