Schedule A (Form It-140) - West Virginia Nonresidents/part-Year Residents Schedule Of Income - 2011

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2011
SCHEDULE
Nonresidents/Part-Year Residents
A
Schedule of Income
IT-140)
(F
orm
SOCIAL
PRIMARY LAST NAME
SHOWN ON
SECURITY
FORM IT-140
NUMBER
PART-YEAR RESIDENTS: ENTER
FROM:
TO:
PERIOD OF
MM
DD
YYYY
WEST VIRGINIA RESIDENCY
MM
DD
YYYY
SChEDULE A
(To Be Completed By Nonresidents and Part-Year Residents Only)
INCOME
COLUMN A
COLUMN B
COLUMN C
ALL INCOME DURING
WV SOURCE INCOME DURING
AMOUNT FROM
FEDERAL RETURN
PERIOD OF WV RESIDENCY
NONRESIDENT PERIOD
50. Wages, salaries, tips (complete Form IT-140W).....................
.00
.00
.00
50
51. Interest..................................................................................... 51
.00
.00
.00
52. Dividends................................................................................. 52
.00
.00
.00
53. Refunds of state and local income tax (see line 42 of
Schedule M)............................................................................
.00
.00
53
54. Alimony received...................................................................... 54
.00
.00
55. Business profit (or loss)........................................................... 55
.00
.00
.00
56. Capital gains (or losses).......................................................... 56
.00
.00
.00
57. Supplemental gains (or losses)...............................................
.00
.00
.00
57
58. Total taxable pensions and annuities....................................... 58
.00
.00
.00
59. Farm income (or loss).............................................................
.00
.00
.00
59
60. Unemployment compensation insurance................................
60
.00
.00
.00
61. Total taxable Social Security and Railroad Retirement
benefits (see line 40 of Schedule M for Railroad Retirement
benefits)..................................................................................
61
.00
.00
62. Other income from federal return (identify source)
62
.00
.00
.00
______________________________________________
63. Total income (add lines 50 through 62)...................................
63
.00
.00
.00
ADJUSTMENTS
64. Deductible payments to an IRA................................................ 64
.00
.00
.00
65. Moving expenses..................................................................... 65
.00
.00
.00
66. Self-employment tax deduction................................................ 66
.00
.00
.00
67. Self-employment health insurance deduction.......................... 67
.00
.00
.00
68. Payments to a Keogh retirement plan...................................... 68
.00
.00
.00
69. Penalty for early withdrawal of savings.................................... 69
.00
.00
.00
70. Other adjustments...................................................................
.00
.00
.00
70
71. Total adjustments (add lines 64 through 70)...........................
.00
.00
.00
71
72. Adjusted gross income (subtract line 71 from line 63 in each
column..................................................................................... 72
.00
.00
.00
73. West Virginia income (line 72, Column B plus line 72, column C).............................................................................
.00
73
74. Income subject to West Virginia state tax but exempt from federal tax.............................
74
.00
75. Total West Virginia income (line 73 plus line 74). Enter here and on line 2 on the reverse side.................................
.00
75
Continued on the Next Page…
*p40201107W*

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