1.   What type of ownership does your business have?

Sole Proprietorship
Partnership
Non-Profit Corporation
Maryland Corporation
Limited Liability Company
Non-Maryland Corporation
Governmental
Fiduciary

2.	Have you paid or do you anticipate paying wages to individuals, including corporate officers, for services performed in Maryland?	Yes No
3.	Please enter your nine-digit federal identification number (FEIN). If you are a sole proprietorship or applying for a sales and use tax license only and do not have a FEIN, enter your Social Security number (SSN):	FEIN: - SSN: - -
	If you need to apply for a FEIN, you can click on the link below and follow the directions to obtain this number from the IRS. Apply for a FEIN.
4.	All applicants must enter the nine-digit Social Security number of the individual owner of the company or officer or agent of a corporation responsible for remitting the taxes	- -
5.	Enter the name of the person whose Social Security number you entered in the previous question:
6.	Enter the legal name of the dealer, employer, corporation or owner (Sole Proprietorship):
7.	Enter the business trade name if different from your response in the previous question:
8.	Enter your Department of Assessment & Taxation Entity Identification Number:

 9.   Enter street address of business location:

  10.   Enter the mailing address if different from the address provided in the previous question

11.	Enter the phone number of the business:	()--
12.	Enter the fax number of the business:	()--
13.	Enter your e-mail address: