1350 STATE OF SOUTH CAROLINA DEPARTMENT OF REVENUE ABL-901C (Rev. 12/31/08) 4368 ABL-901 CHECKLIST For your application to be processed you must fulfill ALL of the following requirements: 1. Completed application, signed, dated and notarized. 2. Submit nonrefundable filing fees. LICENSE FEES SHOULD NOT BE SUBMITTED UNTIL LICENSE IS APPROVED. 3. Submit an Affidavit of Publication from the newspaper running your ad. The affidavit must include a copy of your ad. If you have just started your ad in the newspaper and have not received the ad and affidavit, you must include the receipt from the newspaper with your application. Forward the ad and affidavit from the newspaper as soon as the newspaper provides it to you. Your license/permit cannot be issued until this is received. Must have a current Ad, not more than 90 days old from last publication date. (See ABL 901 Instructions, page 3, for list of approved newspapers for your location.) 4. Must complete the "Consent and Waiver" of the application. 5. Must attach a copy of Articles of Incorporation, if applying as a corporation. 6. Must attach a copy of Articles of Organization, and Operating Agreement, or LLC Supplemental Information Form (this form is located at www.sctax.org, Form #919), if applying as a Limited Liability Corporation (LLC). 7. Must attach a copy of bylaws, if applying as a nonprofit private club. 8. All principals must attach a criminal records check (CRC), not more than 90 days old. If the principal has lived in SC for more than 2 years, obtain the CRC from SLED at www.sled.state.sc.us or SLED Headquarters, Criminal Records Department, 4400 Broad River Rd., P.O. Box 21398, Columbia, SC 29221. If the principal has lived in SC less than 2 years, obtain a CRC from previous state of residency AND a CRC from SLED. If principal is not a SC resident, obtain a CRC from current state of residency. 9. Must attach Certificate of Authority to do Business in SC from the South Carolina Secretary of State's Office, if applying as a foreign corporation. 10. Must attach a copy of your lease, deed or tax bill for the location for which you are seeking a license. The lease, deed, or tax bill must be in the applicant's name and list the physical address of the business location. 11. Must attach partnership agreement, if applying as a partnership or Limited Liability Partnership (LLP). 12. EFFECTIVE JULY 1, 2008: Must attach completed appropriate residency status verification affidavit. Use Verification of Lawful Presense in the US (ABL-577) for owners of sole proprietorships. Use Verification of Lawful Background for Applicant's Principals (ABL-920) for each principal, if other than sole proprietor. Each principal, officer, owner, member, and/or partner MUST sign the appropriate form. If applicable, include his/her non-citizen alien registration number and attach a copy of all appropriate immigration documents. If also applying for 120 days temporary permit or license, in addition to the above, attach: a. $25 for each temporary permit requested. If applying for a temporary liquor by the drink, or temporary retail liquor, an additional $5.00 certification fee is required. b. Must attach a copy of bill of sale, lease, probate document, divorce decree, eviction order, or document showing how the applicant acquired the business. The bill of sale or lease must be in the name of the applicant. c. If applying as a sole proprietor, a current SLED criminal history background check is required on the applicant. If applying as a corporation, partnership, limited liability company or limited liability partnership, a current SLED criminal history background check is required on each principal. (see # 8 above) d. Attach the original existing biennial permit/license from the existing business that has not expired, been suspended or revoked. e. Must attach proof of Grade A DHEC certificate issued for this location, if applying for Restaurant Liquor by the Drink. f. Have a Sales Tax Registration Number. Contact the License and Registration Section at (803) 896-1350. g. If sole proprietor - Social Security Number; other than Sole Proprietor, a FEI number. 43681014 American LegalNet, Inc. www.FormsWorkFlow.com 1350 STATE OF SOUTH CAROLINA DEPARTMENT OF REVENUE APPLICATION FOR RETAIL BEER, WINE, AND LIQUOR ABL-901 (Rev. 9/29/10) 4280 Mail to: SC Department of Revenue, ABL Section, Columbia, SC 29214-0907 File Number: Telephone: (803) 898-5864 DOR Website: www.sctax.org License Type Nonrefundable Filing Fee License Fee On premises beer & wine $ 300.00 $ 600.00 biennially Off premises beer & wine $ 300.00 $ 600.00 biennially Brewpub $ 300.00 $ 2,200.00 biennially 7-day off-premises beer & wine $ 300.00 $ 2,200.00 biennially Sunday/Sabbath beer & wine $ 300.00 $ 650.00 biennially Business (restaurant/hotel/motel) liquor by the drink $ 200.00 $ 1,700.00 biennially Nonprofit private club liquor by the drink $ 200.00 $ 1,700.00 biennially Retail liquor store $ 200.00 $ 1,400.00 biennially Alcoholic liquors (cooking license) $ -0$ 250.00 biennially 120 day temporary beer & wine $ -0$ 25.00 *120 day temporary liquor by the drink $ -0$ 25.00 *120 day temporary retail liquor $ -0$ 25.00 *Certification fee $ -0$ 5.00 *(Certification fee is required, in addition to filing fees, if you are applying for a license at a location that is currently licensed to sell liquor by the drink or retail liquor. 61-6-120) PLEASE PRINT OR TYPE ALL INFORMATION 1. OWNER, PARTNERSHIP, OR CORPORATE CHARTER NAME 5. TRADE NAME (DOING BUSINESS AS) 2. PHYSICAL LOCATION OF BUSINESS REQUIRED (NO P.O. BOX) STREET 6. BUSINESS PHONE NUMBER CITY COUNTY (REQUIRED) STATE ZIP DAYTIME PHONE NUMBER 3. MAILING ADDRESS (FOR ALL CORRESPONDENCE) 7. FEDERAL IDENTIFICATION NUMBER AND/OR SOCIAL SECURITY NO. IN CARE OF STREET 8. NATURE OF BUSINESS CITY 4. TYPE OF OWNERSHIP COUNTY STATE ZIP SOLE PROPRIETOR (one owner) LLC/LLP FOREIGN CORPORATION STATE INC. NON-PROFIT ORGANIZATION OTHER (EXPLAIN) PARTNERSHIP (two or more owners) SC CORPORATION DATE INC. 9. WHAT IS YOUR RETAIL SALES TAX NUMBER? DATE OF INC. If the corporation is publicly traded, you must designate an officer or other person to hold the license. This person must be of good moral character, over the age 21, and a SC resident. This person should be included on the Consent and Waiver along with other principals of the corporation. Name of designated officer or other employee: 10. IS BUSINESS WITHIN SC MUNICIPAL LIMITS? YES NO IF YES, WHICH CITY