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                                         STATE OF SOUTH CAROLINA                                                                        SC8857 
                                         DEPARTMENT OF REVENUE                                                                          (Rev. 7/18/22) 
   dor.sc.gov                REQUEST FOR INNOCENT SPOUSE RELIEF                                                                                    3330
Your name                                                                                                                      SSN

Current mailing address                                             City                                                   State                                           ZIP 

Should I file this request? 
File this request if: 
      • you are a spouse requesting consideration as an innocent spouse, and: 
            o you received a bill from the SCDOR, or 
            o your tax refund was applied to a delinquent South Carolina tax debt for which you are not responsible. 
Do not file this request if: 
      • your refund was taken for an outstanding debt with an outside agency. (This may include balances for hospital bills, EMT bills, 
        child support, student loans, and utility bills.) In this case, you must contact the outside agency for assistance. 
 
You must complete all information on this form and include all supporting documentation for your request to be considered.
                                                                                                                                   Tax year of the joint debt
Part I - Joint debt information:
                                                                                                                                   YYYY YYYY                                   YYYY
Enter the tax years for which you are requesting relief.   
(This is the tax year of the joint debt, not the tax year that the refund was taken.) 
 
Identifying information for the person with whom you incurred the joint debt:
Name                                                                                                                         SSN

Current street address

City                                                          State                                                                      ZIP

Part II - IRS status:
Were you granted innocent spouse relief by the IRS?                                           Yes                            No
If Yes, attach a copy of the verification you received from the IRS.
State the reasons you are entitled to this relief with the SCDOR:

Part III - Current marital status with the person in Part I: 
What is the current marital status between you and the person on Part I?  
 
      Married and still living together  
      since                              MM      DD      YYYY 
       
      Married and living apart since  
                                         MM      DD      YYYY 
       
      Widowed since                                                                  Attach a copy of the death certificate, will, or probate closing statement. 
                                         MM      DD      YYYY 
       
      Legally separated since                                                         Attach a complete copy of your entire separation agreement. 
                                         MM     DD      YYYY 
       
      Divorced since                                                                          Attach a complete copy of your entire divorce decree.
                                         MM     DD      YYYY 
       
   A divorce decree stating that your former spouse must pay all taxes will not necessarily qualify you for relief.
      33301037

Were you a victim of spousal abuse or domestic violence during any of the tax years you are requesting relief? If the answers are not 
the same for all tax years, explain. 
Yes - Attach a statement explaining the situation and when it began. Provide copies of any supporting documentation. This 
includes police reports, restraining orders, doctor's reports or letters, or a notarized statement from a person who was aware of the 
situation. 
 
No
Did you sign the returns? If the answers are not the same for all tax years, explain.
Yes - If you were forced to sign under duress (threat of harm or other form of coercion), attach a statement explaining and verifying 
that your signature was signed under duress.  
 
No - If your signature was forged, attach a statement explaining and verifying the forgery of your signature. 

At the time of signing, did you have a  mental or physical health problem, or do you currently have a mental or physical health problem? 
If the answers are not the same for all tax years, explain.
Yes - Attach a statement to explain the problem and when it began. Provide copies of any documentation. This includes medical 
bills or a doctor's report or letter. 
 
No

Part IV - Your involvement with finances:
How were you involved with preparing the returns for the tax years you are requesting relief? Check all that apply and explain, if 
necessary. If the answers are not the same for all tax years, explain. 
          You filled out or helped fill out the returns. 
 You gathered receipts and cancelled checks. 
 You gave tax documents (such as W-2s, 1099s, etc.) to the person who prepared the returns. 
 You reviewed the returns before they were signed. 
 You did not review the returns before they were signed. Explain below. 
 Other 

Explain how you were involved 

For the years you are requesting relief, how were you involved in the household finances? Check all that apply. If the answers are not 
the same for all tax years, explain.
         You knew the person in Part I had separate accounts. 
 You had joint accounts but you had limited use of them or did not use the accounts. Explain below. 
 You used joint accounts. You made deposits, paid bills, balanced the checkbook, or reviewed the monthly bank statements. 
 You made decisions concerning how money was spent. This includes paying bills or making decisions concerning household 
 purchases.  
 You were not involved in handling money for the household. 
 Other  
  
Explain anything else you want to tell us about your household finances

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Part V - Your current household:
How many people currently live in your household?                          Adults                            Children
What is your current average total monthly household income and expenses? If family or friends are helping to support you, include the 
amount of support as gifts under Monthly income. Under Monthly expenses, enter all expenses, including expenses paid with income 
from gifts. 
            Monthly income                                   Amount        Monthly expenses                                    Amount
                                                                     Federal, state, and local taxes deducted 
Gifts ......................................................         from your paycheck ...............................
Wages (Gross pay)...................................                 Rent or mortgage .................................. 
Pensions ................................................            Utilities................................................ 
Unemployment ........................................                Phone................................................. 
Social security .........................................             
Government assistance, such as housing,                              Food................................................... 
food stamps, grants ..................................               Car expenses, payments, insurance, etc. ... 
Alimony..................................................            Medical expenses, including medical 
                                                                     insurance ............................................ 
Child support...........................................             Life insurance....................................... 
Self-employment business income...............                       Clothing .............................................. 
Rental income .........................................              Child care ............................................ 
Interest and dividends ...............................               Public transportation .............................. 
Other income, such as disability payments,                           Other expenses, such as real estate 
gambling winnings, etc ..............................                taxes, child support, etc. ......................... 
List the type below:                                                 List the type below: 
Type                                                                 Type 
                                                                      
Type                                                                 Type 
                                                                      
Type                                                                 Type 
                                                                      
Total                                                                Total
Provide any other information you would like considered when determining if it would be unfair to hold you liable for the tax. 

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Your daytime phone number, including area code: __________________________
I declare that this return and all attachments are true, correct, and complete to the best of my knowledge. If prepared by 
a person other than the taxpayer, this declaration is based on all information of which the preparer has any knowledge.   
I understand that under SC Code Section 12-54-44 (B)(6)(a), I can be fined and/or imprisoned for furnishing a false 
statement. 
Innocent spouse's signature                                           Date                           Phone

Innocent spouse's email:                                   Preparer's email:

           Preparer                                Date         Check if                         PTIN
           signature                                            self-employed
Paid 
                                                                                                 FEIN
Preparer's Firm name (or 
           yours if self-
Use Only   employed),
           address, ZIP

                                                   Instructions 
What you need to know 
     • Don't file the SC8857 until: 
           o you receive a bill from the SCDOR, or 
           o you receive a notice from the SCDOR that your refund was applied to a delinquent South Carolina tax 
             liability for which you are not responsible.  
     • If your refund was applied to an outstanding debt with another agency, you must contact that agency for 
       assistance.  
     • You must complete all information on this form and include all supporting documentation for your request to be 
       considered. 
     • If you need extra space when providing answers to any of the questions, attach additional pages and include your 
       name and SSN at the top of each page.  
     • The SCDOR may contact you if additional information is needed.  
     • If you are represented by a third party, attach a SC2848, Power of Attorney and Declaration of Representative, 
       available at dor.sc.gov/forms.  
     • Keep a copy of this form and all attachments for you records.  
 
What you need to do 
Mail the completed SC8857, along with all supporting documentation, to:   
SCDOR  
Attn: Innocent Spouse Relief 
Taxpayer Advocate Section 
PO Box 125 
Columbia, SC 29214-0790 

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. 

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