Form Wv/it-101a - West Virginia Employer'S Annual Return Of Income Tax Withheld

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STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div
P.O. Box 1667
Charleston, WV 25326-1667
Craig A. Griffith, Tax Commissioner
Earl Ray Tomblin, Governor
Name
Address
Account #:
City
State
Zip
WEST VIRGINIA EMPLOYER'S ANNUAL RETURN OF INCOME TAX WITHHELD
WV/IT-101A
rtL048 v.2-Web
Save the stamp and your time. You can now view, file and pay this tax at https://mytaxes.wvtax.gov
More taxes will be available for online access in the future.
This form is not to be used for an annual reconciliation. You must file form WV/IT -103.
See instructions on reverse side before completing this form. Please type or print within the boxes.
AMENDED
Tax Year Ending:
Due Date:
Part 1: Complete Lines 1-6
1. Number of employees who received wages, tips and other compensation for the tax year
2. Wages, tips and other compensation for the tax year
.
3. Total WV income tax withheld from wages, tips and other compensation for the tax year
.
4. Total payments for the tax year
.
5. Balance due (If line 3 is greater than line 4, write difference here)
.
6. Overpayment (If line 4 is greater than line 3, write difference here)
Refund
.
Part 2: Tell us about your business. If not applicable to your business, leave blank.
If your business has stopped paying wages check here
and enter final date you paid wages
M
M
D
D
Y
Y
Y
Y
Part 3: Sign your return.
Under penalties of perjury, I declare that I have examined this return, accompanying schedules and statements, and to the best of my knowledge
and belief, it is true, correct 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)
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Div
P.O. Box 1667, Charleston, WV 25326-1667
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297
For more information visit our web site at:
P
4
4 2
0
0
9
0
1
W
File online at https://mytaxes.wvtax.gov

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