Form Abl-29 - Application For Business Local Option Permit
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1STATE OF SOUTH CAROLINA
ABL-29
DEPARTMENT OF REVENUE
APPLICATION FOR BUSINESS
(Rev. 7/3/03)
LOCAL OPTION PERMIT
4250
Mail to: SCDOR, ABL Section, Columbia, SC 29214-0908
For Office Use Only
Telephone: (803) 898-5864
DOR Website:
File Number
Period Covered
DLN
DLN
LOP
14-3970
SLED
34-3973-9200
Important Information: You may apply for this permit in person at the SC Department of Revenue, 301 Gervais St,
Columbia SC or at our Taxpayer Service Centers located in: Charleston - 3 Southpark Circle, Suite 202; Florence - 1452
West Evans St; Greenville - 211 Century Drive, Suite 210-B; Rock Hill - Business and Technology Center, 454 S
Anderson Rd, Suite 202. Taxpayer Service Centers will not accept mailed applications.
PLEASE TYPE OR PRINT:
1. Name
Title
2. Type of business
(
) Hotel/Motel
(
) Restaurant
3. Business name
4. Business address
Street number/name, box number, rural route
City
County
Zip Code
5. Federal ID Number
6. Retail License number
Telephone number
Date(s) permit being applied for:
MONTH/YEAR
SUNDAY DATE
FEES DUE
$
$
$
$
$
$
Total fees due for all dates
4
$
I certify by my signature below that a permanent minibottle license has been issued in my name at the
address shown in item four above. I understand if a violation of any alcoholic beverage laws or
regulations occurs during the period covered by the local option permit, that I and/or the organization
may be charged and if found guilty, that all permanent licenses/permits and unexpired local option
permits may be suspended or revoked and all permit fees forfeited. I further certify that the business
located at the address shown in item four above is in the city/county limits of
and that a local referendum has been passed authorizing the issuance of the local option permit applied
for.
Applicant
42501015
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