Form Wv/sev-401c - Annual Coal Severance Tax Return - 1999 Page 2
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WV/SEV-401C (REV. 10/99)
BUSINESS NAME
SCHEDULE B *SEVERANCE TAX COMPUTATION SCHEDULE
SEVERED
COMPUTATION
ACCOUNT IDENTIFICATION NUMBER
PURCHASED AND PROCESSED
SEVERED AND
BUT NOT
OF SEVERANCE
*
PROCESSED
PROCESSED
TAX
(COLUMN 6)
(COLUMN 5)
(COLUMN 1)
(COLUMN 2)
(COLUMN 3)
(COLUMN 4)
(COLUMN 7)
(COL. 8)
(COLUMN 9)
GROSS VALUE
GROSS VALUE
TOTAL GROSS
AMOUNT PAID
GROSS VALUE
GROSS VALUE
RATE
TAX
OF SEVERED
OF SEVERED
TO BE TAXED
VALUE
OR PAYABLE
TO BE TAXED
PER
(COL. 7 X COL. 8)
RESOURCES BUT
AND PROCESSED
OF PURCHASED
FOR PURCHASED
(ADD COLUMNS
$100.00
(COL. 2- COL. 3)
*
NOT PROCESSED
RESOURCES
4,5,AND/OR 6)
AND PROCESSED
RESOURCES
RESOURCES
1.
Coal
5.00
1a. *Low Seam Coal - Enter Total Gross Receipts from Line 9, Part II and/or Line 1, Part III, Low Seam Schedule
*If you qualify for the reduced rate for low-seam coal, complete Schedule WV/SEV-LS1 before completing this schedule.
** SCHEDULE C - MINIMUM TAX ON COAL PRODUCTION
1. Total Tons Sold
1.
2. Line 1 times $0.75
2.
3. Net Severance Tax Payable (Schedule A, Line 4)
3.
.
4. Net State Severance Tax Ratio (Enter .93, or ratio value from Line 15, Low Seam Schedule LS1)
4.
5. Net State Severance Tax (Multiply Line 3 x Line 4)
5.
6. Net Minimum Tax (Line 2 Minus Line 5) (If Less Than 0, Enter 0 here and on Line 5, Schedule A)
6.
** If you process purchased coal only, do not complete Schedule C.
SCHEDULE D - SUBSIDIARIES REPORTED
FEIN
NAME
FEIN
NAME
1.
5.
2.
6.
3.
7.
4.
8.
Please answer all questions:
1. If you purchased this business in the past twelve (12) months, give the previous owner's full name and address:
___________________________________________________________________________________________________________________________________________
2. During the period covered by this return, did you:
a. Quit business?_______________
Sell or otherwise dispose of your business?_______________
Exact date___________________________
b. If business was sold, give exact name and address of new owner_________________________________________________________________
_________________________________________________________________________________________________________________________________________
3. Address where your records are located______________________________________________________________________________________
4. Principal place of business in West Virginia ___________________________________________________________________________________
5. Nature of business conducted (Describe in Detail)______________________________________________________________________________
6. Give name and account number of any additional business(es) operated in West Virginia by the reporting taxpayer___________________________
__________________________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
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)
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