Wholesale Distributors Malt Beverage Monthly Report
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Wholesale Distributors Malt Beverage Monthly Report Form. This is a Georgia form and can be use in Department Of Revenue Statewide.
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Tags: Wholesale Distributors Malt Beverage Monthly Report, ATT-123, Georgia Statewide, Department Of Revenue
Georgia Department of Revenue
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ATT-123 (REV 8/2006)
Due By the 20 of Each Month
WHOLESALE DISTRIBUTORS MALT BEVERAGE MONTHLY REPORT
WHOLESALE DISTRIBUTOR
STATE LICENSE NO.
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.
Total taxable
(Total Lines 9 and 12, less Lines 3
and 6)
14.
Ga. Excise Tax rate per gallon
15.
Tax due by size
(Line 13 X Line 14)
16.
Gross Tax Due
(Total of all columns in Line 15)
17.
Less attached credit memorandums
issued by Ga. Department of
Revenue
18.
$10.00
Difference , if any (+ or -), between
Lines 4 and 11
13.
$5.00
Disposal and Inventory
(Total Lines 9 and10)
12.
$2.50
Physical inventory—last day of month
11.
$1.67
Total disposal during month
(Total Lines 5 through 8)
10.
$1.30
Additional Dispositions
(Total Schedule F)
9.
$0.48
Sales to dealers and employees
during month (Total Schedule E)
8.
(F) BBL
Sales to military installations during
month (Total Schedule D)
7.
(E) 1/2 Barrel
Sales to other Ga. wholesalers during
month (Total Schedule C)
6.
(D) 1/4 Barrel
Total possessed this month
(Total Lines 1 through 3)
5.
(C) 1/6 Barrel
Purchases from other Ga.
wholesalers during month (Total
Schedule B)
4.
(B) 1/8 Barrel
Purchases from brewers during month
(Total Schedule A)
3.
(A) Gallon
Inventory 1st day of month
(Line 10, Previous Monthly Report)
Net Tax Due
(Line 16 less Line 17)
SUBMIT REPORT AND REMITTANCE TO:
GEORGIA DEPARTMENT OF REVENUE
PO BOX 105458
ATLANTA, GA 30374-5458
AFFIDAVIT
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.
SIGNED _________________________________
TITLE
_____________________________
(Owner, Officer, or General Manager)
Subscribed and sworn to before me this _____ day of _________________________
, 20___________
__________________________________________________________________
(Notary Public)
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