Form It 140Nrs PDF Details

Form It 140Nrs is a unique type of form that can be used in a number of different ways. This form is perfect for any business or individual that needs to keep track of their paperwork. The best part about this form? You can customize it to fit your specific needs! Whether you need to keep track of customer information, employee records, or just want a handy place to organize your documents, Form It 140Nrs is the perfect tool for the job. So what are you waiting for? Start customizing your form today!

QuestionAnswer
Form NameForm It 140Nrs
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesit140nrs.fillab le if i am filing it 140nrs do i need to file it 140 form

Form Preview Example

IT-140NRS

West Virginia

Special Nonresident Income Tax Return 2012

REV. 9-12 (Web Fill-In Form) F

Last Name

First Name

Address

City

*

 

 

 

Your Social Security Number

 

 

 

 

 

 

 

 

 

 

 

If you meet the

described conditions,

ile

 

 

 

this return with the West Virginia State

Tax

 

MI

 

 

Department on or before April 15, 2013 for a

 

 

 

 

 

 

refund of West Virginia income taxes withheld

 

 

 

from wages and salaries

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*

Select

 

*

 

Amended

 

 

 

 

 

 

Return (check box)

 

State

 

Zip Code

 

 

NOTE: Use this form ONLY if you were a resident of Kentucky, Virginia, Pennsylvania, Maryland, or Ohio during the tax year of 2012, West Virginia source income was from wages and salaries and West Virginia income tax was withheld from such wages and salaries by your employer(s). You must complete IT-140W to verify West Virginia income tax withheld in order to receive credit. If you were a resident of a state other than Kentucky, Virginia, Pennsylvania, Maryland, or Ohio, you must check the box Filing as a Nonresident/Part-Year Resident on Form IT-140 to report any income from West Virginia sources.

If you were a domicilary resident of Pennsylvania or Virginia and spent more than 183 days within West Virginia during 2012, you are also considered a resident of West Virginia for income tax purposes. Therefore, you are not eligible to ile this return and must ile Form IT-140 as a resident of West Virginia.

SPECIFIC INSTRUCTIONS ARE ON THE BACK AND PAGE 46

I declare that I was not a resident of West Virginia any time during 2012, I was a resident of the state shown, my only income from sources within West Virginia was from wages and salaries, and such wages and salaries were subject to income taxation by my state of residence.

YOUR STATE OF RESIDENCE (Check one):

1. Commonwealth of Kentucky

2. State of Maryland

3. State of Ohio

4.

Commonwealth of Virginia

Number of days spent in West Virginia

__________________

5.

Commonwealth of Pennsylvania

Number of days spent in West Virginia

__________________

1.Enter your total West Virginia income from wages and salaries..................................................................

2.Enter total amount of West Virginia Income Tax Withheld from your wages and salaries paid by your employer in 2012 (Must complete Withholding tax schedule, page 7)........................................................

3.Overpayment previously refunded or credited (Amended Return Only).....................................................

4.West Virginia Children’s Trust Fund to help prevent child abuse and neglect

Enter the amount of your contribution $5 $25 $100 Other $___________..........................

5.Refund Due You (subtract lines 3 and 4 from line 2)

Refund of $2 or less will be issued only if a written request is attached to this form..................................

1

2

3

4

5

0.00

.00

0.00

.00

0.00

.00

0.00

.00

.00

Direct

Deposit CHECKING SAVINGS ROUTING NUMBERACCOUNT NUMBER

of Refund

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. I authorize the State Tax Department to discuss my return with my preparer.

YES

NO

 

 

 

 

 

 

Your Signature

 

 

Date

 

Telephone Number

 

 

 

 

 

 

Signature of preparer other than above

Date

Address

 

Daytime Phone Number

 

 

 

 

MAIL TO:

BALANCE DUE

 

 

 

 

 

 

 

Preparer: Check here if

REFUND

 

 

 

 

client is requesting that

WV State Tax Department

WV State Tax Department

Preparer’s EIN

 

 

 

 

P.O. Box 1071

 

P.O. Box 3694

 

 

form NOT be e-iled

 

 

 

 

 

 

 

 

Charleston, WV 25324-1071

Charleston, WV 25336-3694

 

 

 

 

–13–*p40201211F*

IT-140W

12

REV. 03-12 B West Virginia Withholding Tax Schedule

Do NOT send W-2’s, 1099’s, K-1’s and/or WV/NRW-2’s with your return

Enter WV withholding information below.

THIS FORM MUST BE FILED EVEN IS YOU HAVE NO INCOME OR WITHHOLDING

PRIMARY LAST NAME

SHOWN ON FORM

IT-140

SOCIAL

SECURITY

NUMBER

1

 

A – Employer or Payer Information

 

 

B – Employee or Taxpayer Information

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

 

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

Employer or Payer Name

 

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0 .00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

City, State, ZIP

 

 

Income Subject to WV WITHHOLDING

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

A – Employer or Payer Information

 

 

B – Employee or Taxpayer Information

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

Employer or Payer Name

 

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0 .00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, State, ZIP

 

 

Income Subject to WV WITHHOLDING

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

A – Employer or Payer Information

 

 

B – Employee or Taxpayer Information

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

Employer or Payer Name

 

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

City, State, ZIP

 

 

Income Subject to WV WITHHOLDING

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

A – Employer or Payer Information

 

 

B – Employee or Taxpayer Information

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

Employer or Payer Name

 

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

City, State, ZIP

 

 

Income Subject to WV WITHHOLDING

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total WV tax withheld from column C above

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0 .00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you have WV withholding on multiple pages, add the totals together and enter the GRAND total on line 11, FormITIT-140NRS- .

–3–*p40201203A*

IT-140W

12

REV. 03-12 B West Virginia Withholding Tax Schedule

Do NOT send W-2’s, 1099’s, K-1’s and/or WV/NRW-2’s with your return

Enter WV withholding information below.

THIS FORM MUST BE FILED EVEN IS YOU HAVE NO INCOME OR WITHHOLDING

PRIMARY LAST NAME

SHOWN ON FORM

IT-140

SOCIAL

SECURITY

NUMBER

1

 

A – Employer or Payer Information

 

B – Employee or Taxpayer Information

 

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

 

Employer or Payer Name

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0 .00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

City, State, ZIP

 

Income Subject to WV WITHHOLDING

 

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

A – Employer or Payer Information

 

B – Employee or Taxpayer Information

 

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

 

Employer or Payer Name

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0 .00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City, State, ZIP

 

Income Subject to WV WITHHOLDING

 

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

 

A – Employer or Payer Information

 

B – Employee or Taxpayer Information

 

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

 

Employer or Payer Name

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

City, State, ZIP

 

Income Subject to WV WITHHOLDING

 

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

A – Employer or Payer Information

 

B – Employee or Taxpayer Information

 

 

 

 

 

C – WV Tax Withheld

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0

.00

 

 

Employer or payer ID from W-2, 1099, K-1, and/or WV/NRW-2

 

Name

 

WV WITHHOLDING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Check the appropriate box

 

 

 

 

 

 

 

Employer or Payer Name

 

Social Security Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W-2

1099

 

K-1

WV/NRW-2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

0.00

 

 

 

 

 

 

 

 

 

 

 

 

 

Enter State Abbreviation

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(from Box #15 on W-2 or Box 11 on 1099)

 

City, State, ZIP

 

Income Subject to WV WITHHOLDING

 

 

 

 

Enter WV withholding Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total WV tax withheld from column C above

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

0 .00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you have WV withholding on multiple pages, add the totals together and enter the GRAND total on line 11, FormITIT-140NRS- .

–3–*p40201203A*

SPECIFIC INSTRUCTIONS FOR IT-140NRS

Important Notice: These instructions are based upon those statutes and reciprocity practices in effect at the time of printing. Amendments may occur that would cause these instructions to change.

KENTUCKY, MARYLAND OR OhIO RESIDENTS

If your West Virginia income during 2012 was from wages and/or salaries only, you may ile the Special Nonresident Form IT-140NRS as a claim for refund of any West Virginia income tax withheld during

2012. If you had West Virginia income from a source other than wages and/or salaries, you must ile the West Virginia Income Tax Return (Form IT-140) and indicate residency status by checking the Nonresident/Part-Year Resident box. You are not allowed a Schedule E credit against your West Virginia

income tax whenever your West Virginia income is other than wages and/or salaries. You should apply for the appropriate credit on the income tax return iled with your state of residence.

PENNSYLVANIA OR VIRGINIA RESIDENTS

If your West Virginia income during 2012 was from wages and/or salaries only AND YOU DID NOT

SPEND MORE THAN 183 DAYS WITHIN WEST VIRGINIA DURING 2012, you may ile the Special

Nonresident Form IT-140NRS as a claim for refund of any West Virginia income tax withheld during

2012. If you had West Virginia income from a source other than wages and/or salaries, you must ile the West Virginia Income Tax Return (Form IT-140) and indicate residency status by checking the Nonresident/Part-Year Resident box. You are not allowed a Schedule E credit against you West Virginia income tax when your West Virginia income is other than wages and/or salaries. You should apply for

the appropriate credit on the income tax return iled with your state of residence.

A domiciliary resident of Pennsylvania or Virginia who spends more than 183 days within

West Virginia during 2012 is also a resident of West Virginia for income tax purposes and is required to ile a resident return (Form IT-140) with West Virginia. A Schedule E credit would

not be allowed on the West Virginia return. You should apply for the appropriate credit on the income tax return iled with your state of residence.

SPECIAL NOTE: Residents of these states may be relieved from iling an annual claim for refund

of West Virginia taxes withheld from their wages and/or salaries by requesting Form WV/IT-104

(West Virginia Certiicate of Nonresidence) from their employer. Form WV/IT-104 may be completed and returned to the employer who would then be authorized to stop withholding West Virginia income tax on wages and/or salaries earned in this state.

–46–

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