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Form Wv/nrsr - Return Of Income Tax Withholding For Nonresident Sale Of Real Property Page 4

WV/NRSR

WEST VIRGINIA STATE TAX DEPARTMENT

REV 1/08

RETURN OF INCOME TAX WITHHOLDING FOR NONRESIDENT SALE OF REAL PROPERTY

2. Date of transfer

1. Property account ID number, address and description

YYYY

3. Check if the transferor/

seller is reporting gain under

the installment method

CHECK ONE

5. Spouse’s SSN number

7. Transferor/Seller is:

4. Transferor/Seller’s

Identification number

SSN

a. Individual

FEIN

b. Corporation

ITIN

c. Trust or Estate

6. Transferor/Seller’s name (Enter only one name, unless husband and wife filing a joint return. If

more than one transferor/seller, use separate forms for each.)

d. Business Trust

e. Partnership

f. S Corporation

Street Address including City, State and ZIP Code

g. Limited Liability Company

h. Limited Liability Partnership

8. Computation of total payment and tax to be withheld (see instructions)

a. Total sales price paid to transferor............................................................................... a

b. Less selling expenses................................................................................................. b

c. Less debts secured by mortgages or other liens on the property................................. c

d. Net proceeds .............................................................................................................. d

e. Total payment (net proceeds paid to transferor)........................................................... e

f. Transferor/seller’s ownership

percentage................................................................................................................... f

g. Transferor/seller’s share of total payment. (multiply Line e by Line f)........................... g

h. Enter applicable rate:

1) 2.5% of total payments, or

2) 6.5% of estimated capital gain $

..........................

i. WV Income Tax withheld (multiply Line g or amount of estimated capital

gain by Line h) (If partial exemption granted, enter amount stated on

Form WV/NRCE)..............................................................................................

COPY B - FOR TRANSFEROR/SELLER (RECORDS COPY)

Form Wv/nrsr - Return Of Income Tax Withholding For Nonresident Sale Of Real Property Page 4

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