Form Wv/sev-401 - West Virginia Annual Severance Tax Return - 2007 Page 2
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1
2WV/SEV-401
(REV. 10/07)
SEVERANCE TAX COMPUTATION SCHEDULE
PAGE 2
(COLUMN 2)
(COLUMN 1)
(COLUMN 3)
(COLUMN 4)
(COL 5)
(COLUMN 6)
GROSS VALUE OF
CLASS
TYPE OF
EXEMPTIONS FOR GAS & OIL
GROSS VALUE OF
RATE PER
TAX
SEVERED RESOURCES (FOR
CODE
NATURAL
PRODUCERS ONLY
SEVERED RESOURCES
$100
(COL 4 X COL 5)
GAS & OIL PRODUCERS ONLY)
RESOURCE
Sand, gravel, or
other mineral
2
5.00
product not
quarried or mined
3
Oil
5.00
5.00
4
Natural gas
Limestone or
5
5.00
sandstone
quarried or mined
Other natural
5.00
7
resource products
TOTAL TAX - Enter here and on Line 1 of the front of return
Please answer all questions:
1. If you purchased this business in the past twelve (12) months, give the previous owner's name and address:
______________________________________________________________________________________________________________
2. During the period covered by this return, did you: 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 kept:_________________________________________________________________________
4. Principal place of business in West Virginia:_____________________________________________________________________
5. Nature of business conducted (Describe in detail):_______________________________________________________________
6. Telephone number of preparer of this return:_____________________________________________________________________
7. 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)
(Title)
(Date)
_______________________________________________________________________________________________________________________________
(Person to Contact Concerning this Return)
(Telephone Number)
__________________________________________________________________________________________________________________________________________
(Signature of Preparer Other than Taxpayer)
(Address)
(Date)
*B23010702A*
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