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Cigar Shipments Into State Of Georgia By Manufacturers Importers And Brokers Form. This is a Georgia form and can be use in Department Of Revenue Statewide.
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Tags: Cigar Shipments Into State Of Georgia By Manufacturers Importers And Brokers, ATT-124, Georgia Statewide, Department Of Revenue
ATT-124 REV. 01/11)
GEORGIA DEPARTMENT OF REVENUE
PROCESSING CENTER
P.O. BOX 740395
ATLANTA, GEORGIA 30374-0395
CIGARS, LITTLE CIGARS,
AND LOOSE AND SMOKELESS TOBACCO
SHIPMENTS INTO GEORGIA BY
MANUFACTURERS, IMPORTERS AND BROKERS
NAME OF DISTRIBUTOR
STATE LICENSE NO.
ADDRESS
RETURN TO BE FILED
TH
ON OR BEFORE THE10
DAY OF THE FOLLOWING
MONTH FOR WHICH THE
REPORT IS FILED
CITY
(Street)
RETURN FOR THE MONTH AND YEAR OF
STATE
ZIP CODE
SCHEDULE OF CIGARS, LITTLE CIGARS, AND LOOSE AND SMOKELESS TOBACCO SALES TO GEORGIA CUSTOMERS
LINE #
INVOICE
DATE
INVOICE
NUMBER
1.
LOOSE TOBACCO
(Wholesale Cost Price)
SMOKELESS
(Wholesale Cost Price)
LARGE CIGARS
(Wholesale Cost Price)
$
$
$
SHIPPED TO
NAME
CITY
LITTLE CIGARS
(Quantity)
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
AFFIDAVIT
I certify, under the penalties for filing false returns, that I have personal knowledge and understanding of statements made in this return and that the figures presented herein,
including accompanying schedules, are true, correct and complete to the best of my knowledge and belief, and are filed in accordance with the law.
SIGNATURE OF OWNER, PARTNER OR OFFICER
TITLE
DATE
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SCHEDULE OF CIGARS, LITTLE CIGARS, AND LOOSE AND SMOKELESS TOBACCO
SHIPMENTS INTO GEORGIA (Continued)
LINE #
16.
INVOICE
DATE
INVOICE
NUMBER
SOLD TO
NAME
CITY
Page 2
LOOSE TOBACCO
(Wholesale Cost Price)
SMOKELESS
(Wholesale Cost Price)
LARGE CIGARS
(Wholesale Cost Price)
$
$
LITTLE CIGARS
(Quantity)
$
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
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SCHEDULE OF CIGARS, LITTLE CIGARS, AND LOOSE AND SMOKELESS TOBACCO
SHIPMENTS INTO GEORGIA (Continued)
Page 3
INSTRUCTIONS
1. Every Cigar, Little Cigar and Loose and Smokeless Tobacco Manufacturer, Importer and Broker must
complete a Cigar, Little Cigar and Loose and Smokeless Tobacco shipment report each month whether or not
there are any shipments to report.
2. Mailing - Sign and date the original report and mail to: Georgia Department of Revenue, Processing Center
th
P.O. BOX 740395, Atlanta, Georgia 30374-0395. Dis tributors shall file this report on or before the 10 day
of the following month for which the report is filed.
3. In accordance with Revenue Regulation 560-8-3-.06(5) the amount of tax due shall be computed on the actual
sale or consumption of the tobacco product within the State of Georgia and shall be payable when the tobacco
product leaves the control of the distributor for sale or consumption of the tobacco product within the State of
Georgia.
NOTE:
ALL ORIGINAL INVOICES SHALL BE RETAINED ON PREMISE FOR 3 YEARS FROM THE DATE
OF REPORT IN ACCORDANCE WITH REVENUE REGULATION 560-8-1-.06. SUCH INFORMATION
SHALL BE MADE AVAILABLE TO THE DEPARTMENT ON DEMAND AND AT NO COST
INCLUDING, BUT NOT LIMITED TO COPIES, POSTAGE OR ANY RELATED ADMINISTRATIVE
COSTS. IF SUCH INFORMATION IS REQUESTED BY THE DEPARTMENT THE SAME MAY BE
SUBMITTED ELECTRONICALLY.
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