Form 097 - Maryland Sales And Use License Application For Out-Of-State Vendors

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Maryland Sales and Use License Application
FORM
097
For Out-of-State Vendors
FEIN Number
SSN of owner, officer or agent responsible for taxes
-
Legal Name of Entity owner
Trade name if different
Number and street
City / town
State
ZIP code
Telephone number
Type of ownership:
Sole proprietorship
Partnership
Non-Maryland corporation
Other: ____________________
Will you have employees with wages subject to Maryland withholding or performing services in Maryland?
Yes
No
Describe business activity which generates revenue:
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Identify owners, partners, corporate officers
Name
Title
Address
Telephone number
• To register for Maryland income tax withholding, unemployment insurance, admissions and amusement, tire fee, or motor fuel
taxes File a Combined Registration Application (COM/RAD - 093) online at
• If you don’t have a federal employer ID number when you submit this application, and one is required, leave the space blank and
submit the number to Central Registration when you receive it from the IRS. Mail to:
Central Registration
Revenue Administration Center
110 Carroll Street
Annapolis, Md. 21411-0001
For questions, call Call Taxpayer Service at 410-260-7980 or toll free 1-800-638-2937, Maryland Relay Service 711.
Maryland tax forms are available online at .
Under penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief it is true, correct and
complete.
Make checks payable and return to:
Comptroller of Maryland
SUT, Revenue Administration Division
PO Box 17405
Baltimore, Maryland 21297-1405
or fax this application to:
Taxpayer or Agent’s signature
Date
Central Registration at 410-260-7908
COM/RAD-097
06/12

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