Name: _________________________________
Physical Address: _________________________
Sales Report for the Months of:
______________ _______________ _______________
MONTH
FOOD SALES
BEER/WINE
SALES
FOOD AND OTHER
SALES
I certify that this report including accompanying Georgia Sales Tax Returns have been
examined by me and are, to the best of my knowledge and belief, a true and complete report
for the months stated.
This _____ day of _____________________, 20__
____________________________________________
Signature
Attach copies of Georgia Sales Tax Returns for the months reported above.
CITY OF DAHLONEGA
465 Riley Road
Dahlonega, Georgia 30533
Phone: 706-482-2706 • Fax: 706-864-4837