Form Com/att-020-3a - Application For A Private Bulk Sale Permit
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2Office Use Only
Office Use Only
Comptroller of Maryland
MATT Regulatory Division
Check No.
Number
Alcohol and Tobacco Tax
Check Amount $
Louis L. Goldstein Treasury Building
Stub
Deposit Date
P.O. Box 2999
Year
Annapolis, MD 21404-2999
410-260-7327
888-784-0145
Approved by
Fax# 410-974-3201
Date
Application for a Private Bulk Sale Permit
Application is made by the undersigned under the provisions of Article 2B of the Annotated Code of
Maryland, as amended, title “Alcoholic Beverages”, for a Private Bulk Sale Permit and the applicant submits
and certifies to the following information.
Fee for Private Bulk Sale Permit - $25.00 (Make check payable to “Comptroller of Maryland”)
Section 1 - All applicants must complete this section. Type or print clearly.
A. Permit is to be issued in the name of
Applicant’s Full Name
(
)
(
)
B. Whose telephone number is
or Toll Free
Fax
C. Whose address is
Street and Number
City
State
9-Digit Zip Code
D. Applicant’s birth date
MM/DD/YY
E. Applicant’s Social Security No.
-
-
Section 2 - Applicant certifies to the following:
9
9
A. All alcoholic beverages to be sold have been legally acquired and transported into
Yes
No
Maryland, in accordance with the alcoholic beverage laws of Maryland.
9
9
B. All alcoholic beverages intended for sale under a Private Bulk Sale Permit are owned
Yes
No
by the applicant.
9
9
C. Attached herewith is a complete inventory of alcoholic beverages to be sold under the
Yes
No
Private Bulk Sale Permit. (Indicate on separate sheet the brand name, bottle size and
number of bottles.)
9
9
D. Applicant understands that a maximum of two Private Bulk Sale Permits may be
Yes
No
obtained in a calendar year.
(Over)
COM/ATT-020-3A
Rev. 7/07
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