Restaurant Quarterly Report Form

Online Submission Form: This form is also available in a printable version.

CITY OF ATHENS
"RESTAURANT QUARTERLY REPORT"

Pursuant to the City of Athens Beer Enforcement Policy dated January 21, 1997 (see attachment), please complete this form and return to the Athens Police Department, Post Office Box 849, Athens, Tennessee, 37371-0849. This form must be received by the APD no later than the 20th of the month after the end of the quarter (or by April 20, July 20, October 20, or January 20). Your noncompliance with the requirements of this policy can result in the revocation or suspension of your beer permit.

Quarter Ending:

Month	Gross Sales	Beer Sales	% of Beer Sales

I hereby certify that the above amounts are reported correctly and accurately.

Name
Title
Name of Restaurant
Date