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Brew Pubs Malt Beverage Production And Tax Return ATT-103 - Georgia
| Brew Pubs Malt Beverage Production And Tax Return Form. This is a Georgia form and can be used in Alcohol And Tobacco Division Department Of Revenue Statewide . |
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ATT-103 (REV. 8/05) GEORGIA DEPARTMENT OF REVENUE ALCOHOL AND TOBACCO DIVISION PO BOX 49728 ATLANTA GA 30359 DUE BY THE 20th OF EACH MONTH BREWPUB' MALT BEVERAGE PRODUCTION AND TAX RETURN S FOR THE MONTH OF NAME OF BREWPUB ADDRESS CITY 19 GEORGIA LICENSE NUMBER STATE ZIP CODE INSTRUCTIONS 1. This report must be filed with the Georgia Department of Revenue on or before the 20th of each calendar month covering all production of malt beverage during the preceding calendar month. 2. The proper tax remittance check, made payable to the Georgia Department of Revenue, for the tax on the total malt beverage production, less the amount shipped to wholesalers, must be attached to this report. 3. An exact copy of all reports filed with the United States Treasury Department must be submitted along with this report. PRODUCTION SUMMARY COMPUTATION OF TAX 1. TOTAL GALLONS PRODUCED = 2. GALLONS SHIPPED TO WHOLESALER = 3. AMOUNT to be REMITTED with REPORT= $ (LINE 1 LESS LINE 2 X 48ยข PER GALLON) AFFIDAVIT Before me, an officer authorized by law to administer oaths, personally appeared an authorized agent, of the above named business, who, first being duly sworn, deposes and says that this report is true and correct to the best of his knowledge and belief, and is filed in accordance with law. Subscribed and sworn to before me This day of NOTARY PUBLIC 19 AUTHORIZED AGENT American LegalNet, Inc. www.FormsWorkflow.com
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