Form It-101v - Employer'S West Virginia Income Tax Withheld

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Employer’s West Virginia Income Tax Withheld
IT-101V
WV State Tax Department
REV 07/11
PO Box 1667
Charleston, WV 25326
payment
Period ending
due date
NO. Of EmPlOyEES aT
END Of PERIOD
voucher
mm
DD
yyyy
mm
DD
yyyy
account number______________________________________
TOTal
REmITTaNCE
■
name
*B42200901W*
address
city
state
ziP

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