Form Cra - Combined Registration Application

Software Vendor Final 10.10.13

2014

Combined Registration

MARYLAND

FORM

Application

CRA

FEIN or SSN ___ ___ ___ ___ ___ ___ ___ ___ ___

7. For Limited Liability Companies only:

a. As a Limited Liability Company, do you employ anyone other than a member?

Yes

b. Has the Limited Liability Company filed IRS form 8832 whereby it elected to be classified as a corporation or is the

Yes

Limited Liability Company automatically classified as a corporation for federal tax purposes?

PART 2. COMPLETE THIS PART IF YOU ARE A NONPROFIT ORGANIZATION.

1. Are you subject to tax under the Federal Unemployment Tax Act?

Yes

If not, are you exempt under Section 3306(c)(8) of the Federal Unemployment Tax Act?

Yes

2. Are you a non-profit organization as described in Section 501(c)(3) of the United States Internal Revenue Code

which is exempt from Income Tax under Section 501(a) of such code?

Yes

If YES, attach a copy of your exemption from Internal Revenue Service.

3. Elect option to finance unemployment insurance coverage. See instructions.

Contributions

Reimbursement of trust fund

If b. is checked, indicate the total taxable payroll ($8,500 maximum per individual per calendar year) $ ________ for calendar year 20___ ___

Type of collateral (check one)

Letter of credit

Surety bond

Security deposit

Cash in escrow

SECTION C: Complete this section if you are applying for an alcohol or tobacco tax license.

1. Will you engage in any business activity pertaining to the manufacture, sale, distribution,

or storage of alcoholic beverages (excludes retail)?

Yes

2. Will you engage in any wholesale activity regarding the sale and/or distribution

of tobacco in Maryland (excludes retail)?

Yes

SECTION D: Complete this section if you plan to sell, use or transport any fuels in Maryland.

1. Do you plan to import or purchase in Maryland, any of the following fuels for resale, distribution, or for your use?

If yes, check type(s) below:

Yes

Gasoline (including av/gas)

Turbine/jet fuel

Special fuel (any fuel other than gasoline)

2. Do you transport petroleum in any device having a carrying capacity exceeding 1,749 gallons?

Yes

3. Do you store any motor fuel in Maryland?

Yes

4. Do you have a commercial vehicle that will travel interstate?

Yes

If you have answered yes to any question in Section C or D, call the Motor-fuel, Alcohol and Tobacco Tax Unit 410-260-7131 for the license application.

SECTION E: Complete this section to request paper coupons.

We provide a free and secure electronic method to file sales and use tax and withholding tax returns, using bFile on the

Comptroller’s Web site If you prefer instead to receive your future tax filing coupons by mail, check here . . . . . . . . . .

SECTION F: All applicants must complete this section.

I DECLARE UNDER PENALTIES OF PERJURY THAT THIS APPLICATION HAS BEEN EXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE

AND BELIEF IS TRUE, CORRECT, AND COMPLETE.

__________________________________________________

___________________________________________

__________________________________

______________________

Signature

Print Name

Title

Date

_____________________________________________________________

___________________________________________

__________________________________________________

Name of Preparer other than applicant

Phone

E-mail address

If the business is a corporation, an officer of the corporation authorized to sign on behalf of the corporation must sign; if a

partnership, one partner must sign; if an unincorporated association, one member must sign; if a sole proprietorship, the

proprietor must sign. (The signature of any other person will not be accepted.)

COM/RAD 093

13-49

Form Cra - Combined Registration Application - 2014 Page 3

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