Form
330
COM-FED/RLS-330 Rev. 09/19
Beer
Franchise
Form
This supplementary statement will be made part of your license or permit le or will become a part of that license or permit le when issued. Any changes to the below must be
in accordance with Maryland Beer Franchise Fair Dealing Act and must be promptly reported to the Comptroller in writing.
I hereby certify that we are the brand owner, U.S. Importer, or designated Maryland agent of said brand owner or U.S. Importer in accordance with Maryland laws. I further certify
that these lings are not inconsistent with the Maryland Beer Franchise Fair Dealing Act or any prior franchise lings made with the Regulatory and Licensing Section.
Signature Title: Owner, Partner or Ocer
(F) (G)
(E)
License or Permit Number of
Maryland Wholesale Distributor
or Non-Resident Brewery
Name of distributor Assigned franchise territories. (Codes provided on page 2)
Comptroller of Maryland
Field Enforcement Division
Regulatory & Licensing Section
P.O. Box 2397,
Annapolis, MD 21404-2397
410-260-7839 or 800-MD-TAXES
FAX #: 410-974-3201
ATT@marylandtaxes.gov
www.marylandtaxes.gov
Page _____ of _____
Print or Type Name Date
(A)
Name of
Supplier
(B) Supplier's
Maryland Non-Resident-Brewery, Non-Resident
or
Resident Dealer
Permit
Number or Maryland Wholesale
or Manufacture
License Number
(C)
Brand Name
(Enter full brand name. Do not
abbreviate.)
(D)
List all sizes
of this brand
Form
330
COM-FED/RLS-330 Rev. 09/19
Beer
Franchise
Form
01 Allegany County 07 Carroll County 13 Harford County 19 St. Mary’s County
02 Anne
Arundel County
08 Cecil County
14 How
ard County
20 Somerset Count
y
03 Baltimore Count
y
09 Charles Count
y
15 K
ent County
21 T
albot County
04 Baltimore Cit
y
10 Dorchester
County
16 Montgomery Count
y
22 WashingtonCount
y
05 Calvert Count
y
11 Frederick County
17 Prince George’
s County
23 Wicomico Count
y
06 Caroline County
12 Garrett County
18 Queen Anne’
s County
24 Worcester
County
0 - Precedes whole territory (Ex. 001) 333 - Secondary Source (wholesalers only)
P - Precedes partial
territory (Ex. P01)
555 - Self
-Import Brand (wholesalers only)
099 - Entire state of
Maryland Except Montgomery County
777 - Ship Chandler
Instructions for Completing COM-FED/RLS-330
1. A different page must be used for each brand.
2. Forms cannot be approved prior to being physically received in the Annapolis office of the Field Enforcement Division. Questions pertaining to the proper completion of the form can be directed to
(410) 260-7839.
3. Forms should only be used for the addition of new brands or to add a new wholesaler or additional territories for an existing brand. Requests for changes or deletions to existing brands must be made
in letter form and must be in accordance with the provisions of the Maryland Beer Franchise Fair Dealing Act.
4. Forms must be dated and signed by an officer of your company.
5. Neatness, completeness and accuracy is essential. Incomplete or incorrect forms will be returned as disapproved and must be resubmitted.
6. Detailed Instructions:
A. Name of Supplier - List your full name as it appears on your license or permit.
B. Maryland Non-Resident Brewery, Resident or Non-Resident Dealer Permit or Maryland Wholesale or Manufacture License Number - This is the official seven (7) digit number
which appears on your license or permit (Example: W100099, M501234, ND12345, NB12345, RD12345).
C. Brand Name - The full and complete name of the beer should be entered. The necessity for abbreviation will be determined by the Field Enforcement Division.
D. Sizes - List all sizes of this product that you wish to sell in Maryland.
E. License or Permit Number of Maryland Wholesale Distributor - This is the official seven (7) digit license/permit number of the Maryland wholesale distributor or non-resident brewery
who is being appointed to sell your brand. Contact your wholesaler to obtain this number. It is important that this number be accurate and legible.
F. Name of Distributor - List the full name of your Maryland wholesale/non-resident brewery distributor as it appears on the distributor’s license.
G. Assigned Franchise Territories - A three (3) digit code must appear for each county or subdivision (or part thereof ) which you are assigning to a given wholesaler for a particular brand.
Below is a list of the two-digit subdivision territory codes in Maryland. If you are assigning the whole territory, the code should be preceded by a “0” (Example: all of Allegany County would
be “001”). If you are assigning only a portion of a territory, then a “P” should precede the code (Example: Part of Allegany County would be “P01”). Note: For every territory in which a “P” is
designated, a detailed description and/or map must accompany the franchise form before approval can be granted. If you are assigning the entire State, except for Montgomery County,
code “099” should be used. If you are selling to a ship chandler, code “777” should be used. If you are a wholesaler self-importing a product, you should use your license number in both the
supplier and distributor boxes and code “555” should be used in the first territory box. If you are a wholesaler acting as a secondary source (i.e. if you have a state-wide license and sell to
other wholesalers in the state, exclusive of a sub-distributorship, then use code “333”. Note that franchise forms must be filed for all brands even those which you as a wholesaler may self-
import or sell to others as a secondary source. In addition, when you as a wholesaler are selling to another wholesaler in a sub-distributorship capacity, these forms must also be completed
and submitted. All items sold to Montgomery County (License Number: CD00001) must also be assigned using this form.
Note: Always use the rst territory code block and leave those not needed blank. If you need more than ve (5) territory boxes for a given wholesaler, skip to the next line repeating the wholesaler’s
number and name. If you need more space for additional distributors, use a second form, repeating your license or permit number and brand information at the top. Consecutively number each
page you are submitting at one time at the top in the space provided.