Form It-140nr/py - West Virginia Nonresident/part-Year Resident Income Tax Return - 1999

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WEST VIRGINIA NONRESIDENT/PART-YEAR RESIDENT INCOME TAX RETURN - 1999
IT-140NR/PY
Or other taxable year beginning ____________, 19 _____ Ending ____________, 19 _____
C
First Name and Middle Initial
Last Name
Your Social Security Number
Spouse's First Name and Middle Initial (if joint return)
Spouse's Last Name (if different)
Spouse's Social Security Number
Present Home Address
USE
If you are filing Form WV-8379 as an
LABEL,
injured spouse, check this box.....
PRINT
City or Town
County
State
Zip Code
OR TYPE
II
FILING STATUS
(CHECK ONE)
Your Year of Birth
1.
Married filing jointly (even if only one spouse had income), Single,
1
Head of household, or Widow(er) with dependent child .........................................................
Spouse's Year of Birth
2
2.
Married filing separately. See instructions on page 5 AND ...................................................
I
Are the name(s) and address above the same as
give spouse's social security number
shown on your 1998 return?
YES
NO
If
above and enter spouse's full name here:
"NO", enter the name(s) and address from your 1998
return.
III
EXEMPTIONS
1
1.
Exemptions claimed on your federal return .........................................................................
2
2.
Additional exemption if surviving spouse: Year spouse died
____________________
Your Telephone Number
3
3.
TOTAL EXEMPTIONS (add boxes 1 and 2). Enter here and use on line 7 below .............
1
1.
TOTAL WEST VIRGINIA INCOME (from line 50 of Schedule A) .....................................
2
2.
FEDERAL ADJUSTED GROSS INCOME (from line 47, Column A of Schedule A) .......................................................
+
3
3.
ADDITIONS TO INCOME from line 67 of Schedule M or specify: _____________________________________
−
4
4.
SUBTRACTIONS FROM INCOME from line 77 of Schedule M or specify: ______________________________
5
5.
MODIFIED ADJUSTED GROSS INCOME (line 2 plus line 3 minus line 4) ....................................................................
6
6.
LOW-INCOME EARNED INCOME EXCLUSION (from worksheet) ...............................................................................
7
7.
EXEMPTIONS (line 3 of Section III above
x $2,000) ........................................................................................
8
8.
WEST VIRGINIA TAXABLE INCOME (line 5 minus lines 6 and 7)
....................................
IF LESS THAN ZERO, ENTER ZERO
9
9.
TENTATIVE TAX (check here
if Schedule T was used to calculate your tax) ..........................................................
10.
INCOME PERCENTAGE
10
Divide line 1 by line 2 and round the result to four places ..................................................
11
11.
WEST VIRGINIA INCOME TAX (multiply line 9 by line 10) ..............................................
12
12.
WEST VIRGINIA INCOME TAX WITHHELD .................................................................
YOU MUST ATTACH LEGIBLE W-2'S OR 1099'S TO SUPPORT THIS AMOUNT.
13
13.
ESTIMATED TAX PAYMENTS AND PAYMENTS WITH EXTENSION ......................
14
14.
BUSINESS TAX/INVESTMENT/EMPLOYMENT/NONFAMILY ADOPTION CREDITS
15
15.
CREDIT FOR INCOME TAX PAID OTHER STATE(S) (attach Schedule E) ..................
16
16.
SUM OF PAYMENTS AND CREDITS (add lines 12 through 15) ..................................................................................
17
BALANCE OF TAX DUE
17.
(line 11 minus line 16) .......................................................
18
PENALTY DUE
18.
(from Form IT-210) .............................................................................
REVIEW THE INSTRUCTIONS TO SEE IF YOU SHOULD FILE FORM IT-210 WITH YOUR RETURN.
1
19
BALANCE DUE
THE STATE
19.
(add lines 17 and 18)
.........................
MAKE CHECKS PAYABLE TO: WV STATE TAX DEPARTMENT
20
OVERPAYMENT
20.
(subtract line 11 from line 16) .......................................................
21
21.
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2000 ESTIMATED TAX ...........
22.
WEST VIRGINIA CHILDREN'S TRUST FUND to help prevent child abuse and neglect.
22
Enter the amount of your contribution:
$2,
$5,
$10,
Other $
23
23.
DEDUCTIONS FROM YOUR OVERPAYMENT (add lines 21 and 22) ..........................................................................
2
24
REFUND
24.
DUE YOU (subtract line 23 from line 20) .....................................................................................................
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
West Virginia State Tax Department,
MAIL TO:
P.O. Box 1071, Charleston, WV 25324-1071

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