Form Com/att-751 - Keg Registration Booklet Order Form

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Comptroller of Maryland
Office Use Only
Office Use Only:
MATT Regulatory Division
Beginning
Order
Alcohol and Tobacco Tax
Book No.
Filled by
P. O. Box 2999
Ending
Date
Annapolis, Maryland 21404-2999
Book No.
410- 260-7131/888-784-0145
Filled
Fax (410) 974-3201
Keg Registration Booklet Order Form
(please print or type)
Licensee’s Name
Date
T/A:
Telephone No.
License address
Md. Central Registration No.
Mailing address if different
City
State
Zip Code
Political Subdivision (County or Baltimore City)
No. of books requested:
Estimated number of kegs
(25 labels per book)
Two copies to be sent to ATT Office
One copy to be kept by retailer
Signature of Licensee
COM/ATT-751
Rev. 7/07

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