DNR Form 158-A "Application for Refund" - Maryland

What Is DNR Form 158-A?

This is a legal form that was released by the Maryland Department of Natural Resources - a government authority operating within Maryland. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2020;
  • The latest edition provided by the Maryland Department of Natural Resources;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of DNR Form 158-A by clicking the link below or browse more documents and templates provided by the Maryland Department of Natural Resources.

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Download DNR Form 158-A "Application for Refund" - Maryland

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MARYLAND DEPARTMENT OF NATURAL RESOURCES
LICENSING AND REGISTRATION SERVICE
APPLICATION FOR REFUND
PLEASE PRINT IN INK – FOR COMPLETE INSTRUCTIONS SEE REVERSE
_______________________
DNR ID#
First Name
Middle Name
Last Name
Social Security or Federal
Identification Number
(Required)
Mailing Address
Daytime Telephone No.
$
________________________________________________________________________________________
City
State
Zip Code
Total Refund Requested
PCA _____________ Source ____________ Amt. ______________
PCA _____________ Source ____________ Amt. ____________
PCA _____________ Source ____________ Amt. ______________
PCA _____________ Source ____________ Amt. ____________
Refund is hereby requested for: (check one)
Refund Amount
I. BOATING
Indicate vessel number
______________________________
.
A
The cost of an unused set of decals returned within 30 days of purchase (decals and
registration card must be returned with this application).
______________
B. The cost of a single set of decals returned in the first calendar year of the vessel’s
2-year registration (decals and registration card must be returned with this application)
NOTE: Only the second year’s registration fee will be refunded.
C. Waiver of penalty $__________________ and/or interest $____________________
______________
D
____________________________________________
. Other: Explanation
______________
___________________
II. COMMERCIAL FISHING
Waterman ID #
____________________________________________________
Explanation
______________
III. OTHER
Explanation ___________________________________________________________
______________
I/We certify, under penalty of perjury, that the statements made herein are true and correct to the best of my/our
knowledge, information and belief.
______________________________________________________________________________________
Applicant’s Signature
Date
Approved By: ____________________________________________
_________________________________________________
Supervisor
Date
Fiscal Officer
Date
DNR 158-A (11/20)
MARYLAND DEPARTMENT OF NATURAL RESOURCES
LICENSING AND REGISTRATION SERVICE
APPLICATION FOR REFUND
PLEASE PRINT IN INK – FOR COMPLETE INSTRUCTIONS SEE REVERSE
_______________________
DNR ID#
First Name
Middle Name
Last Name
Social Security or Federal
Identification Number
(Required)
Mailing Address
Daytime Telephone No.
$
________________________________________________________________________________________
City
State
Zip Code
Total Refund Requested
PCA _____________ Source ____________ Amt. ______________
PCA _____________ Source ____________ Amt. ____________
PCA _____________ Source ____________ Amt. ______________
PCA _____________ Source ____________ Amt. ____________
Refund is hereby requested for: (check one)
Refund Amount
I. BOATING
Indicate vessel number
______________________________
.
A
The cost of an unused set of decals returned within 30 days of purchase (decals and
registration card must be returned with this application).
______________
B. The cost of a single set of decals returned in the first calendar year of the vessel’s
2-year registration (decals and registration card must be returned with this application)
NOTE: Only the second year’s registration fee will be refunded.
C. Waiver of penalty $__________________ and/or interest $____________________
______________
D
____________________________________________
. Other: Explanation
______________
___________________
II. COMMERCIAL FISHING
Waterman ID #
____________________________________________________
Explanation
______________
III. OTHER
Explanation ___________________________________________________________
______________
I/We certify, under penalty of perjury, that the statements made herein are true and correct to the best of my/our
knowledge, information and belief.
______________________________________________________________________________________
Applicant’s Signature
Date
Approved By: ____________________________________________
_________________________________________________
Supervisor
Date
Fiscal Officer
Date
DNR 158-A (11/20)
INSTRUCTIONS FOR COMPLETING APPLICATION
The refund application must be completed in full. Please follow the steps outlined below.
Step 1: Please print DNR ID#, name and address clearly. Your refund will be mailed to the address indicated on
this application.
Step 2: Your Social Security or Federal Identification Number is required by the Comptroller of the Treasury to
obtain a refund.
Step 3: Check the appropriate box indicating the type of refund requested and submit the required information.
I. BOATING – Indicate vessel number for which you are requesting a refund.
A. For a refund of the cost of an unused set of decals returned to the Department within 30 days of
purchase, submit the set of unused decals and registration card with the completed application.
B. For a refund of the cost of a single set of decals returned in the first calendar year of the vessel’s 2-year
registration, submit the set of decals (removed from the vessel) and registration card with the completed
application. Note: Only the second year’s registration fee will be refunded.
C. Waiver of penalty and/or interest. Submit a completed application, and provide an explanation for the
refund request.
D. Boating transactions other than registration and penalty and interest waivers. Submit a completed
application, and provide an explanation for the refund request.
II. and III. COMMERCIAL FISHING or OTHER
A. Submit a completed application, and provide an explanation for the refund request.
PLEASE NOTE: ALL ONLINE FISHING & HUNTING LICENSE SALES ARE FINAL UPON
PURCHASE AND NOT AVAILABLE FOR REFUND
YOUR APPLICATION MAY BE FORWARDED TO ANY OF THE FOLLOWING
DNR LICENSING & REGISTRATION SERVICE CENTERS
Business Hours: 8:30 am to 4:30 pm Monday – Friday (except state holidays)
Annapolis Service Center
Essex Service Center
Bel Air Service Center
Centreville Service Center
160 Harry S Truman Pkwy.
1338 Eastern Blvd. A
501 West MacPhail Rd. #2
120 Broadway Ave. #5
P.O. Box 1869
Essex, MD 21221
Bel Air, MD 21014
Centreville, MD 21617
Annapolis, MD 21404
667-401-0760
410-836-4550
410-819-4100
410-260-3220
1-866-535-8319 (Toll Free in MD)
1-866-623-3187 (Toll Free in MD)
1-866-439-1708 (Toll Free in MD)
1-866-344-8889 (Toll Free in MD)
(No Mail. Open: M/W/F)
Salisbury Service Center
Cumberland Service Center
Solomons Service Center
Frederick Service Center
251 Tilghman Rd Rm #2
13300 Winchester Rd. SW
PO Box 1309
1601-A Bowmans Farm Rd.
Salisbury, MD 21804
Cumberland, MD 21502
14175 Solomons Island Rd. S
Frederick, MD 21701
410-713-3840
301-777-2134
Solomons, MD 20688
240-236-9950
1-866-812-1678 (Toll Free in MD)
(No Mail. Open: Tues/Thurs)
410-535-3382
1-866-679-0906 (Toll Free in MD)
Credit card only at this location
1-866-688-3823 (Toll Free in MD)
DNR 158A back (11/20)
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