Form 130 - Request For Certification Of Tax Filings
Download a blank fillable Form 130 - Request For Certification Of Tax Filings in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 130 - Request For Certification Of Tax Filings with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2REQUEST FOR CERTIFICATION
MARYLAND
OFFICE USE ONLY
FORM
OF TAX FILINGS
130
Tax year(s)
Request:
/
Approved
Control Number Assigned
Denied
Type of
ITIN
SSN
photo ID
Applicant’s Information
Please print in black or blue ink.
Last name
Suffix
First name
M.I.
Current mailing address
City
State
ZIP code
Applicant’s ITIN or SSN
1. Did you file a Maryland tax return during one or both of the previous two years?
If yes, complete 1a and 1b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
1a. Name as shown on return(s), if different from above:
___________________________________________
__________________________
Name
Tax year
__________________________________________
__________________________
Name
Tax year
1b. Mailing address as shown on return(s), if different from above:
___________________________________________________________________________________________________
Street
City
State
ZIP code
Tax year
___________________________________________________________________________________________________
Street
City
State
ZIP code
Tax year
2. Did you file federal Form 4868 (Application for Automatic Extension of Time to File U.S.
Individual Income Tax Return) or Maryland Form 502E (Maryland Application for Extension
to File Personal Income Tax Return) for the most recent tax year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
3. Were you claimed as a dependent on a Maryland tax return during one or both
of the previous two years? If “Yes”, complete 3a. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Yes
No
3a. Name(s) and ITIN(s)/SSN(s) of taxpayer(s) claiming you as a dependent and tax year(s) you were claimed as a dependent.
______________________________________
________________________
___________________
Name of Taxpayer
ITIN/SSN
Tax year(s)
______________________________________
________________________
___________________
Name of Taxpayer
ITIN/SSN
Tax year(s)
*** THIS FORM MUST BE SIGNED IN THE PRESENCE OF A REPRESENTATIVE OF THE ***
COMPTROLLER OF MARYLAND.
SIGNATURE and VERIFICATION: I understand that taxpayer information is confidential and authorize the Comptroller of
Maryland to release the requested information to the Maryland Motor Vehicle Administration in accordance with the Maryland
Highway Safety Act of 2013. And further, I certify that to the best of my knowledge all information provided on this form is true,
correct and complete.
_________________________________________
__________________________________________
Signature of applicant
Date
__________________________________________
Telephone number
Email address
COM/RAD-035
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial