Maryland Form Cra - Combined Registration Application - 2016
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42016
COMBINED
MARYLAND
FORM
REGISTRATION
CRA
APPLICATION
Final 10/30/15
SECTION A: All applicants must complete this section.
1a. Federal Employer Identification Number (FEIN) (9 digits) (See instructions)
1b. Social Security Number (SSN) of owner, officer or agent responsible for taxes
(Required by law)
2. Legal name of dealer, employer, corporation or owner
3. Trade name (if different from legal name of dealer, employer, corporation or owner)
4. Street Address of physical business location (PO box not acceptable)
City
County
State
ZIP code
+4
Telephone number
Fax number
E-mail address
5. Mailing Address (PO box acceptable)
City
State
ZIP code
+4
6. Reason for applying: (Check all that apply.):
New business
Additional location(s)
Merger
Purchased going business
Re-activate/Re-open
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 (PO box acceptable)
City
State
ZIP code
+4
Maryland Number if registered:
8.
Type of registration
9.
Type of ownership: (Check one box)
a.
Sales and use tax
a.
Sole proprietorship
f.
Non-Maryland corporation
b.
Sales and use tax exemption for
b.
Partnership
g.
Governmental
nonprofit organizations
c.
Nonprofit organization
h.
Fiduciary
c.
Tire recycling fee
d.
Maryland corporation
i.
Business trust
d.
Admissions and amusement tax
e.
Limited liability company
e.
Employer withholding tax
10. Date first sales made in Maryland: (MMDDYYYY)
f.
Unemployment insurance
11. Date first wages paid in Maryland subject to
g.
Alcohol tax
withholding : (MMDDYYYY)
h.
Tobacco tax
12. If you currently file a consolidated sales and use tax
i.
Motor fuel tax
return, enter the 8-digit CR number of your account
j.
Transient vendor license
13.
If you have employees, enter the number of your worker’s 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 (MMDDYYY)
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.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
19a. Are you a nonprofit organization applying for a sales and use tax exemption certificate?
Yes
No
If yes, FAILURE TO ENCLOSE REQUIRED DOCUMENTS WILL RESULT IN YOUR APPLICATION BEING
REJECTED AND RETURNED. Please provide a non-returnable copy of (1) IRS determination letter,
(2) articles of incorporation, (3) bylaws, and (4) other organization documents as specified in the instructions.
See page 4, Sales and Use Tax Exemption Checklist and instructions.
19b. Are you a non-profit organization exempt under Section 501(c)(3) of the Internal Revenue Code?
Yes
No
If no, Section (c) (
) or Other: Section
.
COM/RAD-093
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