Solid Waste Return Form

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STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div
P.O. Box 2666
Charleston, WV 25330-2666
Craig A. Griffith, Tax Commissioner
Earl Ray Tomblin, Governor
Name
Address
Account #:
City
State
Zip
WV/SWA-2
SOLID WASTE RETURN
rtL050 v.6 - Web
This form must be completed and returned on or before the 15th day of the month following the month for which the report is made,
EVEN THOUGH NO FEES ARE DUE FROM THE FACILITY.
Save the stamp and your time. You can now view, file and pay this tax at https://mytaxes.wvtax.gov
More taxes will be available for online access in the future.
Period Ending:
Due Date:
FINAL
AMENDED
A. DEP PERMIT NUMBER
1
SOLID
B. MEASUREMENT METHOD
Check Type of Waste:
2
SEWAGE SLUDGE
C. COUNTY
ROUND TO TWO (2) DECIMAL PLACES
WASTE ASSESSMENT
COLUMN A
COLUMN B
FEE COMPUTATION
SOLID WASTE
SEWAGE SLUDGE
1.
Total Waste Disposed of during Month other than from
.
.
Commercial Recyclers (Reference Line 8 for Recyclers)
2. Exclusive Disposals (See Instructions)
.
.
3.
Waste Reused or Recycled
.
.
4.
.
.
Residential Disposals (Residential Free Days Only)
5.
.
.
Assessment Base (Line 1 Minus Lines 2, 3 and 4)
6.
Tax Rates (Other than Commercial Recyclers)
$8.25
$8.25
7.
.
.
Waste Assessment Fee (Multiply Line 5 by Line 6)
8.
.
Total Waste Disposed of During Month by Commercial Recyclers
9.
Tax Rates (Commercial Recyclers)
$2.00
10.
Waste Assessment Fee (Multiply Line 8 by Line 9)
.
11.
.
Total Assessment Fee (Add Lines 7A, 7B and 10A)
12.
.
(PSC) Closure Deduction
13.
Non-Waivable Interest
.
14.
.
Additions to Tax
15.
.
Total Remittance Due (Line 11 Minus 12 Plus 13 and 14)
16.
Total Payments Made for Period Covered by this Return (Amended Only)
.
17. Overpayment (Line 15 minus Line 16) If Line 16 is greater than Line 15, enter 0
.
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)
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Div
P.O. Box 2666, Charleston, WV 25330-2666
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297
For more information visit our web site at:
G
1
4
2
0
0
8
0
1
W
File online at https://mytaxes.wvtax.gov

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