Form Att-24 Schedule D - Schedule Of Cigars, Little Cigars, And Loose And Smokeless Tobacco Sold To Federal Military Installations

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ATT-24 Schedule D (REV.01/11)

SCHEDULE OF CIGARS, LITTLE CIGARS,

PAGE ________ OF ________

GEORGIA DEPARTMENT OF REVENUE

AND LOOSE AND SMOKELESS TOBACCO

PROCESSING CENTER

SOLD TO FEDERAL MILITARY INSTALLATIONS

P.O. BOX 740395

ATLANTA, GEORGIA 30374-0395

NAME OF DISTRIBUTOR

CITY

STATE

RETURN FOR THE MONTH AND YEAR OF

INSTRUCTIONS:

Invoices of exempted product to Federal Military Installations are to be reported separately and shall be retained on premise for 3 years from the date

of report in accordance with Revenue Regulations. Such information shall be made available to the Department on demand and at no cost including

but not limited to copies, postage, and any related administrative costs.

The total amount of any returns made to a distributor should be reported on Schedule A. If all or part of a return is to be transferred back to the

manufacturer Schedule B should be completed after Schedule A.

DATE

SOLD TO

LOOSE TOBACCO

SMOKELESS

LARGE CIGARS

LITTLE CIGARS

LINE #

SHIPPED