202 4CORPORATE DIVERSITY ADDENDUM                          

      Instructions: If you are required to attach   a Corporate Diversity Addendum to your Annual Report, 
      completing the Affidavit on Page 2 is mandatory. A response to both items on Page 1 is required. Failure 
      to provide a complete response to either of the two items may render the entity ineligible for certain state 
      benefits. For more information, refer to COMAR 24.01.07. 

      I. A response to Item I is required. However, the content of your response has no  bearing on eligibility for 
      State benefits. Select below the underrepresented communities which are represented on this entity’s 
      board or in executive leadership. Select all that apply. 

                ☐ Alaska Native 
                ☐ Asian-Pacific Islander 
                ☐ Black  or African-American 
                ☐ Hispanic or    Latino 
                ☐ Native American 
                ☐ Native Hawaiian 
                ☐ One or more of the racial or ethnic groups listed above 
                ☐ None of the above 

      II. Check the box next to the following Corporate Diversity indicators that pertain to this entity.         Note that 
      references to underrepresented communities refers to communities listed   in Item I above. The examples 
      provided are intended to be representative, not exclusive. Select all that apply. 

                1.  ☐      Entity maintains written workforce diversity, equity, and inclusion (“DEI”) policies. 
                2.  ☐      Entity offers DEI training to its workforce. 
                3.  ☐      Entity assigns a senior-level employee as responsible for oversight and direction of the entity’s 
                DEI  efforts.  
                4.  ☐      Entity reports performance of its workforce DEI programs on its website. 
                5.  ☐      Entity includes DEI objectives in performance plans of its managers. 
                6.  ☐      Entity publishes information on its website about its DEI commitments and efforts. 
                7.  ☐      Entity provides career advancement training/opportunities for employees, including members 
                of underrepresented communities. 
                8.  ☐      Entity collaborates with educational institutions, or is an educational institution, serving 
                significant or predominant student populations or affinity groups from underrepresented communities 
                (e.g., career fairs, scholarships, internships, apprenticeships). 
                9.  ☐      Entity has a supplier diversity policy that provides business opportunities to diverse suppliers, 
                including businesses owned by members of underrepresented communities, such as State-certified 
                Minority Business Enterprises (“MBEs”). 
                10. ☐      Entity publicizes its procurement opportunities to encourage participation from businesses 
                owned by members of underrepresented communities. 
                11. ☐      Entity measures percentage of contract dollars awarded to businesses owned by members of 
                underrepresented communities, including  MBEs.  
                12. ☐      Entity provides support and outreach to underrepresented communities and/or organizations 
                that represent underrepresented communities. 

      Only entities that meet at least 33% (4) of the Corporate Diversity Indicators above, by checking all the 
      applicable boxes, qualify to receive a State benefit. 

2024  Corporate Diversity Addendum                                                                                            1 

                                                             AFFIDAVIT  

               UNDER PENALTIES OF PERJURY,  I declare that I have examined this Corporate Diversity  
               Addendum, and to the best of my knowledge and belief, it is true, correct, and complete.  

               Entity/Business Name:  _________________________________________________________________  

               Federal Employer Identification Number (FEIN):  ____________________________________________  

               SDAT Identification Number: ____________________________________________________________ 

               Name of Entity’s representative completing this Affidavit (print clearly):  

               _____________________________________________________________________________________ 

               Title: ________________________________________________________________________________ 

               Signature _____________________________________________ Date___________________________ 

               Penalties for Submitting False Information. 
               If information provided by the entity in this form or by other means is materially false, the entity and the 
               individual providing the false information may be subject to criminal prosecution for perjury, 
               procurement fraud, and other crimes and may be subject to debarment, and all  State benefits or contracts 
               to the entity made in reliance upon the inaccurate form or other information may  be void or subject to 
               termination for default. See COMAR 24.01.07. 

               Submission Instructions.  
               Attach the completed Corporate Diversity Addendum to the Annual Report and mail to: Dept. of 
               Assessments and Taxation, P.O. Box 17052, Baltimore, MD 21297-1052. The Addendum must be 
               submitted with the Annual Report if its completion is required by your answers on the Annual Report. 
               Submitting the Addendum separately will result in significant processing delays to your Annual Report. 

               Additional Resources.  
               For questions specific to Maryland state agencies that grant state benefits, refer to the following list: 
               •  Office of Small, Minority  & Women Business Affairs:  info.gomdsmallbiz@maryland.gov 
               •   Maryland Department of Commerce:  taxincentives.commerce@maryland.gov 
               •   Maryland Department of General Services:  central.procurement@maryland.gov 
               •   Office of the Comptroller of Maryland: taxhelp@marylandtaxes.gov 

               For questions specific to submitting an Annual Report to SDAT, refer to the following list: 
               •   General Questions: 410-767-1330  | sdat.cscc@maryland.gov 
               •   Personal Property Return Questions: 410-767-1170 | sdat.persprop@maryland.gov 

202 4Corporate Diversity Addendum                                                                                            2