Fillable Direct Wine Shippers Permit Application (Comptroller of Maryland)

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Direct Wine Shippers Permit Application (Comptroller of Maryland)

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BROWSE COMPTROLLER OF MARYLAND (MD) FORMS

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I I I I I I I I I I
I I I I I I I I I I
Direct Wine Shipper’s Permit Application
ATTN: You must attach a list of wines you manufactured and intended for sale in Maryland by the permit applicant.
Section 1 - Applicant Information
□
New Permit
□
Renewal (Permit #) DW- _________
A.
Corporate Name and T/A of Wine Manufacturer
B.
Name of Contact Phone Number Fax Number
E-mail address
C.
Mailing address
City State Zip
D.
If the mailing address is a P.O. Box provide physical location address
Office Use
Only
Number ___________________
Permit Year ________________
Stub Number ______________
Approved _________________
Date______________________
Check Number _____________
Check Amount $ ___________
Deposit Date _______________
E. Applicant is a:
□
Corporation
□
Limited Liability Co. Federal Identication Number
□
Partnership
□ Individual Social Security Number
- -
-
Officers of Corporation, Limited Liability Compan , or Partnership:
1 2 3
Name
Home Address
Home Phone No.
Social Security No.
F. The applicant is a person licensed outside the State to engage in the manufacture of wine; or a holder of a Maryland
Class 3 manufacturer’s license or a Class 4 manufacturer’s license: (submit a copy of your current license(s))
State of Issuance Type or Class Expiration Date License #
(attach separate sheet, if needed)
G. Section 1-404 of the Alcoholic Beverages Art., Ann. Code of Maryland titled “Compliance with Worker's Compensation Act"
requires the evidence of such compliance prior to the issuance of any permit. The applicant hereby affirms (complete one):
□
a. Applicant is not an employer required to provide coverage by the Maryland Workers’ Compensation Law; or
□
b. Applicant is an employer required to provide employee coverage by the Maryland Workers’ Compensation Law
and has secured such coverage. As evidence of such coverage, list the name of insurance company and policy
or binder number:
Name of Insurance Company Policy or Binder Number
COM-FED/RLS-38
1
Rev.
5
/1
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Direct Wine Shipper’s Permit Application
Page 2
Section 2 - Permit Information
A. Does the applicant have a valid Maryland sales and use tax license? . ......................
□
Yes
If you checked “Yes”, enter Maryland Combined Registration Number here: _________________
If you checked “No”, complete, sign and attach a Maryland Combined Registration Application
with this application.
□
No
B. Has the applicant ever been convicted of a felony by any state or federal court? ...............
□
Yes
C. Has the applicant ever been convicted of a violation of the laws of the United States, Maryland, or
any other state concerning alcoholic beverages, gaming, or gambling? ......................
□
Yes
(If yes, explain in detail on a separate sheet)
□
No
□
No
D. Does the applicant agree to conform to all the laws, rules, and regulations of the
State of Maryland relating to the business proposed under this permit? . ....................
□
Yes
□
No
E. Does the applicant authorize the Comptroller of Maryland and the Comptroller’s duly authorized
personnel to search without warrant any vehicle, railroad car, vessel, aircraft, or premises used in
the business to be conducted under this permit at any and all hours agreeable to the laws of the
State of Maryland? . .............................................................
□
Yes
□
No
F. Do you agree to le quarterly tax returns, and remit sales tax and pay alcoholic beverage tax due
on sales to consumers in Maryland? If you check “No” to this question, this application cannot be
approved. . .....................................................................
□
Yes
□
No
G. Do you have a Federal Basic Permit issued by the Alcohol and Tobacco Tax and Trade Bureau
(TTB)? (Submit a copy of your Federal Basic Permit) . ...................................
□
Yes
□
No
H. Do you agree to deliver wine to a Maryland consumer through a common carrier who
has been issued a permit by the Comptroller of Maryland?................................
□
Yes
□
No
I. Does the applicant have a nancial interest in a Maryland alcoholic beverages retailer? If yes,
please provide an explanation.......................................................
□
Yes
□
No
J. Have you attached a list of wines (identified by brand name and type)
manufactured by the applicant to be shipped into Maryland? .............................
□
Yes
□
No
ONLY WINES IDENTIFIED ON THIS LIST MAY BE SHIPPED TO CONSUMERS IN MARYLAND BY THE PERMIT HOLDER.
Section 3 - Afdavit of Direct Wine Shipper’s Permit Applicant
I do solemnly declare and afrm, under penalty of perjury, that the contents of the foregoing document are true and
correct to the best of my knowledge, information, and belief.
Signature of Owner, Partner, or Corporate Ofcer Type or Print Name of Owner, Partner, or Corporate Ofcer
Title Date
COM-FED/RLS-38
1
Rev.
5
/1
7
Direct Wine Shipper’s Permit Application
Section 4 - Direct Wine Shipper Permit - Requirements
1. The holder of a direct wine shipper's permit may only
sell wine to a personal consumer who is at least 21
years of age, is a resident of Maryland, and who
purchases wine for personal consumption only and not
for resale or other commercial purposes.
2.
A direct wine shipper's permit entitles the holder to
sell ONLY its own manufactured wine identified in
the included list through the holder of a common
carrier permit to a Maryland consumer by receiving
and filling orders that the consumer transmits by
electronic or other means.
3. The term of a direct wine shipper's permit is one year
and begins on July 1st. The permit must be renewed
annually.
4. A direct wine shipper shall:
a. Ensure that all containers of wine shipped directly
to a consumer in the State are conspicuously
labeled with:
(i) The name of the direct wine shipper;
(ii) The name and address of the consumer who
is the intended recipient; and
(iii) The words "Contains Alcohol: Signature of
Person at Least 21 Years of Age Required for
Delivery".
b. File a quarterly alcoholic beverage tax return
and a quarterly sales and use tax return with the
Comptroller of Maryland, and collect and remit
sales tax and pay alcoholic beverage tax due on
sales to consumers in Maryland. The alcoholic
beverage tax return must state the total amount
of wine, by type, shipped into the State, the price
charged, and the name and address of each
purchaser.
c. Post security for the alcoholic beverage tax in the
amount of at least $1,000 if the applicant is an out-
of-state manufacturer of wine. Existing bonds for
Maryland wine manufacturers may be adjusted
based on tax returns led.
d. Maintain for a period of 3 years complete and
accurate records of all information needed to verify
compliance with the requirements of the Direct
Wine Shipper's Permit.
Page 3
e. Allow the Comptroller of Maryland to perform
an audit of the direct wine shipper's records on
request.
f. Consent to the jurisdiction of the Comptroller
of Maryland or other State unit and the State
courts concerning enforcement of the Direct Wine
Shipper's Permit and any related law.
5. A direct wine shipper may not:
a. Ship more than 18 9-liter cases of wine annually to
a single delivery address.
b. Cause wine to be delivered on Sunday to an
address in the State.
6. “Wine” means any fermented beverage, including light
wines, and wines the alcohol content of which has
been fortied by the addition of alcohol, spirits, or other
ingredients.
7. See Administrative Release No. AB-42 for additional
information.
Section 5 - Application Instructions
1. Submit the $200.00 annual permit fee with the
application. Permit fees are not pro-rated.
2. Incomplete applications will be rejected and returned.
3. Make checks payable to “Comptroller of Maryland.”
4. Sign, date and mail your application to:
Comptroller of Maryland
Field Enforcement Division
Regulatory and Licensing Section
P.O. Box 2999
Annapolis, MD 21404-2999
For more information:
Telephone: 410-260-7314,1-888-784-0145
Fax: 410-974-3201
www.marylandtaxes.com
COM-FED/RLS-38
1
Rev.
5
/1
7
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Direct Wine Shippers Permit Application (Comptroller of Maryland)

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Completed 14 August 2020

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