Att-24 Schedule C - Schedule Of Cigars, Little Cigars, And Loose And Smokeless Tobacco Returned To Manufacturer Form - 2011

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ATT-24 Schedule C (REV. 01/11)
SCHEDULE OF CIGARS, LITTLE CIGARS,
PAGE ________ OF ________
GEORGIA DEPARTMENT OF REVENUE
AND LOOSE AND SMOKELESS TOBACCO
PROCESSING CENTER
RETURNED TO MANUFACTURER
P.O. BOX 740395
ATLANTA, GEORGIA 30374-0395
NAME OF DISTRIBUTOR
CITY
STATE
RETURN FOR THE MONTH AND YEAR OF
INSTRUCTIONS:
Each credit memorandum, issued by manufacturer for cigars, little cigars, and loose and smokeless tobacco returned to the manufacturer, is to be reported
separately and must be supported by attaching hereto a legible copy of credit memorandum. Form ATT-24-Affidavit must also be attached for each excise tax
refund request.
MFG. CREDIT
MFG. CREDIT
DATE
SOLD OR TRANSFERRED TO
LOOSE TOBACCO
SMOKELESS
LARGE CIGARS
LITTLE CIGARS
LINE #
MEMO DATE
MEMO NO.
SHIPPED
(NAME AND ADDRESS)
(Wholesale Cost Price)
(Wholesale Cost Price)
(Wholesale Cost Price)
(Quantity)
$
$
$
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
$
$
$
17.
PAGE TOTALS (Enter Grand Totals on Line 4 of Summary Page)

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