Maryland Request for Certification of Tax Filings

Request for Certification of Tax Filings
TY - 2021 - 130
MARYLAND
FORM

130

REQUEST FOR CERTIFICATION
OF TAX FILINGS

OFFICE USE ONLY
Tax year(s)

Request:

/

Approved

Control Number Assigned

ITIN

Applicant’s Information

SSN

Denied
Type of
photo ID

Print using black or blue ink only.
Last name

Suffix

First name

M.I.

Current mailing address

City

State

ZIP code +4

Applicant’s ITIN or SSN

1.	 Did you file a Maryland tax return during one or both of the previous two years?
If yes, complete 1a and 1b. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Yes 

No

	 1a.	 Name as shown on return(s), if different from above:
		

____________________________________________ 	

___________________________

Name	

Tax year

___________________________________________ 	

___________________________

Name	

Tax year

		

		
		

	 1b.	 Mailing address as shown on return(s), if different from above:
	

____________________________________________________________________________________________________

	

Street	

	

____________________________________________________________________________________________________

	

Street	

City	

State	

City	

ZIP code +4	

State	

Tax year

ZIP code +4	

Tax year

2.	 Did you file federal Form 4868 (Application for Automatic Extension of Time to File U.S.
Individual Income Tax Return) or Maryland Form extension to file personal income tax return
for the most recent tax year?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Yes 

No

3.	 Were you claimed as a dependent on a Maryland tax return during one or both
of the previous two years? If “Yes”, complete 3a.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   

Yes 

No

	 3a.	 Name(s) and ITIN(s)/SSN(s) of taxpayer(s) claiming you as a dependent and tax year(s) you were claimed as a dependent.
	

_______________________________________ 	

	

	

_________________________ 	

____________________

ITIN/SSN	

Tax year(s)

_________________________ 	

____________________

ITIN/SSN	

Tax year(s)

Name of Taxpayer		

_______________________________________ 	

	

Name of Taxpayer		

*** THIS FORM MUST BE SIGNED IN THE PRESENCE OF A REPRESENTATIVE OF THE ***
COMPTROLLER OF MARYLAND.
SIGNATURE and VERIFICATION: I understand that taxpayer information is confidential and authorize the Comptroller of
Maryland to release the requested information to the Maryland Motor Vehicle Administration in accordance with the Maryland
Highway Safety Act of 2013. And further, I certify that to the best of my knowledge all information provided on this form is true,
correct and complete.
	

__________________________________________ 	

	

Signature of applicant		

___________________________________________
Date

			___________________________________________
	
COM/RAD-035	04/22

Telephone number		

Email address

MARYLAND
FORM

130

REQUEST FOR CERTIFICATION
OF TAX FILINGS INSTRUCTIONS

WHO MUST FILE
This form is only required for immigrants presenting foreign
documentation without valid accompanying United States
Citizenship and Immigration Services documentation in order to
obtain a driver’s license or identification card. It is not required
for individuals who have an existing Maryland driver’s license or
identification card.
PURPOSE OF FORM
The Maryland Highway Safety Act of 2013 expands the authority
of the Motor Vehicle Administration (“MVA”) to issue a driver’s
license, identification card, or moped operators permit to an
individual who does not have lawful status, but requires that any
such applicant who is not a current holder of an identification
card under §12-301 of the Transportation Article, a moped
operator’s permit under §16-104.2 of the Transportation Article,
or a license to drive issued under the Transportation Article,
must provide documentary evidence that the applicant, for
each of the preceding 2 years, has filed a Maryland income
tax return or been claimed as a dependent by an individual
who has filed a Maryland income tax return in order to be
issued such card, permit or license by the MVA. To obtain
the required documentation, applicants must complete Form
130 and visit one of the Comptroller’s twelve branch offices to
obtain a letter certifying proof of filing or that they were claimed
as a dependent on another taxpayer’s filing prior to making
application to MVA.
INSTRUCTIONS
This form must be filled out in its entirety and submitted in person
with acceptable proof of identification (see below) to any branch
office of the Comptroller of Maryland. Do not mail this form; it
must be submitted in person.

•	 A photo ID and any 3 of the following 5 items from the most
recent Maryland tax return:
	 -	 Adjusted Gross Income (AGI)
	 -	 Filing Status
	 -	 Number of Exemptions
	 -	 Dollar amount of REFUND or BALANCE DUE
-	 Deduction Method, i.e. Standard or Itemized, and the
dollar amount; or,
•	 Proof of identity acceptable to the MVA
(https://mymva.maryland.gov/go/web/OnlineDocumentGuide),
the address from which the most recent year’s tax return
was filed, and the ITIN or SSN.
NOTE: The name on the Social Security Card or ITIN letter MUST
match the name on the photo identification used to provide proof
of identity.
If you have a different name on your Social Security Card from
your photo ID, you must change your name with the Social
Security Administration (SSA) prior to coming to the Maryland
Comptroller’s Office. The new name must match the name that the
SSA has on record. For information on Social Security Numbers,
visit http://www.socialsecurity.gov/ssnumber/.
If you have a different name on your ITIN letter from your photo
ID, you must change your name with the IRS prior to coming to
the Comptroller of Maryland’s office. The new name must match
the name that the IRS has on record. For information on ITINs
visit www.irs.gov.
WHERE TO SUBMIT FORM 130

Do not sign Form 130 until you are instructed to do so by a
representative of the Comptroller of Maryland, Revenue
Administration Division.

You can submit Form 130 at any of the branch offices listed
below. Offices are open Monday – Friday, 8:30 a.m. - 4:30 p.m.
You must schedule an appointment to submit this form at
a branch office. You may schedule an appointment online at
www.marylandtaxes.gov or by calling 410-260-7980.

PROOF OF IDENTIFICATION

FOR ADDITIONAL INFORMATION OR SPECIAL ASSISTANCE

The following proof of identification is required:

Visit www.marylandtaxes.gov
or call 410-260-7980 or toll-free 800-638-2937.

•	 A photo ID and the original or copy of the ITIN letter from
the IRS or SSN card; or,

Maryland Relay Service (MRS) . . . . . . . . . . . . . . . . . . . . . . 711

BRANCH OFFICES
Annapolis
60 West Street
Suite 102
Annapolis, MD 21404-2434

Frederick
Courthouse/Multiservice Center
100 West Patrick Street, Rm. 2603
Frederick, MD 21701-5578

Towson
Hampton Plaza
300 East Joppa Rd., Ste. Plaza Level 1-A
Towson, MD 21286-3020

Baltimore
State Office Building
301 W. Preston St., Rm. 206
Baltimore, MD 21201-2326

Greenbelt
Triangle Centre
6401 Golden Triangle Drive, Suite 100
Greenbelt, MD 20770-3201

Upper Marlboro
Prince George’s County Courthouse
14735 Main St., Rm. 083B
Upper Marlboro, MD 20772-3051

Cumberland
3 Pershing St., Ste 101
Cumberland, MD 21502-3042

Hagerstown
Crystal Building
1850 Dual Hwy., Suite 201
Hagerstown, MD 21740-6686

Waldorf
1036 St. Nicholas Dr., Unit 202
Waldorf, MD 20603-4760

Elkton
Upper Chesapeake Corporate Center
103 Chesapeake Blvd., Suite D
Elkton, MD 21921-6391

COM/RAD-035	04/22

Salisbury
Sea Gull Square
1306 South Salisbury Blvd., Unit 182
Salisbury, MD 21801-6846

Wheaton
Westfield Wheaton South Building
11002 Veirs Mill Road, Suite 408
Wheaton, MD 20902-5919