Form Wv/bot-301 - Annual Business And Occupation Tax Return For Utilities Page 2
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1
2EXEMPTIONS
LINE CODE
EXEMPTIONS
DESCRIPTION
Please answer all questions:
1. If you purchased this business during the last twelve (12) months, give the name and last known address of the
previous owner. A successor in business could become liable for outstanding taxes owed by a previous owner. If
you did not purchase this business during the last twelve (12) months, write "non applicable".
2.
If you quit business during the last twelve (12) months, write "yes" in the space provided and give the exact date
quit. If you did not, write "no" in this space. If you sold your business during the last twelve (12) months, write "yes"
in the space provided, give the date of the sale, and provide the full name and address of the new owner. If you did
not sell this business, write "no" in this space.
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.
Give the mailing address where you keep your records. If it is the same as the address where we sent this return,
write "same" in the space.
4.
Principal place of business of West Virginia. Write the name of the city or town in West Virginia where you conduct
the majority of your business.
5.
Nature of business conducted. Describe the type of business you are engaged in.
6.
Print or type the full name and telephone number of the person preparing this return. It is much easier to discuss and
correct irregularities found on returns over the telephone than by correspondence.
7.
If you operate any other businesses in West Virginia, give the name and account number for each. If you operate
no other businesses, write "none".
8.
If you entered into an agreement under Internal Revenue Code Section 168 (f)(8), a safe harbor lease, indicate the
the amount of income received for interest $
and/or rental $
and report this amount with your gross income. See instructions.
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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