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2014

INCOME TAX DECLARATION

MARYLAND

FORM

FOR BUSINESS ELECTRONIC

EL101B

FILING

Or fiscal year beginning

2014, ending

Name of corporation or pass-through entity

Federal Employer Identification Number

Present address (number and street)

City or town

State

ZIP code

Part I

Tax Return Information (whole dollars only)

Amount of overpayment to be applied to 2015 estimated tax (Corporations only.) . . . . . . . . . .

REFUND

Amount of overpayment to be refunded (Corporations only.) . . . . . . . . . . . . . . . . . . . . . . . . .

Total amount due. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Part II

Declaration and Signature Authorization

Check appropriate box to consent to:

Direct Deposit of refund or

Electronic Funds Withdrawal (direct debit)

4a. Type of account

Checking

Savings

4b. Routing number

4c. Account number

4d. Direct debit settlement date _______ / _____ / ______ (Enter the date you want the payment withdrawn from the account.)

4e. Direct debit amount _____________________

I consent that the corporation’s refund be directly deposited as designated above and declare that the information shown is

correct. By consenting, I also agree to disclose to the Maryland State Treasurer’s Office certain income tax information including

name, amount of refund and the above bank information. This disclosure is necessary to effect direct deposit.

I authorize the State of Maryland and its designated financial agent to initiate an electronic funds withdrawal payment entry to

the financial institution account indicated for payment of the Maryland taxes owed by the corporation or pass-through entity and

the financial institution to debit the entry to this account. Upon confirmation of consent during the filing of the corporation or

pass-through entity state return, this authorization is to remain in full force and effect, and I may not terminate the authorization.

I also authorize the financial institutions involved in the processing of this electronic payment of taxes to receive confidential

information necessary to answer inquiries and resolve issues related to the payment.

I do not want direct deposit of the refund or an electronic funds withdrawal (direct debit) of the balance due.

Under penalties of perjury, I declare that I am an officer, general partner or managing member of the above corporation or of the pass-

through entity. I have compared the information contained on my electronic return with the information that I provided to my electronic

return originator or entered on-line and that the name(s), address and amounts described above agree with the amounts shown on the

corresponding lines of my 2014 Maryland electronic income tax return. To the best of my knowledge and belief, the return is true, correct

and complete. I consent that the return, including accompanying schedules and statements, be sent to the Maryland Revenue Administration

Division by my electronic return originator or by the electronic return software provider.

Sign

Here

Corporate officer, general partner or managing member’s signature

Title

Date

Wait ten (10) days after the receipt of a valid acknowledgement before calling

1-800-638-2937 or from Central Maryland 410-260-7980, about the refund.

Part III

Declaration of Electronic Return Originator (paid preparer)

I declare that I have reviewed the return of the corporation or pass-through entity and that the entries on this form are complete and

correct to the best of my knowledge. I have obtained the signature of the corporate officer, general partner or managing member, before

submitting the return to the Maryland Revenue Administration Division, have provided that official with a copy of all forms and information

to be filed with the Maryland Revenue Administration Division, and have followed all other requirements described in the Maryland Business

E-File Handbook. This declaration is to be retained at the site of the electronic return originator.

Date

EFIN

Originator’s

Electronic

signature

Return

Originator

Firm’s name (or yours

if self-employed)

Use Only

ZIP code

Phone

and address

COM/RAD-060

Maryland Form El101b Draft - Income Tax Declaration For Business Electronic Filing With Instructions - 2014

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