Form Abl 500 - South Carolina Producer Of Beer And Wine Registration Application
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5SOUTH CAROLINA DEPARTMENT OF REVENUE
Alcoholic Beverage Licensing
301 Gervais St., PO Box 125
Columbia, South Carolina 29214
Telephone (803) 734-0470
South Carolina Producer of Beer and Wine Registration Application
License Year Ending August 31_____
General Information:
The South Carolina statute defines the word "producer" as a brewery, winery, manufacturer, bottler or an importer into
the United States of beer or wine or both.
Applicant Information:
Business or Corporate Name:_____________________________________________________________________
Trade Name (if applicable)_______________________________________________________________________
Check one: (
)Individual proprietorship (
)Partnership
(
)Corporation
If a corporation, under the laws of what State:_____________________________________________
Check one: (
)Brewery
(
)Winery
Importer: (
)Wine (
)Beer
If an importer, list Federal Importer Permit Number______________________________
NOTE: Only products manufactured and/or imported into the United States exclusively by your company can
be shipped into South Carolina to wholesalers licensed by the State of South Carolina.
Business address of Producer_______________________________________________________________________
_____________________________________________________________________________________________
Mailing address (if different from above):__________________________________________________________
_____________________________________________________________________________________________
Telephone number: (
)______________________________ F.E.I. Number_________________________
Name of individual applying on behalf of Producer___________________________________________________
Individual's title__________________________________
Date permit issued____________________
ABL 500 (Rev. 10/96)
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