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Direct Wine Shippers Permit Application Form. This is a Maryland form and can be use in Comptroller Statewide.
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Tags: Direct Wine Shippers Permit Application, RAD-381, Maryland Statewide, Comptroller
Direct Wine Shipper’s Permit Application
Section 1 - Applicant Information
□ New Permit
□ Renewal (Permit #) DW- _________
Number ___________________
Corporate Name and T/A of Wine Manufacturer
Permit Year ________________
A.
Stub Number ______________
Name of Contact
B.
Phone Number
Fax Number
Approved _________________
Date ______________________
E-mail address
Check Number _____________
Mailing address
C.
Check Amount $ ___________
Deposit Date _______________
City
State
Zip
If the mailing address is a P.O. Box provide physical location address
D.
E. Applicant is a:
□ Corporation
□
□ Partnership
-
-
□ Individual
-
Social Security Number
1
2
3
Name
Home Address
Home Phone No.
Social Security No.
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 #
G. Section 9-104 of Article 2B of the Annotated Code of Maryland titled “Workers’ Compensation Compliance” requires the
□ 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
or binder number:
Name of Insurance Company
COM/RAD-381
Rev. 6/11
Policy or Binder Number
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Direct Wine Shipper’s Permit Application
Section 2 - Permit Information
□ Yes
□ No
B. Has the applicant ever been convicted of a felony by any state or federal court? . . . . . . . . . . . . . . .
□ Yes
□ No
......................
□ Yes
□ No
State of Maryland relating to the business proposed under this permit? . . . . . . . . . . . . . . . . . . . . .
□ Yes
□ No
the business to be conducted under this permit at any and all hours agreeable to the laws of the
State of Maryland? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
□ Yes
□ No
on sales to consumers in Maryland? If you check “No
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
please provide an explanation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
□ Yes
□ No
A. Does the applicant have a valid Maryland sales and use tax license? . . . . . . . . . . . . . . . . . . . . . . .
If you checked “Yes
_________________
If you checked “No
with this application.
E. Does the applicant authorize the Comptroller of Maryland and the Comptroller’s duly authorized
Title
COM/RAD-ATT-10-10
Rev. 6/11
Date
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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
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 its own manufactured wine through the holder of
a common carrier permit to a Maryland consumer by
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.
e. Allow the Comptroller of Maryland to perform
an audit of the direct wine shipper's records on
request.
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.
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:
ingredients.
7. See Administrative Release No. AB-42 for additional
information.
(i) The name of the direct wine shipper;
(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".
Section 5 - Application Instructions
1. Submit the $200.00 annual permit fee with the
application. Permit fees are not pro-rated.
3. Make checks payable to “Comptroller of Maryland.”
b. File a quarterly alcoholic beverage tax return
and a quarterly sales and use tax return with the
sales tax and pay alcoholic beverage tax due on
sales to consumers in Maryland. The alcoholic
beverage tax return must state the total amount
Comptroller of Maryland
Revenue Administration Division
Licensing and Registration
P.O. Box 2999
For more information:
purchaser.
c. Post security for the alcoholic beverage tax in the
of-state manufacturer of wine. Existing bonds for
Fax: 410-974-3201
http://compnet.comp.state.md.us
http://www.marylandtaxes.com
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.
COM/RAD-ATT-10-10
Rev. 6/11
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