Form It-140 - West Virginia Resident Income Tax Return - Long Form - 2000
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1
2WEST VIRGINIA RESIDENT INCOME TAX RETURN - LONG FORM - 2000
IT-140
If this return is filed under Extension of time, Enter extended due date _____________
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
City or Town
County
State
Zip Code
❐
injured spouse, check this box.....
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 1999 return?
YES
NO
above and enter spouse's full name here:
If "NO", enter the name(s) and address from your
1999 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 1998 or 1999?_____
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
00
1
federal Form 1040, line 33; Form 1040A, line 19; or Form 1040EZ, line 4) .....................................................................
+
00
2
2.
ADDITIONS TO INCOME from line 28 of Schedule M or specify:
−
00
3
3.
SUBTRACTIONS FROM INCOME from line 39 of Schedule M or specify:
00
4
4.
WEST VIRGINIA ADJUSTED GROSS INCOME (line 1 plus line 2 minus line 3) .......................................................
00
5
5.
LOW-INCOME EARNED INCOME EXCLUSION .........................................................................................................
00
6
6.
EXEMPTIONS (box 3 of Section D above
x $2,000) ..........................................................................................
00
7
7.
WEST VIRGINIA TAXABLE INCOME (line 4 minus lines 5 and 6)
......................................
IF LESS THAN ZERO, ENTER ZERO
❐
❐
❐
8.
INCOME TAX DUE from (check one):
Tax Tables
Rate Schedule
Schedule T
00
8
00
9
9.
WEST VIRGINIA INCOME TAX WITHHELD
..................
(ATTACH LEGIBLE W-2'S OR 1099'S)
(ATTACH LEGIBLE W-2'S OR 1099'S)
(ATTACH LEGIBLE W-2'S OR 1099'S)
(ATTACH LEGIBLE W-2'S OR 1099'S)
(ATTACH LEGIBLE W-2'S OR 1099'S)
00
10
10.
ESTIMATED TAX PAYMENTS AND PAYMENTS WITH EXTENSION ....................
00
11
11.
BUSINESS TAX/INVESTMENT/EMPLOYMENT/NONFAMILY ADOPTION CREDITS .
00
12
12.
CREDIT FOR INCOME TAX PAID TO OTHER STATE(S) (attach Schedule E) .........
00
13
13.
SUM OF PAYMENTS AND CREDITS (add lines 9 through 12) ..................................................................................
00
14
BALANCE OF TAX DUE
BALANCE OF TAX DUE
BALANCE OF TAX DUE
14.
BALANCE OF TAX DUE
BALANCE OF TAX DUE
(line 8 minus line 13) ......................................................
00
15
PENALTY DUE
PENALTY DUE
PENALTY DUE
PENALTY DUE
PENALTY DUE
15.
(from Form IT-210) ..........................................................................
00
1
16
BALANCE DUE
BALANCE DUE
BALANCE DUE
BALANCE DUE
BALANCE DUE THE STATE
16.
(add lines 14 and 15)
.....
MAKE CHECK P
MAKE CHECK P
MAKE CHECK P
MAKE CHECK P
MAKE CHECK PA A A A A Y Y Y Y Y ABLE
ABLE
ABLE
ABLE
ABLE T T T T T O: O: O: O: O: W W W W W est
est
est
est
est Vir
Vir
Vir
Vir
Virginia State
ginia State
ginia State
ginia State T T T T T ax Depar
ginia State
ax Depar
ax Depar
ax Depar
ax Department
tment
tment
tment
tment
00
OVERPAYMENT
OVERPAYMENT
OVERPAYMENT
17
OVERPAYMENT
OVERPAYMENT
17.
(subtract line 8 from line 13) ......................................................
18
00
18.
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2001 ESTIMATED TAX
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2001 ESTIMATED TAX
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2001 ESTIMATED TAX
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2001 ESTIMATED TAX
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2001 ESTIMATED TAX .......
19.
WEST VIRGINIA CHILDREN'S TRUST FUND
WEST VIRGINIA CHILDREN'S TRUST FUND
WEST VIRGINIA CHILDREN'S TRUST FUND to help prevent child abuse and neglect.
WEST VIRGINIA CHILDREN'S TRUST FUND
WEST VIRGINIA CHILDREN'S TRUST FUND
❐
❐
❐
❐
00
19
Enter the amount of your contribution:
$2,
$5,
$10,
Other $
00
20
20.
DEDUCTIONS FROM YOUR OVERPAYMENT (add lines 18 and 19) .................................................................
2
00
REFUND
REFUND
REFUND
21
REFUND
REFUND
21.
DUE YOU (subtract line 20 from line 17) ............................................................................................
REFUND OF $1 WILL BE ISSUED ONLY IF A WRITTEN REQUEST IS ATTACHED TO THIS RETURN.
REFUND OF $1 WILL BE ISSUED ONLY IF A WRITTEN REQUEST IS ATTACHED TO THIS RETURN.
REFUND OF $1 WILL BE ISSUED ONLY IF A WRITTEN REQUEST IS ATTACHED TO THIS RETURN.
REFUND OF $1 WILL BE ISSUED ONLY IF A WRITTEN REQUEST IS ATTACHED TO THIS RETURN.
REFUND OF $1 WILL BE ISSUED ONLY IF A WRITTEN REQUEST IS ATTACHED TO THIS RETURN.
My/our initials in the boxes indicates waiver of my / our rights of confidentiality for the purpose of contacting the preparer regarding this return.
SIGN HERE
– 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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