I,____________________________________________________
________________________________
(Name of individual applying)
Title
of the firm of_________________________________________________________________________________
hereby certify that the information contained in this application and the attached Registration of Beer and Wine form
and Authorization of Wholesalers is true and correct to the best of my knowledge and belief. The Department of
Revenue and Taxation shall have the right within the Statutory limitations to audit and examine the books and records,
papers and memoranda of this form with respect to the administration and enforcement of laws administered by the
SC Department of Revenue and the South Carolina Law Enforcement Division.
_________________________________________
Signature of individual applying
IMPORTANT INFORMATION:
1.
A fee of $200.00 must accompany this application.
2.
Application must be completely filled out and all questions answered before any permit will be issued.
3.
Invoices must be filed with the SC Department of Revenue prior to any shipment into South Carolina.
4.
Monthly reporting forms can be obtained from the SC Department of Revenue upon issuance of your Permit
of Registration.
5.
Monthly reports of shipments must be received by the SC Department of Revenue at 301 Gervais Street,
PO Box 125, Columbia, SC 29214 by the 10th of the following month.
6.
A negative report must be filed with the SC Department of Revenue at 301 Gervais St., PO Box 125,Columbia,
SC 29201, if no shipments are made into South Carolina during the month.
7.
Failure to file proper monthly reports of shipments into South Carolina could result in cancellation of your
Permit of Registration and your product will be treated as contraband.
8.
Permit holders must notify the SC Department of Revenue office of any changes, such as: new brand, new
wholesalers or withdrawals of brands or wholesalers.
9.
A beer must not contain more than five (5%) percent of alcohol by weight.
10.
A wine must not contain more than twenty-one (21%) of alcohol by volume.
ABL 500 (10/96)