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Get MD COT/ST 912 2016-2024

Street Room 310 Baltimore, Maryland 21201-2385 410-767-1700, or 1-800-782-7383 See attachment for instructions Please be sure to attach copies of all necessary documentation. Part A - Claimant Information - Please print clearly Name of Claimant(s) Daytime telephone number Address of Claimant(s) City, state, zip code Relationship to original owner Email Address Part B - Information on Property claimed - OFFICE USE ONLY Social Security or FEIN Number Type of property Holder name.

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