Form Wv/tpt-722 - West Virginia Application For Refund/credit Of Tobacco Tax

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STATE 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/TPT-722
WEST VIRGINIA APPLICATION FOR REFUND/CREDIT OF TOBACCO TAX
rtL194 v 7-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.
SECTION 1 - ERRONEOUS PAYMENT INFORMATION
DATE (MM/YYYY)
AMOUNT
1. Erroneous Payment
.
SECTION 2 - CIGARETTE
REASON
QUANTITY
TAX RATE
DATE (MM/YYYY)
AMOUNT
(Attach Affadavit for Lines 2, 3, 6, & 7)
Cigarette Packages of 20 Returned to
2.
0.5500
.
Manufacturer with WV Stamps Affixed
Cigarette Packages of 25 Returned to
3.
0.6875
.
Manufacturer with WV Stamps Affixed
4.
Stamps Returned to Commissioner (20's)
0.5500
.
5.
Stamps Returned to Commissioner (25's)
0.6875
.
6.
Certified Loss (20's)
0.5500
.
7.
Certified Loss (25's)
0.6875
.
- OTHER TOBACCO PRODUCTS
REASON
VALUE
TAX RATE
DATE (MM/YYYY)
AMOUNT
(Attach Affadavit)
8.
Certified Loss
0.0700
.
.
SECTION 3 - REFUND/CREDIT CALCULATION
DISCOUNT
AMOUNT
9.
Total Amount of Line(s) 2 through 8
.
10.
Less STATUTORY DEDUCTION (WV Code 11-17: Line 9 multiplied by discount rate)
0.0500
.
11.
Less DEALER'S DISCOUNT (Line 9 multiplied by discount rate)
0.0400
.
12.
For REFUND, enter Line 9 minus the sum of Line 10 and Line 11, else enter 0
.
13.
For CREDIT, enter Line 9 minus the sum of Line 10 and Line 11, else enter 0
.
Sign Your Application
(Signature of Taxpayer)
(Name of Taxpayer - Type or Print)
(Title)
(Date)
(Person to Contact Concerning this Return)
(Telephone Number)
(E-mail Address)
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:
O
5
9
0
6
0
9
0
1
W
File online at https://mytaxes.wvtax.gov

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