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Get Md Cot/st 912 2001

1201-2383 410-767-1700, or 1-800-782-7383 TDD 410-767-1967 Please be sure to attach all necessary documentation. See attachment for instructions Part A - Claimant Information X X Name of Claimant(s) Social Security or FEIN Number X X Address of Claimant(s) Daytime telephone number X City, state, zip code X Relationship to original owner Part B - Information on Property claimed Original owner name: Social Security or FEIN Number: Type of property: Holder name: Amount of Property: P.

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