Fillable Form 383: PERMIT APPLICATION FOR DIRECT WINE SHIPMENT (Comptroller of Maryland)

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Form 383: PERMIT APPLICATION FOR DIRECT WINE SHIPMENT (Comptroller of Maryland)

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COMMON CARRIER
PERMIT APPLICATION
FOR DIRECT WINE
SHIPMENT
MARYLAND
FORM
383
Oce Use Only
Permit Number _____________
Permit Year ________________
Stub Number ______________
Approved _________________
Date ______________________
Check Number _____________
Check Amount $ ___________
Deposit Date _______________
□
New Permit
□
Renewal (Permit #) CC- _________
A.
Corporate Name and T/A of Common Carrier
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
Section 2 - Permit Information
A. Is the applicant a business entity that holds itself out as being available to the public to transport in interstate or
foreign commerce for compensation any class of passenger or property? ................................
□
Yes
□
No
B. Does the applicant agree to submit to the Comptroller at the time of application, and on request, information
concerning the training of its drivers for age-verication of consumers to whom wine is delivered? .............
□
Yes
□
No
C. 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
D. Does the applicant agree to verify annually in a manner acceptable to the Comptroller that direct wine
shipments to Maryland consumers were made under valid direct wine shipper’s permits? ...................
□
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. Does the applicant le quarterly reports stating the date of each delivery of wine in the State, and the name and
address of the direct wine shipper, and the consumer who received each delivery? ........................
□
Yes
□
No
E. Applicant is a:
□
Corporation
□
Limited Liability Co. Federal Identication Number
□
Partnership
□ Individual Social Security Number
- -
-
Section 3 - Adavit of Common Carrier 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.
Signature of Owner, Partner, or Corporate Ocer Type or Print Name of Owner, Partner, or Corporate Ocer
Title Date
Section 1 - Applicant Information
COM-FED/RLS – 383 Rev. 09/19
COMMON CARRIER
PERMIT APPLICATION
FOR DIRECT WINE
SHIPMENT
MARYLAND
FORM
383
Page 2
Section 4 – Common Carrier Permit - Regulations
1. The holder of a common carrier permit may only deliver
wine to a Maryland consumer who is at least 21 years of
age.
2. The holder of a common carrier permit may only deliver
wine to a consumer in the State that is shipped by a
direct wine shipper who has a valid Maryland direct
wine shipper’s permit. Possession of a copy of the
current annual direct wine shipper’s permit satises this
requirement.
3. The term of a common carrier permit is one year and
begins on July 1st. The permit must be renewed annually.
4. The holder of a common carrier permit shall:
a. Complete a delivery of wine to a consumer at the
address on the shipping label by obtaining:
(i) the signature of the consumer or another
individual at the delivery address who is at least
21 years old; and
(ii) government-issued photographic identication
showing that the signing individual is at least 21
years old.
b. Refuse delivery of wine to a Maryland consumer
when the recipient of the delivery:
(i) appears to be under age 21; or
(ii) refuses to present valid identication.
c. File a quarterly report with the Comptroller of
Maryland, stating the date of each delivery of wine
in the State, and the name and address of the direct
wine shipper, and the consumer who receives each
delivery.
d. Maintain for a period of 3 years complete and
accurate records of all information needed to verify
compliance with the requirements of the Common
Carrier Permit.
e. Allow the Comptroller of Maryland to perform an
audit of the common carrier records on request.
5. One common carrier permit authorizes all deliveries
under the permit for the permit year. A separate permit
for each truck or vehicle is not required.
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 $100.00 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
For more information:
Telephone: 410-260-7312 or 800-MD-TAXES
ATT@
marylandtaxes.gov
www.marylandtaxes.gov
COM-FED/RLS – 383 Rev. 09/19
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Form 383: PERMIT APPLICATION FOR DIRECT WINE SHIPMENT (Comptroller of Maryland)

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Completed 14 August 2020

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