Form Wv/it-101q - West Virginia Employer'S Quarterly Return Of Income Tax Withheld - Wv Tax Department

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STATE OF WEST VIRGINIA
State Tax Department, Internal Auditing Division
P.O. Box 1667
Charleston, WV 25326-1667
Joe Manchin III, Governor
Christopher G. Morris, Tax Commissioner
Name
Account #:
Address
City
State
Zip
WEST VIRGINIA EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD
WV/IT-101Q
rtL046 v.1-web
Save the stamp and your time. You can now view, file and pay this tax at https://mytaxes.wvtax.gov
More taxes will be available for online access in the future.
Read the instructions on the back of this form before
Quarter Ending:
Due Date:
you fill it out. Please type or print within the boxes.
Part 1: Complete Lines 1-3
1. Number of employees who received wages, tips and other compensation for the Quarter (ending
Mar 31 (Quarter 1), June 30 (Quarter 2), Sept (Quarter 3), Dec 31 (Quarter 4)).
2. Wages, tips and other compensation for the quarter
.
3. Total income tax withheld from wages, tips and other compensation for the quarter
.
Part 2: Total of Payments per month and Total for Quarter
Total Payments for Quarter
Month 1
Month 2
Month 3
(Must Equal Line 3)
.
.
.
.
Part 3: Tell us about your business. If not applicable to your business, leave it blank.
If your business has stopped paying wages check here
and enter final date you paid wages
M
M
D
D
Y
Y
Y
Y
Part 4: Sign your return.
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)
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
INTERNAL AUDITING DIVISION
PO BOX 1667, CHARLESTON, WV 25326-1667
FOR ASSISTANCE CALL (304) 558-3333
TOLL FREE WITHIN WV 1-800-982-8297
For more information visit our web site at:
File online at: https://mytaxes.wvtax.gov
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