Form Abl 230 - Application For Change Of Person Designated To Hold A License Or Permit

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Alcoholic Beverage Licensing
301 Gervais St.,Columbia, SC 29214
Application for change of person designated to hold a license or permit
Current license numbers: B/W________________
S/C________________ Retail Liquor______________
IMPORTANT: Under S.C. Code Ann. Section 61-3-425 (Supp.1993), we may not issue a license and/or permit if you have an outstand ing
tax liability with the SC Department of Revenue or the Internal Revenue Service.
Corporate name_________________________________________
Trade name_______________________________________
Licensed location address________________________________________________________________________________________
(street name/number/route/box)
Name of new officer____________________________________________________________________________________________
(title of officer)
New officer's home address (do not list a PO Box)____________________________________________________________________
(street name/number/route/box)
________________________________________________________________________ Daytime telephone #________________________
(zip code)
Business mailing address (include zip code)______________________________________________________________________________
Social security number_____________________________Date of birth__________________________Race______
Within the past ten years, have you been convicted of a crime that carried a maximum sentence of two years or more? (
)yes ( )No.
Answer "yes" if you were charged and convicted of a crime for which you could have been sentenced to two years or more, even though your
actual sentence was less than two years or you received probation. If "yes" give details on the reverse side of this form.
Have you ever had suspended or revoked any type of alcohol license issued by this department? ( )Yes ( )No. If "yes", give details
on the reverse side of this form.
On what date did you establish your residency in South Carolina?______________________(Must be at least 30 days prior to application).
For retail liquor and sale and consumption requests, submit with this form: a Rider from the bonding company that issued the bond that
is currrently filed with the SC Department of Revenue, showing the new designated person to hold the license/permit.
10. Has there been a change of ownership, possession or control of this business or of the corporation since the original license or permit was
)Yes (
)No. If "yes", give details on the reverse side of this form.
11. How many retail liquor licenses are currently in your name and/or the corporate name________.
12. Enclose the corporate minutes electing you an officer of the corporation, or a statement from the chief executive officer designating
you as the person to hold the license/permit. This application cannot be processed without this information.
13. A records check obtained from the SLED Criminal Justice Information Center must accompany this application. You may obtain
a records check in person at SLED, 4400 Broad River Rd., Columbia, SC between the hours of 8:30 a.m. and 5:00 p.m., or you may obtain
a records check by mail. Forward your request to SLED, PO Box 21398, Columbia, SC 29221-1398, ATTN: Criminal Records Dept.
You must enclose a self-addressed stamped envelope and furnish your full name, social security number and date of birth . Record checks
require a $25.00 fee payable by money order or business check made out to SLED - NO PERSONAL CHECKS ARE ACCEPTED. We
will not accept this form without a SLED records check attached. IT WILL BE RETURNED TO YOU.
Under penalty of perjury, I do hereby attest, that by my signature below, the answers given on this application are true and that I have not falsified
any information. I consent to the search of the premises, covered by the license and/or permit, to any SLED agent, law enforcement agent or
agent of the SC Department of Revenue. If you fail to answer any question on this application, it will be returned to you.
Signature of responsible person
ABL 230 Rev 10/24/96


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Parent category: Financial