Fillable Form 106: STOP PAYMENT REQUEST Revenue Administration Division (Comptroller of Maryland)

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Form 106: STOP PAYMENT REQUEST Revenue Administration Division (Comptroller of Maryland)

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STOP PAYMENT REQUEST
Revenue Administration Division
Refund Unit
FORM
106
COM/RAD-106 03/12 12-49
Tax year MD refund check dated Amount
$
Primary Taxpayer’s printed name Primary Taxpayer’s SSN
Primary Taxpayer’s signature*
Secondary Taxpayer’s printed name Secondary Taxpayer’s SSN
Secondary Taxpayer’s signature*
Current Mailing Address - Street/P.O. Box
Current Mailing Address - City State Zip
Daytime Contact Number
Please place a stop payment on the above referenced refund check and issue a replacement
check at the provided mailing address.
Submit Forms to the Refund Unit via Email, Fax or Mail:
Email: RADREFUND@comp.state.md.us
Fax: 410-260-7890
Mail: Comptroller of Maryland
Revenue Administration Division
Attn: Refund Unit
P.O. Box 1829
Annapolis, Maryland 21404-1829
*Signaturesarematchedtoourmasterles.Electroniclers;attachacopyofyourStateissued
identicationforverication.Onjointlyledreturns,bothtaxpayersmustsignthisrequest.
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Form 106: STOP PAYMENT REQUEST Revenue Administration Division (Comptroller of Maryland)

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Completed 20 July 2020

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