The bill authorizes the Pickens County Commission to impose an additional vehicle license and registration fee of ten dollars ($10) for each new registration, transfer, renewal, or replacement tag on vehicles within the county. This fee will be collected by the county's judge of probate and is intended to supplement existing fees, taxes, and charges associated with vehicle licensing. The proceeds from this additional fee will be directed to the county's general fund, specifically earmarked for providing ambulance services in Pickens County.

Furthermore, the implementation of this fee is contingent upon approval from the county's qualified electors through a referendum scheduled for the first primary election in 2026. The referendum will ask voters whether they support the adoption of this act, and if a majority votes in favor, the fee will take effect immediately. If the majority votes against it, the act will have no further effect. The bill is set to become effective on June 1, 2025, if approved.