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FOR OFFICE USE ONLY

SOUTH CAROLINA DEPARTMENT OF REVENUE

1350

SID#

TAX REGISTRATION APPLICATION

W/H

SALES

INTERNET REGISTRATION: SCBOS.SC.GOV

SCDOR-111

USE

Please Print

Mail TO: SC DEPARTMENT OF REVENUE

(Rev. 11/22/13)

PARTNERSHIP

Use Blue or

REGISTRATION UNIT

8048

Black Ink

LICENSE TAX

COLUMBIA, SC 29214-0140

Section A: Taxes to be Registered for This Business Location - Make Checks Payable to SCDOR

Retail Sales/Accommodations License (Section B - $50 license tax is required)

Use Tax (Section B - No fee required)

Artist & Craftsman's License - Sells created or assembled products only at arts

Withholding Tax (Section C)

shows, crafts shows and festivals within SC (Section B - $20 license tax is required)

Nonresident Withholding Exemption (Section D)

1. Owner, Partnership, or Corporate Charter Name

2. FEIN

SSN

3. Mailing Address (for all correspondence)

4. Type of Ownership

Sole Proprietor (one owner)

In Care Of

Partnership (two or more owners, other than LLP)

LLC/LLP filing as:

Street

Corporation

Partnership

Single Member

South Carolina Corporation

City

State

ZIP

Date Incorporated

5. Business Phone Number

6. Daytime Phone Number

Foreign Corporation

State and Date Incorporated

7. Email Address

8. Fax Number

Other (explain)

9. Physical Location of Business (No P.O. Box)

10. Is Physical Location within Municipal Limits?

Required For All Tax Types

Yes

Which municipality?

(i.e. city/town)

Street

Are you an S.C. Resident?

Yes

City

County (Required)

State

ZIP

How long have you lived in S.C?

Section B: Retail Sales/Accommodations/Artist & Craftsman License/Use Tax

In and out-of-state sellers. A retail license will not be issued to a person with any outstanding state tax liability.

11. Purchaser's Certificate of Registration for Use Tax: Effective Date of Registration

mm/dd/yy

12. Is Your Business Seasonal?

Yes If yes, list months active:

No If no, filing status is monthly . See instructions for more information.

You must file a zero return for active periods with no sales.

13. How Many Retail Sales Locations Do You Operate in S.C. under Your Ownership?

14. Trade Name (Doing Business As)

15. Location of Records (No P.O. Box)

16. Main Business (i.e., Retail Sales, Manufacturing, Service, etc.)

17. Anticipated Date of First Retail Sales

mm/dd/yy

18. Type of Business

Agriculture, Forestry,

Max Tax (Vehicles) (44)

Professional, Scientific,

Health Care & Social

Fishing, & Hunting (11)

Retail Trade (44-45)

& Technical Services (54)

Assistance (62)

Mining (21)

Artists & Craftsman (45)

Management of Companies

Arts, Entertainment, &

Utilities (22)

Transportation &

& Enterprises(55)

Recreation (71)

Construction (23)

Warehouse (48-49)

Administrative & Support,

Accommodation & Food

Manufacturing (31-33)

Information (51)

Waste Management &

Services (72)

Wholesale Trade (42)

Finance & Insurance (52)

Remediation Services (56)

Other Services (81)

Durable Medical

Real Estate, Rental &

Education Services (61)

Public Administration (92)

Equipment (44)

Leasing (53)

19. Check If You Sell These Products

Motor Oil

Tires

Lead Acid Batteries

Large Appliances

Aviation Gasoline/Jet Fuel

Prepaid Wireless Cards

Service to Cellular and Personal Communications Users

Complete Page 2 of This Form to Apply for Withholding Tax

80481013

Form Scdor-111 - South Carolina Department Of Revenue Tax Registration Application - 2013

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