Form Abl-565 - Abl Renewal Form printable pdf download

STATE OF SOUTH CAROLINA

ABL-565

1350

DEPARTMENT OF REVENUE

(Rev. 11/21/13)

ABL RENEWAL FORM

4278

Renew and pay online. Go to

For Office Use Only

Mail to: SCDOR, ABL Section, Columbia, SC 29214-0907

File Number

**Renewal Fee

Renewal Due Date:

License Period Ending

License Type

1. Mailing Name and Address

Any change of address should be noted to the right of the old address.

2. A.

Owner/Corporate Name

Federal ID #

(If Liquor Producer Rep., indicate the company you represent)

Licensee

Social Security #

(If Sole Proprietor)

Retail Sales Tax License #

(REQUIRED)

3. Trade Name (If Applicable)

4. Business Address

Ownership Type

County

5. If there is a change in your location's address, check why: ( ) U.S. Postal Service changed address ( ) Moved location of

business ( ) Other - Explain:

6. Has there been a change in any principal(s), ownership, possession, or control since the date of issuance or last renewal?

Yes

If "yes", give details:

7. Have you, any partner, any principal, or any employee with day-to-day management responsibilities ever been convicted of a crime

or had a license to sell beer, wine, or alcoholic liquors revoked or suspended in this state or any other state?

Yes

If "yes", give details:

Review and sign this application. Return it with the appropriate renewal fee. If this application with the appropriate fee is not

received by the S.C. Department of Revenue prior to the expiration date shown above, you must pay a filing fee along with the

license fee. If your renewal is late, you may be required to file an application for a new license, publish a newspaper notice of your

application, and wait on a SLED investigation. You must cease all sales of beer, wine, or liquor upon the expiration of your

license, and may not resume sales until you receive your new license. Therefore, file your renewal application promptly.

*Note: For faster processing renew online. (See information sheet attached for instructions for online renewing

By signing this application, I certify that all the information listed above is correct.

(Signature of applicant)

Date

Telephone number from 8 am to 5 pm

**61-6-120B: An applicant for license renewal or for a new license at an existing location shall pay a five dollar

certification fee to determine if the exemptions provided for in subsection (A) apply. Subsection A refers to the

distance requirements for retail liquor stores, business liquor by the drink and nonprofit private club liquor by the

drink licenses.

42781021

Form Abl-565 - Abl Renewal Form

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