1350                                        STATE OF SOUTH CAROLINA 
                                            DEPARTMENT OF REVENUE
                                                                               SC616 
                                            NOTIFICATION TO LOCK IN            (Rev. 7/31/19) 
 dor.sc.gov                                 COUNTY DESIGNATION                 3068

1.   Name: 

2.   FEIN or SSN: 

3.   Mailing address: 

4.   County where jobs will be created: 

5.   Number of new full-time jobs to be created: 

6.   Year expansion is planned: 

7.   Type of business (attach a schedule if you need more space): 

8.   The county on line 4 is designated as: 

                                                 Tier IV 
                                                 Tier III 
                                                 Tier II 

Date                                                      Taxpayer name 
                                                           
                                                          Signature of officer (or other appropriate official) 
                                                           
                                                          Print officer's name 
                                                           
                                                          Title

                                        Keep a copy for your records

                                        Mail to:     SCDOR 
                                                      PO Box 125 
                                                 Columbia, SC 29214-0825

     30681027

                                        INFORMATION

For new jobs qualifying for the credit on TC-4, TC-4SA, or TC-4SB, the designation of the county where the 
business's facility is located determines the amount of credit a business receives for each job it creates. There 
are four designations for South Carolina counties, ranging from Tier I (lowest credit) through Tier IV (highest 
credit). County designations are updated each year. 
 
Filing the SC616 prior to the creation of the new jobs eligible for the credit allows a company to lock in the 
current Tier II, III, or IV county designation for jobs created in years one through six. You do not have to use the 
designation  reported  on  the  SC616  if  the  designation  for  the  year  in  which  the  job  was  created  is  more 
favorable to you. 
 
The SC616 is only valid if filed with the SCDOR before a new facility is initially staffed or an existing 
facility is expanded. 
 
The  SC616  covers  all  new  jobs  created  during  the  original  credit  period  beginning  with  the  start-up  or 
expansion  of a business.  The  credit  created  in  year  one  is not affected  by any  future re-designation  of the 
county in later years after the jobs are created. 
 
The SC616 is not required to claim the new jobs credit. It is only required if you wish to lock in the county 
designation. 
 
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. 

 30682025