Form Att-24 - Georgia Loose And Smokeless Tobacco Excise Tax Monthly Return Form - Georgia Department Of Revenue Page 2

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ATT-24 – SCHEDULE A
PAGE
OF
GEORGIA DEPARTMENT OF REVENUE
ALCOHOL & TOBACCO DIVISION
SCHEDULE OF GEORGIA NON-TAX LOOSE & SMOKELESS TOBACCO PURCHASES
DISTRIBUTOR
CITY
RETURN FOR THE MONTH AND YEAR OF
INSTRUCTIONS:
Each invoice of purchase is to be reported separately, and all invoices from a particular supplier should be
listed together in a group In addition, suppliers should be listed in alphabetical order.
LINE #
INVOICE
INVOICE
DATE
PURCHASED FROM
LOOSE TOBACCO
SMOKELESS
DATE
NUMBER
RECEIVED
(Name of Supplier)
(Wholesale Cost Price)
(Wholesale Cost Price)
1.
$
$
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
PAGE TOTALS (Enter Grand Totals on Line 1 of Summary Page)
$
$

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