Form Wv/sev-401c - Annual Coal Severance Tax Return - 2005 Page 2

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WV/SEV-401C (REV. 8/05)
PAGE 2
BUSINESS
SCHEDULE B *SEVERANCE TAX COMPUTATION SCHEDULE
NAME
COMPUTATION
SEVERED
ACCOUNT IDENTIFICATION NUMBER
SEVERED AND
PURCHASED AND PROCESSED
OF SEVERANCE
BUT NOT
PROCESSED
TAX
PROCESSED
(COLUMN 1)
(COLUMN 3)
(COLUMN 4)
(COLUMN 5)
(COLUMN 6)
(COLUMN 7)
(COL 8)
(COLUMN 9)
(COLUMN 2)
TOTAL GROSS
RATE
VALUE
AMOUNT PAID
GROSS VALUE
GROSS VALUE
GROSS VALUE
GROSS VALUE
TAX
PER
OF PURCHASED
OR PAYABLE
TO BE TAXED
OF SEVERED
OF SEVERED
TO BE TAXED
(COL. 7 X COL. 8)
$100
AND PROCESSED
FOR PURCHASED
)
AND PROCESSED
RESOURCES BUT
(ADD COLUMNS
(COL. 2- COL. 3
RESOURCES
RESOURCES
RESOURCES
NOT PROCESSED
4,5,AND/OR 6)
Coal - not qualified
1 .
5.00
as thin seam
Qualified thin
2.
2.00
seam 37" to 45"
Qualified thin seam
3.
1.00
less than 37"
Report on line 1-Sch A
Report on line 1-Sch A
TOTAL
4.
*For tax years beginning on or after April 13, 2001, the severance tax rate on coal produced from refuse, gob piles, slurry ponds, pond fines or other sources of
waste coal is 2.5% and must be reported on annual form WV/SEV-401W.
**SCHEDULE C - MINIMUM TAX ON COAL PRODUCTION
(If you process purchased coal only, do not complete Schedule C)
**Effective April 1, 2000, qualified thin seam coal is not subject to the minimum severance tax (§ 11-13A-3(f)) .
1. Total Tons Sold *(do not include tons from qualified thin seams on or after 4/1/2000)
1
2. Line 1 times $0.75
2
3. Net Severance Tax Payable (Schedule A, Line 4)
3
.
4. Net State Severance Tax Ratio (Enter .93)
4
.93
5
5. Net State Severance Tax (Multiply Line 3 x Line 4)
6. Net Minimum Tax (Line 2 Minus Line 5) (If Less Than 0, Enter 0 here and on Line 5, Schedule A)
6
SCHEDULE D - SUBSIDIARIES REPORTED
FEIN
NAME
FEIN
NAME
1.
5.
2.
6.
3.
7.
4.
8.
Please answer all questions:
1. If you purchased this business in the past twelve (12) months, give the previous owner's full name and address:
___________________________________________________________________________________________________________________________________________
2. During the period covered by this return, did you:
a. Quit business?_______________ Sell or otherwise dispose of your business?_______________ Exact date______________________________
b. If business was sold, give exact name and address of new owner____________________________________________________________________
_________________________________________________________________________________________________________________________________________
3. Address where your records are located_________________________________________________________________________________________
4. Principal place of business in West Virginia _______________________________________________________________________________________
5. Nature of business conducted (Describe in Detail)__________________________________________________________________________________
6. Give name and account number of any additional business(es) operated in West Virginia by the reporting taxpayer______________________________
__________________________________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________________
Under penalties of perjury, I declare that I have examined this return (including accompanying schedules and statements) and to the
best of my knowledge and belief it is true, and complete.
(Signature of Taxpayer)
(Name of Taxpayer - Type or Print)
(Title)
(Date)
(Person to Contact Concerning this Return)
(Telephone Number)
(Signature of preparer other than taxpayer)
(Address)
(Date)

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