ATT-24 Schedule B (REV. 01/11) GEORGIA DEPARTMENT OF REVENUE PROCESSING CENTER P.O. BOX 740395 ATLANTA, GEORGIA 30374-0395 NAME OF DISTRIBUTOR SCHEDULE OF CIGARS, LITTLE CIGARS, AND LOOSE AND SMOKELESS INVENTORY SOLD/TRANSFERRED TO GEORGIA DISTRIBUTORS CITY STATE PAGE ________ OF ________ RETURN FOR THE MONTH AND YEAR OF INSTRUCTIONS: 1. LINE # 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. DATE SHIPPED Separately list all sales and transfers to Georgia Distributors. All documentation shall be retained on premise for 3 years from the date of report in accordance with Revenue Regulations. Such information shall be made available to the Department on demand and at no cost including but not limited to copies, postage, and any related administrative costs. DISTRIBUTOR SOLD/TRANSFERRED TO LOOSE TOBACCO SMOKELESS LARGE LITTLE CIGARS (NAME / CITY/STATE LICENSE NUMBER) (Wholesale Cost Price) (Wholesale Cost Price) (Wholesale Cost Price) (Quantity) $ $ $ PAGE TOTALS (Enter Grand Totals on Line 3 of Summary Page) $ $ $ American LegalNet, Inc. www.FormsWorkFlow.com
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