South Carolina Department of Revenue 
 Data to be Used for Creating Sample Forms for 
 WH1605 (2024) 
 Revised 9/21/2023 
  
 You must submit 1 form for each example, for a total of five test cases. Submissions will not 
 be approved if the correct number of test cases is not provided and/or if South Carolina test 
 cases are not used. 
 
 Return 1: 
 Withholding File Number:       11531111-8 
 FEIN:                          57-0000057 
 Quarter:                       01 
 Year:                          2024 
 Amended:                       No 
 Change of Address:             No 
 Close Account:                 No 
 Name and Address:              Withholding Returns Inc. 
                                123 Time to File  
                                Barnwell, SC 29999 
 SC Tax Withheld Amount:        $46,418.97 
 Deposits or Payment Amount:    $42,896.59  
 Refund Amount:                 $ 
 SC Tax Due Amount:             $3,522.38  
 Penalty and Interest Due:      $53.00 
 Total Tax, Penalty, Int. Due:  $3,575.38 
 
 Return 2: 
 Withholding File Number:       11241112-7 
 FEIN:                          57-0000042 
 Quarter:                       02 
 Year:                          2024 
 Amended:                       No 
 Change of Address:             No 
 Close Account:                 Yes 
 Name and Address:              Bill It Now, Inc 
                                John and Sally Withholds 1234 
                                Time to Pay  
                                Pelzer, SC 29999 
 SC Tax Withheld Amount:        $8,726.49 
 Deposits or Payment Amount:   $8,700.00  
 Refund Amount:                 $ 
 SC Tax Due Amount:             $26.49 
 Penalty and Interest Due:      $ 
 Total Tax, Penalty, Int. Due:  $26.49 
  

 South Carolina Department of Revenue 
 Data to be Used for Creating Sample Forms for 
 WH1605 (2024) 
 Revised 9/21/2023 
  
 Return 3: 
 Withholding File Number:    11111113-6 
 FEIN:                       57-0000043 
 Quarter:                    03 
 Year:                       2024 
 Amended:                    No 
 Change of Address:          No 
 Close Account:              No 
 Name and Address:           Owes Inc. 
                             123 Bill Lane 
                             Ninety Six, SC  29999  
 SC Tax Withheld Amount:     $4,751.00  
 Deposits or Payment Amount: $4,750.00  
 Refund Amount:              $ 
 SC Tax Due Amount:          $1.00 
 Penalty and Interest Due:   $ 
 Total Tax, Penalty, Int. Due:          $1.00 
 
 Return 4: 
 Withholding File Number:    11111114-5 
 FEIN:                       57-0000064 
 Quarter:                    01 
 Year:                       2024 
 Amended:                    Yes 
 Change of Address:          No 
 Close Account:              No 
 Name and Address:           March Filers Inc. 
                             3 Bill St 
                             Denmark, SC  29999  
 SC Tax Withheld Amount:     $28.11 
 Deposit or Payment Amount:  $20.36 
 Refund Amount:              $ 
 SC Tax Due Amount:          $7.75 
 Penalty and Interest Due:   $ 
 Total Tax, Penalty, Int. Due:          $7.75 
  

 South Carolina Department of Revenue 
 Data to be Used for Creating Sample Forms for 
 WH1605 (2024) 
 Revised 9/21/2023 
  
 Return 5:  
 Withholding File Number:    11115415-4 
 FEIN:                       57-0000065 
 Quarter:                    02 
 Year:                       2024 
 Amended:                    No 
 Change of Address:          Yes 
 Close Account:              No 
 Name and Address:           Gotta Withhold 123 
                             Withhold Lane 
                             Branchville, SC  29999-9999  
 SC Tax Withheld Amount:     $6,821.37 
 Deposits or Payment Amount: $6,899.60  
 Refund Amount:              $78.23 
 SC Tax Due Amount:          $ 
 Penalty and Interest Due:   $  
 Total Tax, Penalty, Int. Due:          $