Form Wv/sev-401 - West Virginia Annual Severance Tax Return - 2001
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1
2WV/SEV-401
PAGE 1
(Rev 07/01)
2001
WEST VIRGINIA ANNUAL SEVERANCE TAX RETURN
Tax Year Beginning ____________________, 20_________, Ending __________________, 20________
The first line of this section is your account identification number.
Please reference your account number on all correspondence.
Please change name and address if not correct. If you quit busi-
ness, give the date and the name and address of new owner.
FORM OF BUSINESS (CHECK ONE) CHECK IF:
S CORPORATION
CONSOLIDATED
CORPORATION
SEPARATE
PARTNERSHIP
FINAL
INDIVIDUAL
AMENDED
L L C
BEFORE YOU COMPLETE THIS PAGE, YOU MUST COMPLETE THE SCHEDULE ON THE REVERSE SIDE OF THIS FORM
DO NOT USE SPACE BELOW
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
INTERNAL AUDITING DIVISION
P. O. BOX 425, CHARLESTON, WV 25322-0425
FOR ASSISTANCE CALL (304) 558-3333
TOLL FREE TO 1-800-WVA-TAXS (1-800-982-8297)
MAKE CHECKS PAYABLE TO THE:
WEST VIRGINIA STATE TAX DEPARTMENT
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