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CITY OF MARIETTA
Business License Division, 205 Lawrence St., P. O. Box 609
Marietta, GA 30061 Telephone (770) 794-5520
Malt Beverage Reporting Form
Business Name Account #
Locati
on:
Part A- S
ales for consumption off-premises
1. For the Month Ending: (Enter month/day/year) 1._______________
2. Calculate taxes due.
¼ Barrel
1/6 Barrel
(twenty-four 12-oz
3._______________
4.______________
_
3. Penalty (Line 2 X .1, if postmarked after due date )
4. Outstanding penalties for each successive month or portion thereof.
Number of outstanding months ____________
Total outstanding taxes due
(sum of lines 5 from outstanding ____________ x .1
monthly reports)
5. Total Due (Sum of Lines
2, 3 and 4)
5._______________
*This report must be postmarked by the 10th day of the month following the period for which the
tax is due.