Form Wv/cst-240 - West Virginia State Tax Department Claim For Refund Or Credit For Sales Or Use Tax Paid On Exempt Purchases

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WEST VIRGINIA STATE TAX DEPARTMENT CLAIM
WV/CST-240
REV 12/09
FOR REFUND OR CREDIT FOR SALES OR USE TAX
PAID ON EXEMPT PURCHASES
SALES
USE
CHECK APPROPRIATE
BOX:
REFUND
CREDIT
SEE INSTRUCTIONS FOR FILING
WEST VIRGINIA ACCOUNT
ON REVERSE SIDE
IDENTIFICATION NUMBER
MAIL TO:
LEGAL BUSINESS OR
WEST VIRGINIA SATE TAX
CORPORATE NAME
DEPARTMENT
OWNER’S NAME
INTERNAL AUDITING DIVISION
(IF SOLE OWNER)
PO BOX 425
CHARLESTON, WEST VIRGINIA
STREET ADDRESS
25322-0425
CITY, STATE, & ZIP CODE
FOR ASSISTANCE CALL:
NAME AND TELEPHONE NUMBER
(304) 558-3333 OR TOLL-FREE
OF CONTACT PERSON
1-800-982-8297
(A)
(C)
(D)
(E)
(B)
(F)
NAME OF VENDOR
INVOICE
USE OF
TYPE
INVOICE
AMOUNT
NUMBER
PURCHASE
OF TAX
DATE
OF TAX
This claim form is for West Virginia sales/use tax only.
Total this page
Enter the total of all pages in either the “TOTAL CREDIT” or the “TOTAL REFUND” box on the first page.
TOTAL CREDIT
TOTAL REFUND
ENTER THE AMOUNT OF CREDIT TO BE APPLIED AND THE PERIOD COVERED IN THE APPROPRIATE SPACES BELOW. ENTER THE AMOUNT
OF CREDIT ON THE CREDIT LINE OF THE APPLICABLE TAX RETURN. A COPY OF THIS CLAIM MUST BE ATTACHED TO EACH RETURN ON
WHICH CREDIT IS CLAIMED. ALL REFUND REQUESTS SHOULD BE MAILED SEPARATELY TO THE ABOVE-REFERENCED ADDRESS.
WV/CST-210 Direct Pay Sales/Use
$_______________Monthly____________to____________: Quarterly from____________to____________
WV/CST-200CU Consumers Sales/Use
$_______________Monthly____________to____________: Quarterly from____________to____________
Under penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief
it is true, correct and complete.
Signature
Date

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