STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div
P.O. Box 425
Charleston, WV 25322-0425
Name
Address
Account #:
City
State
Zip
WEST VIRGINIA SEVERANCE TAX - ESTIMATE
WV/SEV-400
rtL120 v 9-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.
Period Ending:
Due Date:
See back of return for instructions and information.
TAX COMPUTATIONS
RESOURCE
TAXABLE AMOUNT
RATE
TAX DUE
1.
SAND or GRAVEL
.
.
OIL
2.
.
.
NATURAL GAS
3.
.
.
COALBED METHANE
4.
.
.
LIMESTONE or SANDSTONE
5.
.
.
Other Natural Resources
6.
.
.
7.
Gross Amount of Tax (Add Lines 1 through 6)
.
8.
Investment Credits
.
Adjusted Tax (Line 7 minus Line 8)
9.
.
$41.67 Per Month Annual Exemption
10.
.
Total Tax Due (Line 9 minus Line 10)
11.
.
This form is for quarterly or monthly reporting only and cannot be used as an annual or final return. This form must be completed and returned
even though no business may have been transacted. If your business was sold or discontinued, please indicate the exact date and the new owner
on the back of this form.
SIGNATURE
DATE
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Div
P.O. Box 425, Charleston, WV 25322-0425
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297
For more information visit our web site at:
G
1
1
2
0
0
8
0
1 W
File online at https://mytaxes.wvtax.gov