1350                                      STATE OF SOUTH CAROLINA 
                                              DEPARTMENT OF REVENUE                               I-309 
                                    NONRESIDENT SHAREHOLDER OR PARTNER AFFIDAVIT                  (Rev. 8/12/19) 
    dor.sc.gov                       AND AGREEMENT INCOME TAX WITHHOLDING                                   3313

I certify and agree to the following:

1. I am a nonresident shareholder or partner. 
    
   My name is: 
    
2. My address is: 
                                                          Street address
    
                                                          City, state, and ZIP
3. My SSN or FEIN is: 
    
4. The income this affidavit and agreement applies to is: 
    
                       Distributed or undistributed South Carolina income from an S Corporation. 
    
                       Distributed or undistributed South Carolina income from a Partnership. 
    
5. Entity's name: 
    
6. Entity's address: 
                                                          Street address
    
                                                          City, state, and ZIP
7. Entity's FEIN: 
    
8. I agree to timely file appropriate returns and make payment of all South Carolina taxes required by law. 
    
9. I agree that I am subject to the personal jurisdiction of the SCDOR and the courts of South Carolina for the purpose of 
   determining and collecting any South Carolina taxes, including Estimated Taxes, together with any related interest and 
   penalties. 
    
10. This agreement will be binding upon my heirs, representatives, assigns, successors, executors, and administrators. 
    
11. I understand the SCDOR may revoke the withholding exemption granted under SC Code Section 12-8-590(F) at 
   any time it determines I am not abiding by the terms of this agreement.

I declare under penalty of perjury that I have examined this affidavit and that, to the best of my knowledge and belief, it is 
true, correct, and complete.
Under SC Code Section 12-54-44(B)(6)(a), a person who willfully makes and subscribes any return, statement, or other 
document that contains, or is verified by, a written declaration made under penalties of perjury that they do not believe to 
be true and correct as to every material matter is guilty of a felony and, upon conviction, must be fined not more than $500 
or imprisoned not more than five years, or both, together with the cost of prosecution.

Signature of shareholder or partner                                                           Date

Print name of shareholder or partner

    33131020

                                                  INSTRUCTIONS

Requirement to Make Withholding Payments
SC  Code  Section  12-8-590  requires  an  S  Corporation  or  Partnership  to  withhold  taxes  at  the  rate  of  5%  on  each 
nonresident  shareholder's  or  partner's  share  of  South  Carolina  taxable  income.  There  are  several  exceptions  to  the 
withholding requirements. An S Corporation or Partnership is not required to withhold Income Taxes with regard to any 
nonresident  shareholder  or  partner  (1)  who  submits  an  affidavit  and  agreement  or  (2)  for  which  the  S  Corporation  or 
Partnership reports their income on a composite nonresident Income Tax return.

Purpose of Affidavit
The  affidavit  is  used  by  a  nonresident  shareholder  or  partner  to  request  an  exemption  from  the  withholding  required 
pursuant to SC Code Section 12-8-590. Shareholders or partners who will be included in a composite Individual Income 
Tax return do not need to complete this affidavit.

Who May Submit This Affidavit
Any nonresident shareholder or partner with South Carolina income from an S Corporation or Partnership may submit the 
agreement to the S Corporation or Partnership. Shareholders and partners whose income will be reported on a composite 
nonresident Income Tax return are automatically exempt from withholding and are not required to submit an affidavit to 
the  S  Corporation  or  Partnership.  Any  Income  Tax  due  must  be  paid  by  the  unextended  due  date  of  the  composite 
nonresident Income Tax return and is subject to the declaration of Estimated Tax rules.

Where and When to Submit This Affidavit
Shareholder or Partner Instructions:
A shareholder or partner should fully complete the affidavit and submit it directly to the S Corporation or Partnership. The 
affidavit should be signed by a shareholder of the S Corporation or a partner in the Partnership. A separate affidavit must 
be submitted by each shareholder or partner for stock that is jointly owned.
The affidavit is valid for all subsequent years and should not be resubmitted to the entity as long as (1) the shareholder's 
or partner's nonresident status remains unchanged or (2) the withholding exemption is not revoked by the SCDOR.

S Corporation or Partnership Instructions:
The S Corporation or Partnership must remit all affidavits to the SCDOR.
S  Corporations  should  attach  the  affidavits  to  the  SC1120S-WH  (Withholding  Tax  on  Income  of  Nonresident 
Shareholders)  and  file  with  the  SCDOR  on  or  before  the  15th  day  of  the  third  month  following  the  close  of  the  S 
Corporation's tax year. 
 
Partnerships should attach the affidavits to the SC1065 (Partnership Return) or the SC8736 (Request for Extension of 
Time to File South Carolina Return for Fiduciary and Partnership) and file with the SCDOR on or before the 15th day of 
the third month following the close of the Partnership's tax year. 
 
Affidavits  remain  valid  for  subsequent  tax  years  and  should  only  be  filed  with  the  SCDOR  in  the  first  year  that  the 
shareholder or partner submits an agreement to the entity. 
 
For more information, see SC Revenue Procedure #17-2 at dor.sc.gov/policy. 
Learn more about Income Taxes at dor.sc.gov/tax.

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. 
The Family Privacy Protection Act 
Under the Family Privacy Protection Act, the collection of personal information from citizens by the SCDOR is limited to the information 
necessary for the SCDOR to fulfill its statutory duties. In most instances, once this information is collected by the SCDOR, it is protected 
by law from public disclosure. In those situations where public disclosure is not prohibited, the Family Privacy Protection Act prevents 
such information from being used by third parties for commercial solicitation purposes.