Request Form - Lien Certificate / Tax Status Report

2. FINANCE DIVISION FREDERICK COUNTY, MARYLAND Treasury Department
4. Instructions
   -Complete all of the below requested information. Property identification can be found on the Maryland State Department of Assessments & Taxation website (http://sdat.dat.maryland.gov/RealProperty/Pages/default.aspx)
   - Each individual parcel/property number will require its own lien certificate/tax status report and all Deeds require a lien certificate/tax status report to be accepted.
   - All lien certificate/tax status reports require a $20.00 fee to be paid.
   - For all e-recording submissions (via Simplifile), the $20.00 fee will be collected at the time of recording by Frederick County.
   - Submit the completed lien certificate/tax status report as a supporting document in Simplifile.
   - For all other submissions, the completed lien certificate/tax status report must accompany the document it supports along with a $20.00 check, payable to 'Treasurer of Frederick County'.
   - Please allow 2-business days for this request to be completed.
6. Property Identification
8. District*
   ##
9. Account # / Parcel #*
   ######
10. District
    ##
11. Parent Acct /Parcel #
    (if applicable) ######
13. Name of Current Owner:*
15. Premise Address:*
17. City*
18. State*
19. Zip*
21. Requestor Information
23. Name of Applicant:*
25. Address*
27. City*
28. State*
29. Zip*
31. Phone Number:*
    ###-###-####
32. Choose one*

    1. Fax/E-mail (enter in field to right)
    2. Mail to Requestor
33. E-mail Address
34. Fax Number:
36. Treasury Department
    30 North Market Street Frederick, MD 21701
    301-600-1111 - Fax 301-600-2347
    TTY: Use MD Relay Services
    E-mail: TaxStatus@FrederckCountyMD.gov https://www.frederickcountymd.gov/TaxStatus
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field