STATE OF MARYLAND
Department of Labor, Licensing and Regulation
Secondhand Precious Metal Object Dealers / Pawnbrokers
500 N. Calvert St., Room 304
Baltimore, Maryland 21202-3651
(410) 230-6222 (Baltimore area), or (888) 218-5925 (Toll Free)

Application To Transfer License to a New Business Location

SECTION 1. INSTRUCTIONS FOR APPLICANTS
1. The dealer / pawnbroker must complete this form. All information must be typewritten or clearly printed in ink. Incomplete forms will not be accepted. Mail the completed form and all other required documents to the above address.
2. You must submit an approved Use and Occupancy Permit from the local zoning board
3. If you are also changing your business name you must file a separate "Application to Change Business Name" with the Secretary of the Department.
4. You may not conduct business under your license at the new location until you receive written approval of the change of location from the Secretary of the Department of Labor, Licensing and Regulation.

SECTION 2. DEALER'S INFORMATION
Dealer's Name (Last, First, M.I.):
 
Home Address:
 
City, State, Zip: 
Registration Number:     Social Security No.: 
Home Telephone No.:     E-mail Address: 

SECTION 3. CURRENT BUSINESS LOCATION INFORMATION
Business Name:
 
Current Business Address:
 
City, State, Zip: 
County:     Bus. Telephone No.: 
E-mail: 

SECTION 4. NEW BUSINESS LOCATION
I hereby request the Secretary of the Department of Labor Licensing and Regulation for permission to change the place of business for which my licensee has been issued to the following location:
Address:
 
City, State, Zip:
 
County:   Federal Tax Number: 
Bus. Telephone No.:   E-mail: 
Check one of the following options:
  The business will be operated under the current name indicated on my license.
  The business will be operated under a new name and I have applied / am applying for permission from the Secretary of the Department to rename my business.

SECTION 5. STORAGE INFORMATION
Address at which precious metals or gems will be stored, if different from business address. Note: Items must be stored in same county or city, if Baltimore City, where license is held per Section 12-305(a) Business Regulation Article Annotated Code of Maryland.

Address:
 
City, State, Zip:
 
County:     Bus. Telephone No.: 

SECTION 6. NAMES OF EMPLOYEES TO BE EMPLOYED AT NEW LOCATION

The following employees will be employed by me at the new location indicated above to engage in the buying or selling, or supervising the buying or selling of secondhand precious metal objects or pawn transactions:
1. Name: SSN:
2. Name: SSN:
3. Name: SSN:
4. Name: SSN:
5. Name: SSN:

Please note that you must submit the "Dealers Report of Employee Form" for each employee listed above who has not been previously reported to the Department and approved to engage in or supervise secondhand precious metal object or pawn transactions.

SECTION 7. QUESTIONS AND CERTIFICATIONS
Since receiving your last license (circle the correct answers):
1. Have you ever been convicted of a felony or misdemeanor in any State or Federal court? Yes No
2. Have you ever had this type of license denied, suspended, or revoked by Maryland or any other State? Yes No
3. Have you been convicted of or received probation before judgement of any drug offense committed after January 1,1991? Yes No

    If you have answered yes to any of the above questions, you must submit the following:

    • A typed letter giving a complete explanation of the incident(s)
    • A true test copy of the applicable court document(s)
    • A copy of the final order in your case(s)

    Please mail these documents to the above address.

    APPLICANT'S AFFIDAVIT

    I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION CONTAINED HEREIN IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE, INFORMATION AND BELIEF. I further authorize the release of any information contained within this application to an authorized representative of the Department of Licensing and Regulation for further investigation. I further certify that I have paid all undisputed taxes and unemployment insurance contributions payable to the Comptroller or the Department of Labor, Licensing and Regulation or have provided for payment in a manner satisfactory to the unit responsible for collection.
    Signature of Applicant    

    Date Signed



    FOR OFFICE USE ONLY
    Date Received:
    APPROVED BY:
       Date
    DENIED BY:
       Date
    REASON FOR DENIAL: