Form Cra - Combined Registration Application - 2014
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4Software Vendor Final 10.10.13
2014
Combined Registration
MARYLAND
FORM
Application
CRA
SECTION A: All applicants must complete this section.
1 a. 9 digit Federal Employer Identification Number (FEIN) (See instructions.)
b. Social Security Number (SSN) of owner, officer or agent responsible for taxes
(Required by law.)
3. Trade name (if different from Legal name of dealer, employer, corporation or owner.)
2. Legal name of dealer, employer, corporation or owner
4. Street Address of physical business location (P.O. box not acceptable)
City
County
State
ZIP code
(9 digits if known)
Telephone number
Fax number
E-mail address
5. Mailing address (P.O. box acceptable)
City
State
ZIP code
(9 digits if known)
6. Reason for applying:
New business
Additional location(s)
Merger
Purchased going business
Re-activate/Re-open
(Check all that apply.)
Change of entity
Remit use tax on purchases
Reorganization
Other (describe) _________________________
7. Previous owner’s name: First Name or Corporation Name
Last Name
Title
Telephone number
Street address (P.O. box acceptable)
City
State
ZIP code
(9 digits if known)
8.
Type of registration:
Maryland Number if registered:
9.
Type of ownership:
(must check appropriate box(es))
(Check one box)
a.
Sales and use tax
_________________________
a.
Sole proprietorship
f.
Non-Maryland corporation
b.
Sales and use tax exemption
b.
Partnership
g.
Governmental
for nonprofit organizations
_________________________
c.
Nonprofit organization
h.
Fiduciary
c.
Tire recycling fee
_________________________
d.
Maryland corporation
i.
Business trust
d.
Admissions & amusement tax
_________________________
e.
Limited liability company
e.
Employer withholding tax
_________________________
10. Date first sales made
f.
Unemployment insurance
_________________________
in Maryland: (mmddyyyy)
____ ____ ____ ____ ____ ____ ____ ____
g.
Alcohol tax
_________________________
11. Date first wages paid
in Maryland subject
to withholding: (mmddyyyy)
____ ____ ____ ____ ____ ____ ____ ____
h.
Tobacco tax
_________________________
12. If you currently file a
i.
Motor fuel tax
_________________________
consolidated sales and
use tax return, enter the
j.
Transient vendor license
_________________________
8-digit CR number of
____ ____ ____ ____ ____ ____ ____ ____
your account:
13. If you have employees, enter the number of your workers’ compensation insurance policy or binder:
14. (a) Have you paid or do you anticipate paying wages to individuals, including corporate officers, for services performed in Maryland?
Yes
No
(b) If yes, enter date wages first paid (mmddyyyy):
____ ____ ____ ____ ____ ____ ____ ____
15. Number of employees:
16. Estimated gross wages paid in first quarter of operation:
17. Do you need a sales and use tax account only to remit taxes on untaxed purchases?
Yes
No
18. Describe for profit or nonprofit business activity that generates revenue. Specify the product manufactured and/or sold, or the type of service performed.
1
COM/RAD 093
13-49
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