Free Disclosure Statement for Raffles of Real Property - MDSOS - Maryland

Disclosure Statement for Raffles of Real Property

Disclosure Statement for Raffles of Real Property
Office of the Secretary of State, State House, Annapolis MD 21401 Telephone: (410) 974-5534 or (800) 825-4510

In accordance with COMAR 01.02.07.03, as promulgated under the authority of Criminal Law Article, §12-106, Annotated Code of Maryland, a charitable organization conducting a raffle of real property in the State of Maryland is required to file this disclosure statement at least 10 business days prior to the advertisement of the raffle or the sale of any chance or ticket. Date disclosure statement is completed: 1. Name, address, and telephone number of charitable organization:

2. Name, business address, and telephone number of authorized representative of charitable organization:

3. Home address and telephone number of authorized representative of charitable organization:

4a. Address of property to be raffled:

Disclosure Statement for Raffles of Real Property - page 2

4b. Briefly describe the property to be raffled (e.g. single-family structure, brick and frame construction, 4 bedrooms, 1½ baths, with garage):

4c. County in which property is located: AA - Anne Arundel

5a. Date any license or permit to conduct the raffle was obtained:

5b. Name and address of local authority issuing license or permit:

6. Raffle winner to be selected on
(circle one) at

(date) at

a.m./p.m.
(location of drawing).

7. The price of each ticket or chance is $ . (A sample ticket or photocopy of a ticket showing both sides must be attached to this form.) 8a. The current fair market value of the property to be raffled is $ .

8b. Indicate the basis for the above estimate of current fair market value or attach a copy of a current appraisal:

Is an appraisal attached? yes

no

9. Indicate the dollar amount and nature of all liens and encumbrances on the property, if any, that will remain the responsibility of the raffle winner on transfer of the property:

Disclosure Statement for Raffles of Real Property - page 3

10. Provide a good faith estimate of the closing or settlement costs, if any, that the raffle winner will have to pay to acquire title to the property: $ 11. State the conditions, if any, under which the charitable organization reserves the right to cancel the raffle, together with a description of the method by which the organization will refund the purchase price paid for each chance or ticket sold prior to the cancellation of the raffle: 12. Indicate the name, address, and telephone number of any party with whom the charitable organization has entered into an agreement for such a party to carry out or assist in carrying out the raffle on behalf of the charitable organization for compensation, and attach a copy of such an agreement:

13. A copy of all agreements entered into between the charitable organization and the party that sold or is selling the real property to the charitable organization must be attached to the disclosure statement. If the total purchase price of the real property is not reflected in the above agreement(s), the total purchase price of the property is $ .

Affidavit
State of County of

________________________________ (name of authorized representative of charitable organization), being duly sworn, deposes and says that he/she is the ___________________ (title) of the _________________________________ (name of charitable organization) which has completed the foregoing disclosure statement pursuant to COMAR 01.02.07, that he/she has read and understands the foregoing statements and knows the contents thereof, that the same is true to his/her own knowledge, and that this statement was made for the purpose of complying with the requirements of Criminal Law Article, §12-106 of the Annotated Code of Maryland and COMAR 01.02.07.

Signature of authorized representative Typed or printed name

Disclosure Statement for Raffles of Real Property - page 4

Title Subscribed and Sworn to before me, this ______ day of ____________, 200___. Notary Public or other Officer Authorized to Administer

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