COM/SUT205 07/18 18-49
Signature Print name
Date Title
MARYLAND
FORM
SUT205
Sales and Use Tax
Refund Application
Legal Name of Entity owner Trade name if different
Number and street
City / town State ZIP code +4
Telephone number
FEIN Number or SSN of owner, officer or agent responsible for taxes
Sales and Use Tax Registration Number
The undersigned hereby requests the comptroller to refund sales and use tax in the amount of $ , less discount
previously taken, if applicable, of , for a net refund of $ . This sum is the amount of sales and
use tax that has been improperly paid, or collected and subsequently refunded, by the undersigned for the reasons described below:
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
Name
(List the names of the persons to whom you paid the
tax. If you are a vendor who has refunded or credited
tax to customers, list the customers’ names.)
Date of
sale
Amount of
sale
Amount of
tax
Date
of tax
refund/
credit*
Amount of
tax refund/
credit*
If additional space is required, attach additional sheets and provide the information using the same format. *Complete if you are a
vendor who has refunded or credited tax to a customer.
NOTE: To expedite this application, non-returnable copies of records supporting the refund request should accompany this form.
These records should include, when appropriate, sales and purchase invoices or journals, resale certicates and cancelled checks
corresponding to entries in this application. If it is impractical to forward copies of all supporting documents, the records must be
made readily available for review by an employee of the Compliance Division, if requested.
I HEREBY CERTIFY under the penalties of perjury that I have examined the information set forth in this application including any
accompanying schedules or statements and that said information is true, accurate and complete to the best of my knowledge and
belief.
For Ofce Use Only
Claim Code ___ Claim No. ___________
Amount approved ___________________
Liabilities _________________________
Check issued ______________________
Amount credited ___________________
Approved by _______________________
Approved by _______________________
Direct inquiries and mail application to:
Comptroller of Maryland
Compliance Division
301 West Preston Street, Room 303
Baltimore, Maryland 21201-2383
For more information email questions to:
CDSTREFUNDS@comp.state.md.us
or call 410-767-1530.
Maryland Relay (MRS) at 711
