Form Wv/tel-501 - Telecommunications Tax Annual Return Page 2

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INSTRUCTIONS FOR QUESTIONS ONE THROUGH SEVEN
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 you quit.
If you did not, write “no” in the 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 the 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 in 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 in detail 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”.
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)
PAGE 2 OF 2

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