Form Com/mft044 - Application For Petroleum Transporter Registration
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1
2comptroller of Maryland
MATT Regulatory Division
Motor Fuel Tax
P.O. Box 1751
Annapolis, MD 21401-1751
410-260-7215
1-888-784-0142 or 0141
Application for Petroleum Transporter Registration
In accordance with the business regulation article, § 10-401 of the annotated code of Mary-
land, 1992 edition and any cuMulative suppleMent
1. _________________________________________
account # ___________________________________
legal name of registrant
___________________________________________
trade name
___________________________________________
address
___________________________________________
city
state
Zip code
2. Federal Identification Number (FEIN/Social Security) ___________________________________________________
3. do you transport motor fuel into Maryland from another state?
yes _____
no _______
4. do you transport motor fuel from Maryland into another state?
yes _____
no _______
5. Total number of highway vehicles transporting
fuel with a carrying capacity exceeding 1,749 gallons
__________
6. Total number of waterborne vessels transporting motor fuel
__________
7 Total number of rail tank cars transporting motor fuel
__________
8. I certify, under the penalty provided by law, that the statements and information furnished hereon are true and correct to
the best of my knowledge. (Reference Business Regulation Article, §10-401 and §10-411)
printed name & title
authorized signature
date
area code & phone #
Important
incomplete applications cannot be processed
Follow directions on reverse side
COM/MFT044 (Rev 7/07)
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Parent category: Financial