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FORM STOP PAYMENT REQUEST
Revenue Administration Division
106 Refund Unit
Tax year MD refund check dated Amount
$ .
Primary Taxpayer’s printed name Primary Taxpayer’s SSN
Primary Taxpayer’s signature*
Secondary Taxpayer’s printed name Secondary Taxpayer’s SSN
Secondary Taxpayer’s signature*
Current Mailing Address - Street/P.O. Box
Current Mailing Address - City State Zip Code +4
Daytime Contact Number
* Signatures are matched to our master files. Electronic filers; attach a copy of your State issued
identification for verification. On jointly filed returns, both taxpayers must sign this request.
Please place a stop payment on the above referenced refund check and issue a replacement
check at the provided mailing address.
Submit Forms to the Refund Unit via Email, Fax or Mail:
Email: RADREFUND@marylandtaxes.gov
Fax: 410-260-7890
Mail: Comptroller of Maryland
Revenue Administration Division
Attn: Refund Unit
P.O. Box 1829
Annapolis, MD 21404-1829
COM/RAD-106 09/20
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