Form Wv/sev-401 - West Virginia Annual Severance Tax Return - 2006 Page 2
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1
2WV/SEV-401
PAGE
(REV. 1/07)
SEVERANCE TAX COMPUTATION SCHEDULE
2
(COLUMN 3)
(COULMN 4)
(COL 5)
(COLUMN 6)
(COLUMN 1)
(COLUMN 2)
RATE PER
EXEMPTIONS FOR GAS & OIL
VALUE OF
TAX
TYPE OF
GROSS VALUE OF
CLASS
$100
PRODUCERS ONLY
SEVERED RESOURCES
(COL 4 X COL 5)
NATURAL RESOURCE
SEVERED RESOURCES (FOR
CODE
GAS & OIL PRODUCERS ONLY)
Sand, Gravel, or
Other Mineral
2
5.00
Product Not
Quarried or Mined
5.00
3
Oil
4
5.00
Natural Gas
Limestone or
5
5.00
Sandstone
Quarried or Mined
Other Natural
7
5.00
Resource Products
TOTAL TAX - Enter here and on Line 1 on 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)
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