Brew Pubs Malt Beverage Production And Tax Return
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Brew Pubs Malt Beverage Production And Tax Return Form. This is a Georgia form and can be use in Department Of Revenue Statewide.
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Tags: Brew Pubs Malt Beverage Production And Tax Return, ATT-103, Georgia Statewide, Department Of Revenue
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
19
NAME OF BREWPUB
GEORGIA LICENSE NUMBER
ADDRESS
CITY
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 48¢ 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
19
NOTARY PUBLIC
AUTHORIZED AGENT
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