Addition to the State of Maryland Department of Health and ...
FEDERAL EMPLOYER IDENTIFICATION NUMBER
Addition to the Maryland Department of the Environment Water Quality Laboratory Certification Application:
Effective July 1, 2003, House Bill 935, the Budget and Reconciliation and Financing Act of 2003, requires the Maryland Department of Health and Mental Hygiene (DHMH) to verify through the Office of the Comptroller that the applicant’s undisputed taxes and unemployment insurance contributions have been paid.
In order to verify this information the Department must have the Federal Employer Identification Number (FEIN) of the business to which the certificate will be issued or the Social Security Number of the individual to whom the certificate will be issued. If you have any questions, please contact us at 410-537-3712.
Laboratory Name:
Street Address:
City, State, Zip Code:
Mailing Address:
City, State, Zip Code:
Federal ID Number or FEIN:
Or
Social Security Number:
Name of Contact Person:
Phone Number of Contact Person:
FEIN Request 2010.doc
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