Form It-140nr/py - West Virginia Nonresident/part-Year Resident Income Tax Return - 2000
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1
2WEST VIRGINIA NONRESIDENT/PART-YEAR RESIDENT INCOME TAX RETURN - 2000
IT-140NR/PY
IT-140NR/PY
IT-140NR/PY
IT-140NR/PY
IT-140NR/PY
If this return is filed under Extension of Time, Enter extended due date _____________
C
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
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. .......................................................................................................
I I I I I
Are the name(s) and address above the same as
❒
❒
Give spouse's social security number
shown on your 1999 return?
YES
NO
If
above and enter spouse's full name here:
"NO", enter the name(s) and address from your 1999
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
00
1.
TOTAL WEST VIRGINIA INCOME (from line 50 of Schedule A) .....................................
2
00
2.
FEDERAL ADJUSTED GROSS INCOME (from line 47, Column A of Schedule A) .......................................................
+
3
00
3.
ADDITIONS TO INCOME from line 67 of Schedule M or specify: _____________________________________
−
00
4
4.
SUBTRACTIONS FROM INCOME from line 78 of Schedule M or specify: ______________________________
5
00
5.
MODIFIED ADJUSTED GROSS INCOME (line 2 plus line 3 minus line 4) ....................................................................
00
6
6.
LOW-INCOME EARNED INCOME EXCLUSION ...........................................................................................................
7
00
7.
EXEMPTIONS (line 3 of Section III above
x $2,000) .......................................................................................
8
00
8.
WEST VIRGINIA TAXABLE INCOME (line 5 minus lines 6 and 7)
....................................
IF LESS THAN ZERO, ENTER ZERO
❒
00
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 ..................................................
00
11
11.
WEST VIRGINIA INCOME TAX (multiply line 9 by line 10) ..............................................
00
12
12.
WEST VIRGINIA INCOME TAX WITHHELD .................................................................
YOU MUST ATTACH LEGIBLE W-2'S OR 1099'S TO SUPPORT THIS AMOUNT.
13
00
13.
ESTIMATED TAX PAYMENTS AND PAYMENTS WITH EXTENSION ......................
14
00
14.
BUSINESS TAX/INVESTMENT/EMPLOYMENT/NONFAMILY ADOPTION CREDITS
15
00
15.
CREDIT FOR INCOME TAX PAID OTHER STATE(S) (attach Schedule E) ..................
00
16
16.
SUM OF PAYMENTS AND CREDITS (add lines 12 through 15) ..................................................................................
00
17
BALANCE OF TAX DUE
17.
(line 11 minus line 16) .......................................................
18
00
PENALTY DUE
18.
(from Form IT-210) .............................................................................
REVIEW THE INSTRUCTIONS TO SEE IF YOU SHOULD FILE FORM IT-210 WITH YOUR RETURN.
1
19
00
BALANCE DUE
THE STATE
19.
(add lines 17 and 18)
..................
MAKE CHECKS PAYABLE TO: WV STATE TAX DEPARTMENT
20
00
OVERPAYMENT
20.
(subtract line 11 from line 16) .......................................................
00
21
21.
AMOUNT OF OVERPAYMENT TO BE CREDITED TO 2001 ESTIMATED TAX ...........
22.
WEST VIRGINIA CHILDREN'S TRUST FUND to help prevent child abuse and neglect.
❒
❒
❒
❒
00
22
Enter the amount of your contribution:
$2,
$5,
$10,
Other $
00
23
23.
DEDUCTIONS FROM YOUR OVERPAYMENT (add lines 21 and 22) ....................................................................
2
24
00
REFUND
24.
DUE YOU (subtract line 23 from line 20) ...............................................................................................
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.
Spouse’s Signature
Your Signature
Date
Date
Signature of preparer other than taxpayer
Date
DO NOT USE SPACE BELOW
MAIL TO:
West Virginia State Tax Department,
P.O. Box 1071, Charleston, WV 25324-1071
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