Form Wv/it-103 - Withholding Annual Reconciliation
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2STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div
P. O. Box 3943
Charleston, WV 25339-3943
_____________________________________________________________
Name
Account #: ________________
_____________________________________________________________
Address
_____________________________________________________________
City
State
Zip
B0
WV/IT-103
WEST VIRGINIA WITHHOLDING ANNUAL RECONCILIATION
30
IT103 v.1
To be filed on or before February 28.
Calendar Year: ___________________
First Quarter
.00
Second Quarter
.00
Third Quarter
.00
Fourth Quarter
.00
TOTAL FOR THE YEAR
(A)
.00
Number of Withholding tax statements (W-2's/1099's) transmitted
Total WV tax shown as withheld by all statements transmitted
(B)
.00
DO NOT SEND PAYMENT WITH THIS FORM
Attach an explanation if Block (A) is different from Block (B). If there is an underpayment, visit https://mytaxes.wvtax.gov to remit
payment separately using MyTaxes or visit our website to download an IT-101V payment voucher. If there is an overpayment, an
amended IT-101Q return for period(s) involved is required. Check the appropriate box to request the refund.
Sign Your Return
Under penalties of perjury, I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge
and belief it is true and complete.
(Signature of taxpayer)
(Name of taxpayer - type or print)
(Title)
(Date)
(Person to contact concerning this return)
(Telephone number)
(E-mail address)
(Signature of preparer other than taxpayer)
(Address)
(Date)
MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
Tax Account Administration Div
P. O. Box 3943, Charleston, WV 25339-3943
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297
For more information visit our web site at:
File online at https://mytaxes.wvtax.gov
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