Form 502B Fillable Maryland Dependents Information
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

(Attach to Form 502 505 or 515 ) (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (checkbox) Unchecked (Initial) (Last name) (Last name) (Social Security number) (Spouse s first name) (Spouse's Social Security number) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (text) (Your first name) 1 Enter the total number of boxes checked below for Regular dependents (4) 1 1 First name 1 First name 1 First name 1 First name 1 First name 1 First name 2 Enter the total number of additional boxes checked below for dependents 65 or over (5) 2 2 Social Security Number 2 Social Security Number 2 Social Security Number 2 Social Security Number 2 Social Security Number 3 Relationship 2 Social Security Number 3 Relationship 2 Social Security Number 3 Relationship 3 Relationship 3 Relationship 3 Relationship 3 Relationship 3 Total dependent exemptions (Add lines 1 and 2 and enter the total here and on line (C) of the 4 Regular 4 Regular 4 Regular 4 Regular 4 Regular 5 65 or over 4 Regular 5 65 or over 4 Regular 5 65 or over 5 65 or over 5 65 or over 5 65 or over 5 65 or over Black Ink COM/RAD 026 Dependents (If a dependent listed below is age 65 or over please check both boxes 4 and 5 ) Exemptions area of Form 502 505 or 515 ) 3 Initial Initial Initial Initial Initial Initial Initial Last name Last name Last name Last name Last name Last name Last name MARYLAND Dependents' Information NAME SSN Page 2 Print Using Blue Social Security Number Spouse s first name Spouse's Social Security Number Summary Your first name