Form Sctc-111 - Business Tax Application - 2000
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2SCTC-111
SOUTH CAROLINA DEPARTMENT OF REVENUE
FOR OFFICE USE ONLY
(Rev. 9/22/00)
BUSINESS TAX APPLICATION
SID# ___________________
8011
W/H ____________________
SALES __________________
SC DEPARTMENT OF REVENUE
USE ____________________
REGISTRATION UNIT
COLUMBIA, SOUTH CAROLINA 29214-0140
LICENSE TAX ____________
TELEPHONE (803) 898-5872
14-2601
TAXES TO BE REGISTERED FOR THIS BUSINESS LOCATION
WITHHOLDING (complete section A)
SALES (complete section C; $50.00 license tax is required)
Nonresident contract registration (
)
PURCHASER'S CERTIFICATE ( complete section D)
complete section B
COMPLETE BOTH SIDES OF THIS APPLICATION
PLEASE PRINT OR TYPE ALL INFORMATION
1. OWNER,PARTNERSHIP, OR CORPORATE CHARTER NAME
2. TRADE NAME (DOING BUSINESS AS)
3. PHYSICAL LOCATION OF BUSINESS REQUIRED (NO P.O. BOX)
4. BUSINESS PHONE NUMBER
DAYTIME PHONE NUMBER
5. FEDERAL IDENTIFICATION NUMBER
STREET
7. TYPE OF BUSINESS
CITY
COUNTY (REQUIRED)
STATE
ZIP
6. MAILING ADDRESS (FOR ALL CORRESPONDENCE)
BINGO
ACCOMMODATIONS
TOBACCO/CIGARETTE
RETAIL
MANUFACTURING
OTHER ____________
IN CARE OF
GOVT.
SERVICE
CONTRACT CONSTRUCTION
WHOLESALE
AGRICULTURE
HOUSEHOLD
STREET
8. MAIN BUSINESS (I.E., RETAIL FURNITURE SALES)
CITY
COUNTY
STATE
ZIP
9. LOCATION OF RECORDS (NO P.O. BOX)
8A. CHECK IF YOU SELL THESE PRODUCTS
(for solid waste purposes):
MOTOR OIL
LEAD ACID BATTERIES
TIRES
LARGE APPLIANCES
9A. NAME OF BANKING INSTITUTION USED
8B. DO YOU SELL AVIATION GASOLINE?
YES
NO
8C. DO YOU PROVIDE SERVICE TO CELLULAR AND
PERSONAL COMMUNICATIONS USERS?
10. TYPE OF OWNERSHIP
YES
NO
SOLE PROPRIETOR
LLC/LLP
(one owner)
UNINCORPORATED ASSOCIATION; ENTER LEGAL NAME.
PARTNERSHIP
SC CORPORATION DATE INC.
(two or more owners)
FOREIGN CORPORATION
(attach copy of articles or certificate of authority).
OTHER (EXPLAIN)
11. NAME(S) OF BUSINESS OWNER, GENERAL PARTNERS, OR OFFICERS:
IF PARTNER
SOCIAL SECURITY NUMBER
NAME/TITLE/GENERAL PARTNERS
HOME ADDRESS
PERCENT OWNED
ARE YOU A SC RESIDENT? (Y/N) ______________
HOW LONG HAVE YOU LIVED IN SC? ______________ (YEARS, MONTHS)
12. DID YOU BUY THIS BUSINESS FROM SOMEONE IN S.C. ?
YES
NO
IF YES, ENTER DATE OF PURCHASE
NAME OF PREVIOUS OWNER
PRESENT ADDRESS
STREET
S.C.E.S.C. ACCOUNT NUMBER
CITY
STATE
ZIP
S.C. TAX ACCOUNT NUMBER
IS THE OWNER COMPLETELY
DID YOU CONTINUE WITHOUT INTERRUPTION 95%
OUT OF BUSINESS IN S.C.?
YES
NO
OF THE PREDECESSOR'S BUSINESS?
YES
NO
13. FIRST DATE OF EMPLOYMENT IN S.C.
14.
15. ESTIMATE NUMBER OF EMPLOYEES IN S.C.
ANTICIPATED DATE OF FIRST S.C.PAYROLL
mo/day/year
mo/day/year
16. IS BUSINESS WITHIN SC MUNICIPAL LIMITS?
17. IS YOUR BUSINESS SEASONAL?
YES
NO
WHICH CITY? ________________________
YES
NO
IF YES, LIST MONTHS ACTIVE.
COMPLETE REVERSE SIDE OF THIS FORM
I CERTIFY THAT ALL INFORMATION ON THIS APPLICATION, INCLUDING ANY ATTACHMENTS, IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
SIGNATURE OF OWNER, ALL PARTNERS, OR CORPORATE OFFICER
TITLE
DATE
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