Form C-245 - Protest Pursuant To Revenue Procedures Act
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1
2STATE OF SOUTH CAROLINA
1350
1350
DEPARTMENT OF REVENUE
C-245
Protest Pursuant to Revenue Procedures Act
(Rev. 10/10/07)
S S
S.C. Code Ann.
12-60-10, et seq.
6177
Section I:
Taxpayer Identification
Taxpayer Name (s):
(Please type or print)
Address:
City:
State:
Zip Code:
Telephone:
Period (s) Covered:
Type (s) of Tax (es) or matter. Check all that apply:
Corporate Income Tax
Deed Recording Fee
Employer Withholding Tax
Individual Income Tax
Liquor by the Drink Tax
Motor Fuel Tax
Partnership Income Tax
Regulatory Violation
Sales and Use Tax
Other (Specify)__________________________
Identification Number (Social Security Number, License Number, File Number, etc.):
Section II:
Department of Revenue Document to be Attached
Please attach a copy of the Department of Revenue document or notice you received which led to the filing of this protest.
Section III:
Reason for Protest
State all the reasons you disagree, including a statement of facts supporting your position and the law or other authority
upon which you rely. (If the amount of proposed assessment is less than $2,500 you need not provide your legal authority
unless you are a partnership, "S" corporation, an exempt organization or an employee plan and the proposed tax is
imposed by Chapters 6, 11, or 13 of Title 12.) The law or other authority supporting your position must be furnished on all
regulatory violations. Add additional sheets if necessary.
(over)
61771028
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