Application For Annual Business License Form - Hobby County Business License Department
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3HORRY COUNTY BUSINESS LICENSE DEPARTMENT
ID# __________________
Post Office Box 1275, Conway, South Carolina 29528
Telephone (843) 915-5620 Fax (843) 915-6220
Keyed By: ____________
APPLICATION FOR ANNUAL BUSINESS LICENSE
SIC / Rate: ________/___
Business License Will Be Issued/Mailed Subject To Approval
FOR OFFICE USE
DBA NAME OF BUSINESS:
□
□
Corporation
LLC
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□
Single Owner
Co-Partnership
MAILING ADDRESS:
BUSINESS PHONE #:
CELL #:
FAX #:
PHYSICAL ADDRESS OF BUSINESS:
TYPE OF BUSINESS:
FEDERAL ID#:
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RESIDENT BUSINESS
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NON-RESIDENT BUSINESS
S.C. RETAIL LIC. #:
(OUTSIDE OF HORRY COUNTY)
OWNER NAME:
SOCIAL SECURITY #:
LAST,
FIRST
MIDDLE INITIAL
OWNER NAME:
SOCIAL SECURITY #:
LAST,
FIRST
MIDDLE INITIAL
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NAME OF PREVIOUS OWNER AND BUSINESS NAME:
DID YOU TAKE OVER AN EXISTING BUSINESS?
YES
NO
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__________________________________
IS BUSINESS LOCATED IN CITY LIMITS
IF YES, WHICH ONE?
:
YES
NO
START DATE OF BUSINESS IN HORRY COUNTY: _____________________
CORPORATION NAME: __________________________________________
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TAX MAP # WHERE BUSINESS IS LOCATED:___________________________
OPERATED FROM HOME?
YES
NO
CONTRACTORS MUST COMPLETE THIS SECTION
PYROTECHNIC (FIREWORKS) LICENSE #: ________________
BINGO HALLS- SC STATE LICENSE #: ____________________
SC STATE CONTRACTOR LIC #: ______________________
HOSPITALITY ACCOUNT #: _______________________________
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REPORTED GROSS INCOME ESTIMATED THRU APRIL 30
FEE CALCULATION
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REPORTED GROSS INCOME PER JOB (NON-RESIDENTS ONLY)
(a) GROSS INCOME:
$ _________________________
JOB SITE ADDRESS:
(SEE BACK)
(b) MINUS: EXEMPT INCOME: $ __________________________
_________________________________________________________________
(SEE BACK)
(c) TOTAL GROSS
$ __________________________
AMUSEMENT MACHINES Coin Operated
CALCULATED LICENSE FEE
$ __________________________
(SEE BACK FOR FEES)
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AMUSEMENT /BILLIARD-POOL TABLE FEE $ _____________
OWNER OF MACHINES
YES
NO
# OF MACHINES ____________
TOTAL OF LICENSE FEES
$ _________________________
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BUSINESS WHERE MACHINES ARE LOCATED
YES
NO
PENALTY
$ _________________________
GROSS INCOME ________________
FEE DUE $ ___________________
(5% FOR EACH MONTH LATE MAX 30%)
***********************************************************************************
TOTAL LICENSE FEE DUE
$ _________________________
OWNER OF BILLIARDS OR POOL TABLES
(SEE BACK FOR FEES)
NUMBER OF TABLES __________
-PAYMENT MUST ACCOMPANY APPLICATION –
GROSS INCOME________________
FEE DUE $ ___________________
************************************************************************************************************************************************************
I certify under oath that the information given in this license application is true, that the gross income is accurately reported, or
estimated for a new business, without any unauthorized deductions, and that all assessments, fees, licenses, property taxes, and any
other charges due and payable to the County have been paid.
I have obtained County permits and am in compliance with all
regulatory codes of Horry County. I understand the County ordinance provides for penalty and license revocation for making false or
fraudulent statements on this application.
________________________
_________________________
_________________
__________
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Parent category: Business