Request for License Roster - LLR
REQUEST FOR LICENSE ROSTER
1. License Roster Requested: (i.e., "Dentistry")
Select License Type...
2. Each request must be accompanied by a $10 check made payable to the respective Board. Requesting roster be sent by: Email or Mail
Company Name:
Email:
Phone:
Mailing Address:
City:
State:
Zip Code:
Please confirm what type of list you're requesting:
Return Mailing Address: (Select Board) Select Board...
P.O. Box 11329 Columbia, SC 29211
3. STATEMENT OF COMPLIANCE WITH THE SOUTH CAROLINA FAMILY PRIVACY PROTECTION ACT OF 2002 Section 30-2-50 of the Code of Laws of the State of South Carolina provides that no person or private entity shall knowingly obtain or use any personal information obtained from a public body for commercial solicitation. The South Carolina Department of Labor, Licensing and Regulation gives notice to you, as a requestor of records from this agency, that obtaining or using these public records for commercial solicitation is prohibited.
Commercial solicitation means contact by telephone, mail or electronic mail for the purpose of selling or marketing a consumer product or service. State law requires agencies to take measures to ensure no personal information is distributed for unlawful purposes.
The following uses of the information are not considered to be commercial solicitation under the law:
? Offering membership in a credit union; ? Notification of continuing education opportunities; ? Selling or marketing banking, insurance, securities, or commodities services provided by an institution or entity
defined in or required to comply with the Federal Gramm-Leach-Bliley Financial Modernization Act, 113 Stat. 1338; or ? Contacting persons for political purposes using information on file with state and local voter registration offices.
Any person who knowingly uses public records for commercial solicitation is guilty of a misdemeanor and, upon conviction, must be fined an amount not to exceed $500 or imprisoned for a term not to exceed one year, or both.
For a complete copy of the South Carolina Family Privacy Protection Act of 2002, visit:
I hereby certify that I have read the above information regarding the South Carolina Family Privacy Protection Act of 2002, and that I will not use any of the information obtained from the South Carolina Department of Labor, Licensing and Regulation for commercial solicitation directed to any person in this State.
Print Name Request for License Roster (5/22)
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