DO NOT MAIL
COM/RAD-059
MARYLAND
FORM
EL101
e-File DECLARATION
FOR ELECTRONIC FILING
2016
Part I Tax Return Information (whole dollars only)
1. Amount of overpayment to be applied to 2017 estimated tax ..............................1.
2. Amount of overpayment to be refunded to you ........................................2.
3. Total amount due (Pay in full by April 18, 2017. See instructions.) ..........................3.
Keep this form for your records. Do not send this form to the State of Maryland unless specifically requested to do so. See Instructions on Page 2.
Print using blue or black ink only.
First Name Initial Last Name SSN/Taxpayer Identification Number
Spouse's First Name Initial Spouse's Last Name SSN/Taxpayer Identification Number
Part II Taxpayer Declaration and Signature Authorization
Under penalties of perjury, I declare that 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) and amounts described above agree with
the amounts shown on the corresponding lines of my 2016 Maryland electronic income tax return. To the best of my knowledge and
belief, my return is true, correct and complete. I consent that my return, including accompanying schedules and statements, be
sent to the Maryland Revenue Administration Division by my electronic return originator or by my electronic return software
provider.
Your PIN: check one box only
I authorize __________________________________________ to enter or generate my PIN
EROrmname
asmysignatureonmytaxyear2016electronicallyledincometaxreturn.
IwillentermyPINasmysignatureonmytaxyear2016electronicallyledincometaxreturn.Checkthisboxonly if you are
entering your own PIN andyourreturnisledusingthePractitionerPINmethod.TheEROmustcompletePartIIIbelow.
Your signature _____________________________________________________________________________ Date _________________________
Spouse's PIN: check one box only
I authorize __________________________________________ to enter or generate my PIN
EROrmname
asmysignatureonmytaxyear2016electronicallyledincometaxreturn.
IwillentermyPINasmysignatureonmytaxyear2016electronicallyledincometaxreturn.Checkthisboxonly if you are
entering your own PIN andyourreturnisledusingthePractitionerPINmethod.TheEROmustcompletePartIIIbelow.
Spouse's signature _________________________________________________________________________ Date _________________________
Practitioner PIN Method Returns Only
Part III Certication and Authentication - Practitioner PIN Method Only
ERO’s EFIN/PIN.Enteryoursix-digitEFINfollowedbyyourve-digitself-selectedPIN.
IcertifythisnumericentryismyPIN,whichismysignatureforthetaxyear2016electronicallyledincometaxreturnforthe
taxpayer(s).IconrmthatIamsubmittingthisreturninaccordancewiththerequirementsofthePractitionerPINmethodandthe
MarylandMeFHandbookforAuthorizede-leProviders.
ERO's signature ___________________________________________________________________________ Date _________________________
Entervedigits.
Do not enter all
zeros.
Entervedigits.
Do not enter all
zeros.
Do not enter
all zeros.
REFUND
COM/RAD-059
MARYLAND
FORM
EL101
e-File DECLARATION
FOR ELECTRONIC FILING
INSTRUCTIONS
2016
Purpose of Form
Form EL101 is the declaration document and signature
authorization for an electronically filed return by an electronic
return originator (ERO). Complete Form EL101 when the
Practitioner PIN method is used or when the taxpayer authorizes
the ERO to enter or generate the taxpayer's personal
identification number (PIN) on his or her e-filed individual
income tax return. The ERO must retain Form EL101 for 3 years
from the return due date. Note: Do not send this form to the
State of Maryland unless specifically requested to do so.
When and How to Complete
IF the ERO is... Then...
Not using the Practitioner
PIN method and the taxpayer
enters his or her own PIN
Do not complete Form
EL101.
Using the Practitioner PIN
method and is authorized to
enter or generate the
taxpayer’s PIN
CompleteFormEL101,
Parts I, II, and III.
Using the Practitioner PIN
method and the taxpayer
enters his or her own PIN
CompleteFormEL101,
Parts I, II and III.
Not using the Practitioner
PIN method and is
authorized to enter or
generate the taxpayer’s PIN
CompleteFormEL101,
Parts I and II.
ERO Responsibilities
The ERO will:
1. Enter the name(s) and Social Security number(s) of the
taxpayer(s) at the top of the form.
2. Complete Part I using the amounts from the 2016
Maryland tax return of the taxpayer(s).
3. Enter or generate, if the taxpayer(s) authorizes, the PIN of
the taxpayer(s) and enter it in the boxes provided in Part
II.
4. Enter on the authorization line on Part II the ERO firm
name (not the name of the person who prepared the
return), if the ERO is authorized to enter the e-file PIN of
the taxpayer(s).
5. After completing (1) through (4), give the taxpayer(s)
Form EL101 for completion and review. The acceptable
delivery methods include hand delivery, US mail, private
delivery service, email and fax.
6. EROs may sign Part III of the form using a rubber stamp,
mechanical device (such as a signature pen), or computer
software program. The signature must include either a
facsimile of the signature of the Individual ERO or of the
printed name of the ERO.
Note: The ERO must receive the completed and signed Form
EL101 from the taxpayer before the electronic return is
transmitted. Do not send this form to the State of Maryland
unless specifically requested to do so.
Taxpayer Responsibilities
1. Verify the accuracy of the prepared income tax return,
including direct deposit or direct debit information if
applicable.
2. ChecktheappropriateboxinPartIItoauthorizetheERO
to enter or generate your e-file PIN or do it yourself.
3. Indicate or verify your e-file PIN when authorizing the ERO
to enter or generate it (the e-file PIN must have five digits
other than all zeroes).
4. Sign and date Form EL101. Taxpayers must sign Part II
using handwritten signature, rubber stamp, mechanical
device (such as signature pen) or computer software
program.
5. Return the completed Form EL101 to the ERO by hand
delivery, US mail, private delivery service or fax. Note:
The return will not be transmitted until the ERO receives
the signed EL101. Do not send this form to the State
of Maryland unless specifically requested to do so.