Sc Dor Form Fs 102 2019

STATE OF SOUTH CAROLINA DEPARTMENT OF REVENUE FS-102 INSTALLMENT AGREEMENT REQUEST Rev. 11/29/12 Instructions If you would like to make scheduled payments on your outstanding liability complete this form. A nonrefundable payment agreement fee of 45. 00 will be charged and added to your liability. If you have an open sales license please contact the Taxpayer Service Center that serves your county to discuss your account. If your company qualifies for the Job Development Credit you will be considered not current until all returns are filed and liabilities are paid in full* A minimum down payment of 10 of the total balance due is required with this request. Refunds seized and applied to liabilities in the agreement will reduce the total agreement amount but will not substitute for regular scheduled payments. A tax lien s will be recorded for the liability ies covered under this agreement. Penalty and interest will continue to accrue until paid in full* All future tax returns must be timely filed and paid for the agreement to remain in effect. Failure to make your scheduled monthly payments and/or file and pay all required returns timely may result in enforced collection activity. We are unable to set up an official payment plan if you are currently in Bankruptcy. Your check must be made payable to the SC Department of Revenue. Please note your name and social security number on the check. You may be required to make future payments with certified funds or with electronic methods available through the Department. You will be notified if your request is approved or denied* If down payment is not included or application is not complete it will be denied and returned to you. Please check one of the following payment options Electronic Funds Withdrawal EFW allows funds to be automatically withdrawn from your checking or savings account on a pre-assigned date. Please attach your voided check or your micro specification sheet from your bank with this application for the account you request to be drafted* Check Certified Funds or Electronic Funds Transfer ePay. Upon approval coupons will be mailed to you. You may submit payment electronically by going to the agency s website at www. sctax. org click on the link to ePay. ePay will allow you to provide payment by credit card MasterCard or VISA or by electronic funds withdrawal EFW from your bank account. If you have any questions about installment agreements call 803 898-5611 or your local Taxpayer Service Center listed on the back of this form* Please complete each section below. This information is required in order to approve this application* Your first name and initial Last name Your social security number Your home phone number If a joint return spouse s first name and initial Spouse s social security number Work/Daytime phone number Current Mailing Address City State ZIP code Your Employer Address City state and ZIP code Name of your bank or other financial institution Email Type Tax Periods Covered or Tax Year s Requested Monthly Payment Requested Payment Date 1st thru 28th I hereby waive all rights under Chapter 60 of Title 12 of the SC Code of Laws including but not limited to 12-60-420 12-60-440 and 12-60-450.