Inventory Reporting
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1City of Dawsonville
Excise Tax Reporting Form
P.O. Box 6, 415 Highway 53 East Suite 100
Consumption on Premises
Dawsonville, Georgia 30534
Phone: (706)265-3256
Distilled Spirits
Email:
clerk@dawsonville-ga.gov
Website:
BUSINESS NAME:
City License #
____
Address:
State License #
____
Address:
Telephone:
____
MONTHLY PERIOD REPORTED:
,
th
Remit on or before the 10
day of the succeeding month to avoid penalty.
INVENTORY REPORTING
INVENTORY REPORTING: WHOLESALER COMPANY NAME
In Liters
In Ounces
(List all inventory purchased for month reporting from each company.)
1
2
3
4
5
6
7 Total Volume purchased
(Add lines 1-6)
8 Beginning Inventory of month reporting
9 Total inventory for month reporting
(Add lines 7+ 8)
10 Ending Inventory of month reporting
11 Total inventory sold for month reporting
(Subtract line 10 from line 9)
Average ounces per drink sold:
Average price per drink sold:
EXCISE TAX REPORTING
Gross Sales
(Alcoholic beverage by the drink)
1
Tax: 3% of line 1
2
On-time Reporting Credit
3
th
(Subtract 3% of line 2 for reports received at City Hall by the 10
)
Penalty 10%
4
th
(Penalty must be applied to reports received at City Hall after the 20
)
$
Make checks payable to: City of Dawsonville
Total Remitted
5
th
Note: Reports received after the 20
of each month will be assessed a 10% penalty as defined in
th
Section 3-45(a)(b)and(c) of the Alcohol Ordinance.
(If the 20
is on a weekend – report due Monday)
I hereby certify that the information reported herein is true, correct and complete to the best of my knowledge.
Print Name
Telephone
Email Address
__________________________________________________
Signature
Date
Page 12
Rev. Nov.2010
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