Georgia > Statewide > Department Of Revenue > Alcohol And Tobacco Division
Wholesale Distributors Malt Beverage Monthly Report ATT-123 - Georgia
| Wholesale Distributors Malt Beverage Monthly Report Form. This is a Georgia form and can be used in Alcohol And Tobacco Division Department Of Revenue Statewide . |
|
||||||
 Get this form for FREE as a print-only pdf |
|||||||
|
Georgia Department of Revenue ATT-123 (REV 2/2011) WHOLESALE DISTRIBUTORS MALT BEVERAGE MONTHLY REPORT STATE LICENSE NO. Due By the 20 of Each Month th WHOLESALE DISTRIBUTOR FOR CALENDAR MONTH OF: 20 ADDRESS STREET CITY STATE ZIP CODE REPORT IN NUMBER OF CASES OR KEGS ACCORDING TO PACKAGING AND SIZE OF CONTAINER SUMMARY 1. 2. 3. Inventory 1st day of month (Line 10, Previous Monthly Report) Purchases from brewers during month (Total Schedule A) Purchases from other Ga. wholesalers during month (Total Schedule B) Total possessed this month (Total Lines 1 through 3) Sales to other Ga. wholesalers during month (Total Schedule C) Sales to military installations during month (Total Schedule D) Sales to dealers and employees during month (Total Schedule E) Additional Dispositions (Total Schedule F) Total disposal during month (Total Lines 5 through 8) Physical inventory--last day of month Disposal and Inventory (Total Lines 9 and10) Difference , if any (+ or -), between Lines 4 and 11 Total taxable (Total Lines 9 and 12, less Lines 3 and 6) Ga. Excise Tax rate per gallon Tax due by size (Line 13 X Line 14) Gross Tax Due (Total of all columns in Line 15) Less attached credit memorandums issued by Ga. Department of Revenue Net Tax Due (Line 16 less Line 17) (A) Gallon (B) 1/8 Barrel (C) 1/6 Barrel (D) 1/4 Barrel (E) 1/2 Barrel (F) BBL 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. $0.48 $1.30 $1.67 $2.50 $5.00 $10.00 SUBMIT REPORT AND REMITTANCE TO: 18. GEORGIA DEPARTMENT OF REVENUE PO BOX 105458 ATLANTA, GA 30374-5458 I hereby certify, under penalty of law, that this is a true and correct report including supporting schedules and documents, of the malt beverage transactions during the month shown above. AFFIDAVIT SIGNED _________________________________ (Owner, Officer, or General Manager) TITLE _____________________________ , 20___________ Subscribed and sworn to before me this _____ day of _________________________ __________________________________________________________________ (Notary Public) American LegalNet, Inc. www.FormsWorkFlow.com
|
|||||||
