Request For Tax Clearance Certificate Sample Form printable pdf download

Request For Tax Clearance Certificate Sample Form

SAMPLE

Request For Tax Clearance Certificate

In accordance with Section 13-803 of the Tax-General Article of the Maryland

Annotated Code, we are requesting a Tax Clearance Certificate in connection with the

listed project.

Name of nonresident contractor

applying for tax clearance: ________________________________________

Address: ______________________________________________________

Telephone number: _____________________________________________

E-mail: _______________________________________________________

Fax number: __________________________________________________

Type of project: ________________________________________________

Site Address: __________________________________________________

Name of person required to withhold

3 percent of the contract price: ____________________________________

Address: ______________________________________________________

Telephone number: _____________________________________________

E-mail: _______________________________________________________

Fax number: ___________________________________________________

Contract completion date:_________________________________________

Total contract price: _____________________________________________

Date submitted: ________________________________________________

Request For Tax Clearance Certificate Sample Form