Form Att-125 - Wholesale Distributors Monthly Report Of Malt Beverages Containing Less Than One-Half Of One Percent Alcohol By Volume

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ATT-125 Summary (Rev. 1/13)

Due by 20

of each month

Georgia Department of Revenue

Alcohol and Tobacco Division

Telephone: (404) 417-4900

Email: ATDIV@dor.ga.gov

WHOLESALE DISTRIBUTORS MONTHLY REPORT OF MALT BEVERAGES CONTAINING LESS

THAN ONE-HALF OF ONE PERCENT ALCOHOL BY VOLUME

Submit online

https://gtc.dor.ga.gov

WHOLESALE DISTRIBUTOR

(

STATE LICENSE NO

FILING PERIOD

MM/DD/YYYY)

ADDRESS

CITY

ZIP CODE

STATE

REPORT IN NUMBER OF CASES OR KEGS ACCORDING TO PACKING AND SIZE CONTAINER

(A)

SUMMARY

(B)

(C)

(D)

(E)

(F)

(G)

(H)

(I)

24/12

1. Inventory 1

day of month

(Line 10, Prev. Monthly

Report)

2. Pu rchases from brewers

during month

(Total Schedule A)

3. Purchases from other Georgia

Wholesalers during month

(Total Schedule B)

4. Total possessed this month

(Total Lines 1 thru 3)

5. Sales to other Georgia

Wholesalers during month

(Total Schedule C)

6. Sales to military installations

during month.

(Total Schedule D)

7. Sales to dealers and

employees during month.

(Total Schedule E)

8. Additional Dispositions

(Total Schedule F)

9. Total disposal during month

(Total Lines 5 thru 8)

10. Physical Inventory last day

of month

11. Disposal and Inventory

(Total lines 9 and 10)

AFFIDAVIT

I hereby certify, under penalty of law, that this is a true and correct report including supporting schedules and documents, of Malt Beverage containing less

than one-half of one percent alcohol by volume transactions during the month shown above.

Signed:___________________________________

Title:_______________________________

(Owner, Officer or General Manager)

Subscribed and sworn to before me this _______ day of _______________ ______. ______________________________________________

(Notary Public)