Form It-140 - West Virginia Resident Income Tax Return - Long Form - 1999
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1
2WEST VIRGINIA RESIDENT INCOME TAX RETURN - LONG FORM - 1999
IT-140
Or other taxable year beginning ____________, 19 _____ Ending ____________, 19 _____
A
First Name and Initial
Last Name
Your Social Security Number
Spouse's First Name and Initial (if joint return)
Spouse's Last Name (if different)
Spouse's Social Security Number
Present Home Address
USE
LABEL,
If you are filing Form WV-8379 as an
PRINT
injured spouse, check this box.....
City or Town
County
State
Zip Code
OR TYPE
C
FILING STATUS
Your Year of Birth
(CHECK ONE)
1.
Married filing jointly (even if only one spouse had income), Single,
Spouse's Year of Birth
1
Head of household, or Widow(er) with dependent child .........................................................
2
2.
Married filing separately. .......................................................................................................
B
Are the name(s) and address above the same
Give spouse's social security number
as shown on your 1998 return?
YES
NO
above and enter spouse's full name here:
If "NO", enter the name(s) and address from your
1998 return.
D
EXEMPTIONS
1
1.
Exemptions claimed on your federal return ........................................................................
(SEE INSTRUCTIONS IF YOU MARKED FILING STATUS 2 ABOVE)
2.
Did your spouse die in 1997 or 1998?_____
If yes (and
2
you have not remarried), enter 1 and the year your spouse died _______________
TOTAL EXEMPTIONS (add boxes 1 and 2). Enter here and use on line 6 below.
3.
Your Telephone Number
3
If box 3 is zero, enter $500 on line 6 below ........................................................................
1.
FEDERAL ADJUSTED GROSS INCOME (must be the same amount as reported on
1
federal Form 1040, line 33; Form 1040A, line 18; or Form 1040EZ, line 4) .....................................................................
+
2
2.
ADDITIONS TO INCOME from line 28 of Schedule M or specify:
−
3
3.
SUBTRACTIONS FROM INCOME from line 38 of Schedule M or specify:
4
4.
WEST VIRGINIA ADJUSTED GROSS INCOME (line 1 plus line 2 minus line 3) .......................................................
5
5.
LOW-INCOME EARNED INCOME EXCLUSION (from worksheet on reverse) ............................................................
6
6.
EXEMPTIONS (box 3 of Section D above
x $2,000) ....................................................................................
7
7.
WEST VIRGINIA TAXABLE INCOME (line 4 minus lines 5 and 6)
...................................
IF LESS THAN ZERO, ENTER ZERO
Tax Tables
Rate Schedule
Schedule T
8.
INCOME TAX DUE from (check one):
8
9
9.
WEST VIRGINIA INCOME TAX WITHHELD
..................
(ATTACH LEGIBLE W-2'S OR 1099'S)
10
10.
ESTIMATED TAX PAYMENTS AND PAYMENTS WITH EXTENSION ...................
11
11.
BUSINESS TAX/INVESTMENT/EMPLOYMENT/NONFAMILY ADOPTION CREDITS
12
12.
CREDIT FOR INCOME TAX PAID TO OTHER STATE(S) (attach Schedule E) ........
13
13.
SUM OF PAYMENTS AND CREDITS (add lines 9 through 12) ..................................................................................
14
BALANCE OF TAX DUE
14.
(line 8 minus line 13) ......................................................
15
15.
PENALTY DUE
(from Form IT-210) ..........................................................................
REVIEW THE INSTRUCTIONS TO SEE IF YOU SHOULD FILE FORM IT-210 WITH YOUR RETURN.
.
1
16
16.
BALANCE DUE THE STATE
(add lines 14 and 15)
.
MAKE CHECK PAYABLE TO: West Virginia State Tax Department
17
OVERPAYMENT
17.
(subtract line 8 from line 13) ......................................................
18
18.
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2000 ESTIMATED TAX ........
19.
WEST VIRGINIA CHILDREN'S TRUST FUND to help prevent child abuse and neglect.
19
Enter the amount of your contribution:
$2,
$5,
$10,
Other $
20
20.
DEDUCTIONS FROM YOUR OVERPAYMENT (add lines 18 and 19) ........................................................................
2
21
REFUND
21.
DUE YOU (subtract line 20 from line 17) ...................................................................................................
REFUND OF $1 OR LESS WILL BE ISSUED ONLY IF A WRITTEN REQUEST IS ATTACHED TO THIS RETURN.
SIGN HERE –
Returns which are not signed will NOT be processed (joint returns must be signed by BOTH spouses, even if
only one had income). 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, correct, and complete.
Your Signature
Date
Spouse's Signature
Date
DO NOT USE SPACE BELOW
Signature of preparer other than taxpayer
Date
Address of preparer
Telephone
MAIL TO: West Virginia State Tax Department
P.O. Box 1071, Charleston, WV 25324-1071
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