Form Abl-569 - Beer And Wine Producers Authorization Of Wholesalers And Brands

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STATE OF SOUTH CAROLINA
STATE OF SOUTH CAROLINA
1350
1350
DEPARTMENT OF REVENUE
DEPARTMENT OF REVENUE
ABL-569
BEER AND WINE PRODUCERS
(Rev. 10/22/14)
4286
AUTHORIZATION OF WHOLESALERS AND BRANDS
Registered Producer/Importer
Name
Address
List South Carolina Alcohol License Number
Contact Person
Telephone No. (
)
INSTRUCTIONS:
List below the brands, alcoholic content and wholesalers along with their territories in South Carolina you intend to ship
into South Carolina. You must be either the American producer or the primary American source of supply in the United
States of the brand. ATTACH A COPY OF YOUR FEDERAL LABEL APPROVAL FOR EACH BRAND.
BEER MUST NOT CONTAIN MORE THAN FOURTEEN PERCENT ALCOHOL BY WEIGHT
WINE MUST NOT CONTAIN MORE THAN TWENTY-ONE PERCENT ALCOHOL BY VOLUME
Alcoholic
Country of Origin
Name Brand/Label
Size
Wholesaler
Content
(if imported)
%
You may only ship to a licensed South Carolina Wholesaler. Prior to shipment into the geographic boundaries of South
Carolina, the registered producer shall, by First Class, mail to the Department of Revenue a correct and complete invoice,
showing in detail the items in such shipment by quantity, type, brand and size and the point of origin and point of
destination.
42861021

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