Form Att-153 - Wholesalers Malt Beverage Report Of Inventory - 2013

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ATT-153 (REV. 1/13)

DUE TO BE FILED BY 10

DAYS PAST DUE DATE

Georgia Department of Revenue

Alcohol and Tobacco Division

Telephone: (404) 417-4900

ATDiv@dor.ga.gov

E-mail:

WHOLESALERS MALT BEVERAGE REPORT OF INVENTORY

Submit online at

https://gtc.dor.ga.gov

NAME OF WHOLESALER

STREET

CITY

STATE

ZIP CODE

INVENTORY OF MALT BEVERAGE IN THE POSSESSION OF THE ABOVE NAMED

WHOLESALER AS OF CLOSE OF BUSINESS ON JANUARY 31 AND JULY 31 EACH YEAR

SIZE OF CONTAINER AND

NUMBER OF CASES OR

NUMBER PER CASE

KEGS

NUMBER PER CASE

KEGS

48/7

oz Case

36/8

oz Case

24/12

oz Case

24/14

oz Case

24/16

oz Case

12/32

oz Case

24/7

oz Case

24/8

1/4

oz Case

Barrel - Each

1/2

oz Case

Barrel - Each

IMPORTANT

The inventory as reflected and recorded on this document will be used for the purposes of determining tax liability. Upon the signing of this

document by the wholesaler or its authorized agent, the wholesaler agrees and acknowledges that the inventory figures reflected above shall be

binding on the wholesaler for purposes of calculating the wholesaler's tax liability pursuant to O.C.G.A. § 3-5-60. It is therefore imperative that you

are in accord and agreement as to the accuracy of the inventory before affixing your signature to same.

The undersigned does hereby swear, subject to criminal penalties for false swearing, that a complete inventory has been conducted of all malt

beverages on hand on date above given, and further swears that the inventory figures recorded above accurately reflect the inventory of malt

beverages on hand on the date indicated above; and the undersigned hereby attests and affirms this report to be correct and accurate.

Sworn to and subscribed before me

this ____ day of ____________ 20____.

Signed ____________________________

(Signature of Officer, Partner or Owner of above named company)

______________________________________________

Notary Public

______________________________________________

My Commission expires:

(Title)

Signature: This report must be signed by the owner, if a natural person; and in cases where the owner is a partnership, by a partner thereof; and if a corporation, by an officer thereof.