West Virginia Employer'S Return Of Income Tax Witthed Form

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STATE OF WEST VIRGINIA
State Tax Department, Internal Auditing Division
P.O. Box 1667
Charleston, WV 25326-1667
Joe Manchin III, Governor
Virgil T. Helton, Tax Commissioner
Name
Address
City
State
Zip
WEST VIRGINIA EMPLOYER'S RETURN OF INCOME TAX WITHHELD
Notice to Employers
Electronic filing is voluntary for employers. Electronic Funds Transfer (EFT) is mandatory for all employers having a monthly
withholding liability of $100,000 or more. Annual notifications will be made to those employers affected by the mandatory
electronic payment requirement. Paper returns are still required and are to be mailed to the address below.
WV STATE TAX DEPARTMENT
RD-EFT
P.O. BOX 11895
CHARLESTON, WV 25339-1895
Note: You must file this return even if no tax has been withheld for this period.
MAKE CHECKS PAYABLE TO:
MAIL TO:
WEST VIRGINIA STATE TAX DEPARTMENT
WEST VIRGINIA STATE TAX DEPARTMENT
INTERNAL AUDITING DIVISION
FOR ASSISTANCE CALL: (304) 558-3333
P.O. BOX 1667
TOLL FREE (800) 982-8297
CHARLESTON, WV 25326-1667
Visit our web site at: for on-line filing information.
PLEASE CUT HERE. USE BLUE OR BLACK INK TO COMPLETE VOUCHER. DO NOT WRITE IN BARCODE AREA.
EMPLOYER'S RETURN OF
WV/IT101 v.40
INCOME TAX WITHHELD
Period:
Account ID #
NUMBER OF EMPLOYEES AT END OF PERIOD
,
Due:
1. TAX WITHHELD
,
,
.
THIS PERIOD
2. ADJUSTMENTS
,
,
.
(PLUS OR MINUS)
Name
3. TAX DUE
,
,
.
THIS PERIOD
Address
4. INTEREST
,
.
City
State
Zip
5. PENALTY
,
.
6. TOTAL REMITTANCE
$
,
,
.
SIGNATURE
DATE

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