11. Purchaser's certificate of registration for Use Tax: effective date of registration (MM-DD-YY)
10. Is physical location within municipal limits?
Yes No
Which municipality?
Are you an SC resident? Yes No
How long have you lived in SC? YR MO
15. Location of records (no PO Box)
12. Is your business seasonal? Yes If yes, list months active:
No If no, filing status is monthly. See instructions for more information.
13. How many retail sales locations do you operate in SC under your ownership?
You must file a zero return for active periods with no sales.
14. Trade name or business name
In and out-of-state sellers. A retail license will not be issued to a person with any outstanding state tax liability.
16. Main business (i.e., Retail Sales, Manufacturing, Service, etc.)
Section B: Retail Sales/Accommodations/Artist & Craftsman License/Use Tax
17. Anticipated date of first retail sales (MM-DD-YY)
Register online at MyDORWAY.dor.sc.gov
(Rev. 12/18/19)
Lead Acid Batteries
19. Check if you sell these products
Motor Oil Large Appliances
Agriculture, Forestry,
Fishing, & Hunting (11)
Mining (21)
Utilities (22)
Construction (23)
Manufacturing (31-33)
Wholesale Trade (42)
Durable Medical
Equipment (44)
18. Type of business
Max Tax (Vehicles) (44)
Retail Trade (44-45)
Artists & Craftsman (45)
Transportation &
Warehouse (48-49)
Information (51)
Finance & Insurance (52)
Real Estate, Rental &
Leasing (53)
Professional, Scientific,
& Technical Services (54)
Management of Companies
& Enterprises(55)
Administrative & Support,
Waste Management &
Remediation Services (56)
Education Services (61)
Health Care & Social
Assistance (62)
Arts, Entertainment, &
Recreation (71)
Accommodation & Food
Services (72)
Other Services (81)
Public Administration (92)
Service to Cellular and Personal Communications Users
Aviation Gasoline/Jet Fuel
Prepaid Wireless Cards
Section A: Taxes to be registered for this business location
1. Owner, partnership, or corporate charter name (legal name)
7. Email
Sole Proprietor (one owner)
Partnership (two or more owners, other than LLP)
LLC/LLP filing as:
Corporation Partnership Single Member
State and date incorporated
Foreign Corporation
State and date incorporated
Other (explain)
In Care Of
3. Mailing address (for all correspondence)
City State ZIP
5. Business phone number
6. Daytime phone number
8. Fax number
4. Type of ownership
9. Physical location of business (no PO Box)
City County State ZIP
Use Tax (Section B - No fee required)
Artist & Craftsman's License - Sells created or assembled products only at arts
shows, crafts shows and festivals within SC (Section B - $20 license tax is required)
Withholding Tax (Section C)
Nonresident Withholding Exemption (Section D)
Retail Sales/Accommodations License (Section B - $50 license tax is required)
Make checks payable to SCDOR.
Mail to: SCDOR, PO Box 125, Columbia, SC 29214-0850
Every employer with employees earning wages in South Carolina must register for Withholding Tax. Other types of payments also
require state tax withholding. See instructions for more information.
20. Check the box that applies to your business:
02 Resident business 05 Nonresident business
21. Check the filing frequency for your withholding returns (See Form 105 for withholding payment frequencies):
Quarterly 01 Annual (Must meet specific requirements to select Annual. See instructions.)
22. Anticipated date of first payroll:
Upon completion of both pages, sign and date the application below.
Under penalty of law, I certify that this information is correct, true, and complete to the best of my knowledge.
Section E: Names of Business Owner, General Partners, Officers, or Members
Home Address
Social Security
Nonresident businesses who have activity but no employees in South Carolina are granted exemption from Withholding Tax. See
instructions for more information.
Section D: Nonresident Withholding Exemption
I agree to file SC tax return I am not subject to SC Tax Jurisdiction (no NEXUS)
DateTitleSignature of owner, all partners, or corporate officer
Section C: Withholding Tax
Main business:
23. Sole Proprietor FEIN (required):
Social Security Privacy Act Disclosure
It is mandatory that you provide your Social Security Number on this tax form if you are an individual taxpayer. 42 U.S.C. 405(c)(2)(C)(i)
permits a state to use an individual's Social Security Number as means of identification in administration of any tax. SC Regulation
117-201 mandates that any person required to make a return to the SCDOR must provide identifying numbers, as prescribed, for
securing proper identification. Your Social Security Number is used for identification purposes.
DateTitleSignature of owner, all partners, or corporate officer
DateTitleSignature of owner, all partners, or corporate officer
DateTitleSignature of owner, all partners, or corporate officer
DateTitleSignature of owner, all partners, or corporate officer