1350 STATE OF SOUTH CAROLINA ABL-20 DEPARTMENT OF REVENUE BEER, WINE & LIQUOR PROTEST FORM (Rev. 7/30/08) 4246 PERSON FILING THE PROTEST: Name: Home Address: City: State: Zip Code: Mailing Address: County: City: State: Zip Code: Phone No.: ( ) County: Fax No.: ( ) E-mail Address: If you do not live within the same county as the location that is being protested, do you live within five (5) miles of the location being protested: Yes No LOCATION BEING PROTESTED: Name of Applicant or Permit/License Holder: Location Being Protested: Address: City: State: Zip Code: County: Type of Permit or License Being Protested (Check All Appropriate Spaces): Beer and Wine Permit: New Location: Liquor by the Drink License: Beer, Wine or Liquor Wholesaler: Renewal: SPECIFIC REASONS WHY THE APPLICATION OR RENEWAL SHOULD BE DENIED (Attach Additional Pages if Needed): Note: Your protest must be received by the Department of Revenue NOT later than (1) 15 days from the date the proposed location was posted by SLED; or (2) The last date to protest as sworn in the Notice of Advertisement in the newspaper: whichever occurs the latest. 42461020 American LegalNet, Inc. www.FormsWorkFlow.com (REASONS CONTINUED) I, , will will not (Check Only One) attend a contested case hearing before the Administrative Law Court and offer testimony as to why I believe the location listed in this protest should not be issued a new beer and wine permit and/or liquor license or should not have its beer and wine permit and/or liquor license renewed. (See item 1 below.) Please note the following: (1) If the protest states that the protestant does not wish to attend a contested case hearing before the Administrative Law Court, then the protest is invalid and the department, by law, must continue to process the application and must issue the permit or license if all other statutory requirements are met. (2) If the protest is valid and states that the protestant wishes to attend a contested case hearing before the Administrative Law Court, then the department must determine, via letter, e-mail, fax or some other method, that the protestant does intend to attend the contested case hearing and offer testimony before the Administrative Law Court. (3) If the protestant advised the department of his or her intention to attend the contested case hearing before the Administrative Law Court, but does not attend the hearing, then such protestant may, by law, be assessed a fine or penalty to include court costs. (4) The protestant must either live in the same county as the location that is being protested or must live within five (5) miles of the location being protested. Under penalties of perjury, the information contained in this protest form is true and correct to the best of my knowledge. Signature of Person Protesting Permit/License Date Mail to: South Carolina Department of Revenue, Alcoholic Beverage Licensing, PO Box 125, Columbia, SC 29214-0907 NOTE: THE INFORMATION COLLECTED ON THIS FORM IS SUBJECT TO PUBLIC SCRUTINY AND RELEASE. 42462028 American LegalNet, Inc. www.FormsWorkFlow.com