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STATE OF SOUTH CAROLINA
ANNUAL REPORT OF ELECTRIC COOPERATIVE CL-4
CORPORATION PROPERTY AND GROSS RECEIPTS (Rev. 6/7/22)
dor.sc.gov Due by the 15th day of the fourth month following the close of the taxable year. 3135

Return for period ending - -

License Fee period ending - -

FEIN

Name

Mailing address

City State ZIP
Change of Address Initial Return Final Amended
Check if you filed a federal or state extension
PART I COMPUTATION OF LICENSE FEE - ELECTRIC COOPERATIVES
1. Fair market value of property owned and used to conduct business in SC as determined by the
SCDOR for Property Tax purposes for the preceding tax year ....................................................... 1. $ 00
2. License Fee: fair market value component (multiply line 1 by .001)................................................. 2. 00
(A) Total System (B) In South Carolina
Operating revenues (list below):
$ 00 00
00 00
00 00
00 00
3. Total operating revenues .................................................................. 3. 00 3. 00
Other receipts (list below):
00 00
00 00
00 00
00 00
4. Total other receipts.......................................................................... 4. 00 4. 00
5. Total gross receipts (add line 3 and line 4) ........................................... 5. 00 5. 00
6. License Fee: gross receipts component (multiply line 5, column B by .003) .............................. 6. 00
7. Total License Fee (add line 2 and line 6, cannot be less than $25) ......................................... 7. 00
8. Section 12-20-105 Credit (see Part II and instructions)......................................................... 8. 00
9. Balance of License Fee (subtract line 8 from line 7, cannot be less than zero) .......................... 9. 00
10. Interest 00 Penalty 00.................... 10. 00
11. Total License Fee, Interest, and Penalty (add line 9 and line 10)..................... BALANCE DUE 11. 00
PART II INFRASTRUCTURE CREDIT INFORMATION
Unused Infrastructure Credit Infrastructure Credit Infrastructure Credit Infrastructure Credit Carried
Carried Forward from Last Year Earned This Year Taken This Year Forward for One Year Only
$ $$ $

Describe the types of infrastructure provided by the taxpayer to eligible projects. Types of infrastructure are listed in SC Code Section
12-20-105(C). Eligible projects are described in SC Code Section 12-20-105(B).

31351034

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CL-4 Page 2
PART III ANNUAL REPORT TO BE COMPLETED BY ALL ELECTRIC COOPERATIVES
1. Name
2. Organized under the laws of the state of
3. Location of the registered office of the Cooperative in South Carolina
In the city of Registered agent at this address
4. Principal office address
5. Total number of authorized shares of capital stock, itemized by class and series, if any, within each class:
Number of shares Class Series

6. Total number of issued and outstanding shares of capital stock itemized by class and series, if any, within each class:
Number of shares Class Series

7. Names and business addresses of the directors (or individuals functioning as directors) and principal officers in the Cooperative:
Attach separate schedules if you need more space.
Name Title Business address

8. Date organized Date commenced business in South Carolina
9. Date of this report FEIN
10. If foreign entity, the date qualified to do business in South Carolina
11. Was the name of the Cooperative changed during the year? Previous name
12. The Cooperative's books are in the care of
Located at (street address)

Under penalty of law, I certify that I have examined this return, including accompanying annual report, statements, and schedules,
and it is true and complete to the best of my knowledge.
Sign
Here
Signature of officer Officer's title Email

Print officer's name Date Phone number
I authorize the Director of the SCDOR or delegate to discuss this return, Preparer's printed name
attachments, and related tax matters with the preparer. Yes No
Paid Preparer's Date Check if Preparer's phone number
signature
Preparer's self-employed
Firm's name (or PTIN or FEIN
Use Only yours if self-employed)
and address ZIP
If this is an Electric Cooperative's final return, signing here authorizes the SCDOR to disclose that information with the South Carolina Secretary of
State (SCSOS). You must close with the SCSOS and the SCDOR.

Signature Date
Attach a complete copy of your federal return.
Have a balance due? Pay online! It's quick and easy! Use our free online tax portal, MyDORWAY, at dor.sc.gov/pay. Select
Business Income Tax Payment to get started.
If you pay by check, make your check payable to SCDOR and include your name, FEIN, tax year, and CL-4 in the memo.
Mail Balance Due returns to: Mail Refund or Zero Tax returns to:
SCDOR SCDOR
Corporate Taxable Corporate Refund
PO Box 100151 PO Box 125
Columbia, SC 29202 Columbia, SC 29214-0032
31352032

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INSTRUCTIONS
Electric Cooperatives are subject to an annual License Fee according to SC Code Section 12-20-100. The License Fee
equals 0.1% (rounded up) of the fair market value of property owned and used in South Carolina to conduct business, as
determined by the SCDOR for the prior year's Property Tax. Distribution Electric Cooperatives must add 0.3% (rounded
up) of gross receipts from services rendered from regulated business in South Carolina during the prior tax year. The
minimum License Fee is $25.

Line 1: The fair market value of property owned and used in the conduct of business in South Carolina is the tax
assessment value divided by 10.5%. This amount is shown on the PT-422, South Carolina Property Tax Proposed
Assessment.

Line 5: Gross receipts, as used in SC Code Section 12-20-100, include all receipts from operations in South Carolina,
and other profit and loss items located in South Carolina. Income from intangibles used to conduct business in South
Carolina is also included in gross receipts. For more information, see SC Regulation 117-1075.1, available at dor.sc.gov/
policy.

Line 8: If the company paid cash to provide infrastructure for a qualifying project, enter the amount of credit applied on
line 8 and complete Part II. Attach a schedule to the return that includes the following:
• the name of the person completing the project
• a description of the project
• the county where the project is located
• the sections of the statute the project qualifies under
• the amounts paid in cash
• recipient and date of payment
• a description of the infrastructure provided
• the date the infrastructure was completed or is expected to be completed

If the infrastructure has not been completed as of the date the return is filed, include a waiver of the statute of limitations.
Beginning with the 2022 tax year, the maximum credit for a single tax year may not exceed $600,000. If the total credit
claimed is for a project located in a Tier II, Tier III, or Tier IV county, the maximum aggregate credit amount is increased
by $50,000 for Tier II Counties, $100,000 for Tier III Counties, and $150,000 for Tier IV Counties. Find Information Letters
with the annual county rankings at dor.sc.gov/policy. If the credit is more than the tax liability, the excess may be carried
forward and deducted in the following tax year. For more information on Infrastructure Credits, see SC Code Section
12-20-105 and SC Revenue Ruling #18-8, available at dor.sc.gov/policy.

Line 10: See the SC1120 Instructions for information on calculating interest and penalties. Forms are available at dor.sc.
gov/forms. A Penalty and Interest Calculator is available on our free online tax portal, MyDORWAY, at dor.sc.gov/
calculator.

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