Contact your city or county business licensing office with questions regarding this form.
Application produced by the South Carolina Business Licensing Officials Association.
The SC Business Licensing Officials Association is an affiliate of the Municipal Association of SC.
Buying an existing construction business?
If yes, purchased business’ name:
Business leasing space to another business?
Mail business license renewals to mailing address listed in the business information section on the previous page?
If not, corporate address:
Change of use to building?
Existing business with no prior license?
Independent contractors (Form 1099)?
If yes, names:
If yes, landlord name and address:
Restrictive covenants? If yes, provide copy.
Applicant Certification (Contact the municipality in which you are doing business to determine if a notarized signature is required.)
1. I hereby certify that all information provided is true and correct to the best of my knowledge and that the gross revenue is
accurately reported or estimated for a new business without any unauthorized deduction.
2. I certify that assessments, delinquencies and personal property taxes due to the jurisdiction are fully paid.
3. I understand that providing false or fraudulent information may result in penalties, business license revocation and/or
prosecution to the fullest extent possible.
4. I am aware of and understand the jurisdiction’s requirements and codes, and the issuance of a business license is contingent
upon strict and consistent compliance with all of the jurisdiction’s requirements.
5. I understand that failure to comply with these requirements may result in business license revocation as well as other
compliance or legal efforts.
6. I also understand and authorize the jurisdiction and its agents to utilize all information on this application to ensure that all
other federal, state and local laws are complied with.
For Office Use Only
Approved by all necessary departments? Yes No
Approved? Yes No Date:
Business license # Rate class:
Rate Base rate: $ Every $1,000 after: $
Amount due Fee: $ Penalties: $ Total: $
Decal required? Yes No Cost/each: $ Total: $
Receipt Amount paid: $ Date paid: Number of decals:
Staff name: Signature: Date: