Form Abl 902c - Abl 902 Checklist (Page 3 of 11) in pdf

DESIGNATED AGENT

You must designate a person to receive all notices from the Department of Revenue concerning your permit/license. These

notices will be sent to the person at the mailing address shown in question 3. It is your responsibility to keep the department

advised of any change regarding this person or your mailing address as the law will presume you received all notices sent to the

address you have given us.

Name of Designated Agent:

CONTACT PERSON

The S.C. State Law Enforcement Division will conduct an investigation on this application, and will need to meet with the contact

person at the location for which you are seeking a permit or license, to discuss the business and ownership of the business. Give

the name and telephone numbers (daytime and evening) of the contact person who can meet with the SLED agent for this purpose.

Name of Contact Person

(daytime)

Telephone Number

(evening)

If the agent is unable to contact the Contact Person or if the Contact Person cannot discuss the ownership of the business, your

application will be delayed.

Processing of this application may take six to eight weeks, or more. If the application is denied by the Department or

protested by a member of the public or law enforcement, it could take up to six months or more for a hearing to be held and a

decision made on the application by the Administrative Law Court.

If applying for an off-premises beer and wine permit, wholesale beer and wine permit, or 7-day beer and wine permit, I do

hereby stipulate that I will not permit the on-premise consumption of beer and wine on the licensed premises. I understand

that a violation of this stipulation will be a violation against the permit and shall constitute sufficient grounds to suspend or

revoke the beer and wine permit. Nothing herein shall be construed so as to prevent or prohibit "Tastings" in accordance

with and as specifically permitted by S.C. Code Ann. Section 61-4-960.

I understand that a misstatement or concealment of fact in an application is sufficient grounds for the revocation of the license or

permit. I consent to the inspection of the premises covered by this license or permit by any agent of the SC Department of Revenue or

any law enforcement officer.

I have read the instructions to this application and to the best of my knowledge, all information provided with this application is true and

accurate.

SWORN to and subscribed before me this

day of

, year of

Notary Public for

Applicant (owner, partner, or corporate officer)

My Commission Expires:

Notary (L.S.)

Notary (printed name)

Social Security Privacy Act Disclosure

It is mandatory that you provide your social security number on this tax form. 42 U.S.C 405(c)(2)(C)(i) permits a state to use an individual's social

security number as means of identification in administration of any tax. SC Regulation 117-201 mandates that any person required to make a return to

the SC Department of Revenue shall provide identifying numbers, as prescribed, for securing proper identification. Your social security number is used

for identification purposes.

43092022

Form Abl 902c - Abl 902 Checklist Page 3

Related Articles

Related forms

Related Categories