Free Ceremonial Pen Request Form - Maryland

Ceremonial Pen Request Form
Office of the Secretary of State, State House, Annapolis, Maryland 21401 Ceremonial pens, used to sign bills during the 2009 General Assembly, are available through the Office of the Secretary of State for a fee of $10.00 each. Please provide information for each recipient using the form below (copy the form as many times as necessary). Multiple bills will not be printed individually on one card. Each bill will be printed individually on a card and charged individually. Send the form and fee to Pen Request, Office of the Secretary of State, State House, Annapolis, MD 21401. Make checks payable to the "Office of the Secretary of State."

Use the "Tab" key to move to the next line in the form when filling the form out online.

One recipient per form. Please print. Pen Recipient's Name: Requestor's Name: Mailing Address:

Bill Number:

Chapter Number:

For SOS Use Only

Print Form