Form Abl-946 - Applicant And Principal Consent And Waiver printable pdf download

1350

STATE OF SOUTH CAROLINA

ABL-946

DEPARTMENT OF REVENUE

(Rev. 1/28/14)

APPLICANT AND PRINCIPAL CONSENT AND WAIVER

4407

SC Code Ann. Section 61-2-160 prohibits the issuance of any permit or license under Title 61 unless the South Carolina Department of

Revenue determines that the applicant does not owe the State of South Carolina any delinquent taxes, penalties, or interest. If an

application is made for a license or permit by a person other than an individual, all principals of such applicant are deemed to be the

applicant. S.C. Code Ann. Section 61-2-100(C).

For purposes of processing this application or any renewals of permits or licenses issued under Title 61, the undersigned applicant or

principal authorizes the Department of Revenue to release to any party, person or entity, information concerning the applicant’s or

principal’s South Carolina taxes. The information that may be released includes, but is not limited to, information relating to delinquent

taxes, penalties and interest, outstanding liabilities, or information concerning failure to file returns. For purposes of processing this

application and any renewals, the applicant or principal waives the provisions of Sections 12-54-240 and 30-2-10, et seq.

Further, the applicant or principal authorizes S.C. Law Enforcement Division (SLED) to check, examine and release to the Department

of Revenue the criminal history record of the applicant or principal and further authorizes the Department of Revenue to share that

information with other principals or applicants for purposes of processing the application or any renewal.

This Consent and Waiver shall be effective as of the date set forth below and shall remain in effect until revoked in writing by

the applicant or a principal signing this Consent and Waiver or until the applicable permit or license is terminated or revoked.

Notwithstanding any other provisions, the Department of Revenue can require a new Consent and Waiver any time it deems

necessary.

SOCIAL SECURITY DISCLOSURE

In compliance with the Federal Privacy Act of 1974, the disclosure of an individual’s social security number on this form is mandatory.

SC regulation 117-201 provides that any person required to make a return, statement or document to the Department must include

identifying numbers on such return, statement or document if the Department requests such information. Social security numbers are

primarily used for the purposes of identifying taxpayers and monitoring tax compliance and/or fraud.

1 - 12 is a list of principal types. Each principal type must complete and sign a box below.

Principal Types:

1. The owner (if sole proprietorship);

2. All officers of the business or entity which owns the business;

3. All partners (limited partners that cannot exercise management control need not sign);

4. All persons who own twenty-five percent (25%) or more of the value of the business entity;

5. All persons who own twenty-five percent (25%) or more of the combined voting power of the business or entity;

6. A manager of a limited liability company which is managed by managers;

7. A member of the limited liability company which is not managed by managers;

8. Any fiduciary who manages, controls title, or is otherwise in control of the business;

9. All employees who will have day-to-day operational management responsibility for the business or entity; and,

10. If a publicly traded corporation, the designated license holder (designated agent) (must be over 21 and a resident of S.C.).

11. All other principals must be listed also. If not a publicly traded corporation, list all stockholders.

12. If a nonprofit organization, list all officers and directors of the organization.

* CONTINUED ON THE NEXT PAGE. ALL PAGES MUST BE INCLUDED TO BE VALID.*

**ALL PRINCIPALS MUST SIGN IN THE PRESENCE OF A NOTARY**

***IF A REQUIRED PRINCIPAL DOES NOT SIGN, THIS APPLICATION WILL BE DENIED***

Additional Space on Back.

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Form Abl-946 - Applicant And Principal Consent And Waiver

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