Form Wv/sev-401 - West Virginia Severance Tax Return
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2STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div.
P.O. Box 425
Charleston, WV 25322-0425
______________________________________________________________________
Name
______________________________________________________________________________
Address
Account #:
______________________________________________________________________________
________________________
City
State
Zip
WV/SEV-401
West Virginia seVerance tax return
rtl. 110 v. 12-Web
Taxpayers required to file electronically will no longer receive returns for tax types subject to the mandatory requirement by
mail. Please visit for additional information.
Extension Date: _____ _____ _____________
Period Ending:
Due Date
M M D D
Y Y Y Y
Check if: CoNSoliDAtED
SEPARAtE
FiNAl
AMENDED
Before you comPleTe This Page, you musT comPleTe The schedules on The reverse side of This form
1. total tax (From Severance tax Computation Schedule Page 2)
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2. total Credits (Schedule tC – line 7 on Page 2 – Attach Appropriate Schedules)
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3. Adjusted tax (line 1 minus line 2) if line 2 is greater than line 1, enter 0
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4. total Payments made for the Period Covered by this Return and any Credit from Prior Years overpayment
(Must attach credit letter)
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5. Balance of tax Due (line 3 minus line 4)
if line 4 is greater than line 3 enter 0, and enter amount overpaid on line 10.
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6. NoN-WAiVABlE iNtERESt
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7. ADDitioNS to tAx
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8. PENAltY FoR uNDERPAYMENt oF EStiMAtED tAx
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9. totAl tAx AND lAtE FiliNg ChARgES DuE (Add line 5 through 8)
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10. overpayment Amount (line 4 minus line 3) if line 3 is greater than line 4, enter 0
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11. Amount of line 10 to be Credited to Next Year’s tax
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12. Amount of line 10 to be Refunded (line 10 minus line 11)
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mail To: WesT virginia sTaTe Tax deParTmenT
Tax account administration division
P.o. Box 425, charleston, Wv 25322-0425
for assisTance call (304) 558-3333 Toll free (800) 982-8297
*b23031001w*
for more information visit our web site at
file online at https://mytaxes.wvtax.gov
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