Form Sctc 111 - Business Tax Application With Instructions Page 4

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ITEM 15 - Enter estimated number of employees working in SC.
ITEM 16 - Check appropriate block to indicate if business is located within SC municipal limits. Enter name of city.
ITEM 17 - Indicate if your business is seasonal and enter which months the business is active.
SIGNATURE - Application must be signed by owner, all partners, or corporate officer. IF THE SIGNATURE(S) IS
OMITTED, THE APPLICATION WILL BE REJECTED. Attach additional sheets for signatures, if
necessary.
SECTION A:
WITHHOLDING
Check appropriate block to indicate separate returns for each location or consolidated returns for all
locations.
Check appropriate block for status and classification of employer.
SECTION B:
NONRESIDENT/CONTRACT WITHHOLDING EXEMPTION
SC statutes require state income tax to be withheld from payments on contracts in excess of $10,000
made to nonresidents. Nonresidents who have no activity and no employees in South Carolina are
granted exemption from statute requirements by completing Section B of the application (SCTC-111).
Provide a completed form I-312 (Affidavit of Registration) to the withholding agent with whom you are
contracting. Form I-312 is not furnished to the South Carolina Department of Revenue.
SECTION C:
RETAIL SALES LICENSE
Retailers selling in/into this state are required to have a South Carolina Retail Sales Tax License.
License tax in the amount of $50.00 is required. APPLICATION WILL BE REJECTED IF THE LICENSE
TAX IS NOT ENCLOSED.
Check appropriate block for in-state or out-of-state seller.
Enter the anticipated date retail sales will begin (open date). APPLICATION WILL BE REJECTED IF
THE DATE IS OMITTED.
Enter the number of retail sales locations in SC under your ownership.
SECTION D:
PURCHASER'S CERTIFICATE OF REGISTRATION FOR USE TAX
Enter effective date of registration (open date).
SECTION E:
Enter mailing address if different from front of application.
Enter account number(s) in the space provided if currently or previously registered with SC Department
of Revenue under this ownership.
Enter the name of the Financial institution (Bank, Credit Union ...) used by the Business.
Enter your Internet/E-mail address.

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