Form El101b - Income Tax Declaration For Business Electronic Filing - 2014

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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)
00
1.
Amount of overpayment to be applied to 2015 estimated tax (Corporations only.) . . . . . . . .
00
2.
Amount of overpayment to be refunded (Corporations only.) . . . . . . . . . . . . . . . . . . . . . . .
REFUND
00
3.
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 Direct debit settlement date _______ / _____ / ______ (Enter the date you want the payment withdrawn from the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

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