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STATE OF SOUTH CAROLINA
1350
1350
1350
1350
DEPARTMENT OF REVENUE
C-530
(Rev. 3/31/14)
REQUEST FOR PENALTY WAIVER
6406
Use this form to request a penalty waiver. If you have any questions concerning this matter, please call the telephone
number on the notice or document on which this request is based. Please return this document to the SCDOR address
shown on the notice or document.
Section I:
Taxpayer Identification
Taxpayer Name(s):
(type or print)
Mailing Address:
City:
State:
Zip Code:
Telephone:
Period(s) Covered:
Type(s) of Tax(es) or matter. Check all that apply:
Corporate Income Tax
Employer Withholding Tax
Individual Income Tax
Liquor by the Drink Tax
Motor Fuel Tax
Partnership Income Tax
Regulatory Violation
Sales and Use Tax
Tobacco Tax
Other (Specify)
Identification Number (Social Security Number, License Number, File Number, etc.):
Section II:
Reason for Penalty Waiver Request
Explain the reason for your waiver. Explain in detail why you are requesting a penalty waiver with the SCDOR and why
the issue(s) listed above should be decided in your favor. State the facts on which you base your request. Provide, if
known, the law, rules, or cases in support of your arguments. Please be careful not to simply state the “assessment is too
high” or the “assessment is wrong,” but, provide specific reasons for your belief. Include any documentation that you
believe supports your Penalty Waiver Request. Attach additional pages if necessary.
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