Fillable Form 381: PERMIT APPLICATION B. Section 1 - (Comptroller of Maryland)

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Form 381: PERMIT APPLICATION B. Section 1 - (Comptroller of Maryland)

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Oce Use Only
Permit Number __________
Permit Year _____________
Stub Number ___________
Approved ______________
Date __________________
Check Number __________
Check Amount $ ________
Deposit Date____________
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
E. Applicant is a:
Corporation
Limited Liability Co. Federal Identication Number
Partnership
Individual Social Security Number
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. The Annotated Code of Maryland, Alcoholic Beverages Article, Section 1-404 titled “Compliance with Workers’ Compensation Act”,
requires the evidence of such compliance prior to the issuance of any permit. The applicant hereby arms (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
ATTN: You must attach a list of wines you manufactured and intended for sale in Maryland by the permit applicant.
1 2 3
Name
Home Address
Home Phone No.
Social Security No.
Ocers of Corporation, Limited Liability Company, or Partnership:
COM-FED/RLS-381 Rev. 09/19
MARYLAND
FORM
381
DIRECT WINE SHIPPER’S
PERMIT APPLICATION
-
-
-
Section 2 - Permit Information
A. Does the applicant have a valid Maryland sales and use tax license? ............................ Yes No
If you checked “Yes”, enter Maryland Combined Registration Number here: _______________________
If you checked “No”, complete, sign and attach a Maryland Combined Registration Application or
a copy of the conrmation page from your on-line application. You may apply on-line for the
Combined Registration number at the following link:
https://interactive.marylandtaxes.gov/webapps/comptrollercra/entrance.asp
B. Has the applicant ever been convicted of a felony by any state or federal court? ................... Yes No
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 No
(If yes, explain in detail on a separate sheet)
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 (identied by brand name and type) manufactured by the applicant to be
shipped into Maryland? ............................................................ Yes No
K. Is the applicant the winery who manufactures all of the wines on the list to be shipped to Maryland? .... Yes No
(If NO, you do not qualify for a Direct Wine shippers permit. Fulllment houses/Third party shippers who
do not manufacture wine do not qualify for a Direct Wine Shipper permit).
By initialing here _________ , you indicate that you understand that all wines on the included list that are
shipped to Maryland are manufactured by the direct Wine Shipper Permit applicant.
L. Will the Maryland direct wine Shipper Permit holder be utilizing a third party shipper/fulllment
house for orders to a Maryland customer? .............................................. Yes No
If yes, please identify ___________________________________ ______________________________
Page 2
Section 3 - Adavit of Direct Wine Shipper’s Permit Applicant
I do solemnly declare and arm, under penalty of perjury, that the contents of the foregoing document are true and correct to
the best of my knowledge, information, and belief.
ONLY WINES IDENTIFIED ON THIS LIST MANUFACTURED BY THE APPLICANT, MAY BE SHIPPED TO CONSUMERS IN
MARYLAND BY THE PERMIT HOLDER.
Signature of Owner, Partner, or Corporate Ocer Type or Print Name of Owner, Partner, or Corporate Ocer
Title Date
COM-FED/RLS-381 Rev. 09/19
MARYLAND
FORM
381
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 identied in the included
list through the holder of a common carrier permit to a
Maryland consumer by receiving and lling 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 LICENSE NAME AS STATED on the Maryland
Direct Wine Shipper’s Permit.
(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.
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
fortied 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 & Licensing Section
P.O. Box 2999
Annapolis, MD 21404-2999
410-260-7314 or 800-MD-TAXES
ATT@
marylandtaxes.gov
www.marylandtaxes.gov
Page 3
COM-FED/RLS-381 Rev. 09/19
MARYLAND
FORM
381
DIRECT WINE SHIPPER’S
PERMIT APPLICATION
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Form 381: PERMIT APPLICATION B. Section 1 - (Comptroller of Maryland)

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Completed 14 August 2020

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