Form Wv/sdr - Requisition For Soft Drink Tax Stamps - 2008
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2STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div
P.O. Box 2991
Charleston, WV 25330-2991
Name
Address
Account #:
City
State
Zip
WV/SDR-2008
REQUISITION FOR SOFT DRINK TAX STAMPS
rtL185 v 3 -Web
Taxpayers required to file electronically will no longer receive returns for the tax types subject to the mandatory
requirement by mail. Please visit for additional information.
COMPLETE SECTION 2 ON THE BACK OF THIS RETURN
SECTION 1 - TAX CALCULATION
Total (From Section 2 - Total Face Value)
1.
00
.
2.
Discount *
.
3.
Amount Remitted (Line 1 minus Line 2)
.
*
NO discount allowed on orders of less than $25.00
A discount of 5% on orders of $25.00 and less than $50.00
A discount of 10% on orders of $50.00 or more
Address to Mail Stamps
Street Address (Physical Address Only - No Post Office Box Addresses)
Street Address 2
City
State
Zip Code
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)
(E-mail Address)
(Signature of preparer other than taxpayer)
(Address)
(Date)
YOU MUST RETAIN A COPY FOR YOUR RECORDS
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Div
P O Box 2991, Charleston, WV 25330-2991
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297
For more information visit our web site at: www wvtax gov
File online at https://mytaxes wvtax gov
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