Form Gsr-01 - West Virginia Request For Statement Of Good Standing
Download a blank fillable Form Gsr-01 - West Virginia Request For Statement Of Good Standing in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Gsr-01 - West Virginia Request For Statement Of Good Standing with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Clear All Fields On This Form
West Virginia
GSR-01
West Virginia
State Tax
Request for Statement of Good Standing
Rev. 11/15
Department
Taxpayer Identification Number _____________________________
Complete Business Name ___________________________________________________________________________
Business Location __________________________________________________________________________________
Mailing Address ____________________________ _______________________ _____________ ________________
Street
City
State
Zip
Type of business (check one):
Partnership
Sole Ownership
Corporation/LLC
Other
______________________
I understand that in the event that this business is not in good standing with the Tax Department I will be notified in writing
as to what tax returns or tax payments are considered not filed or paid and who to contact with any questions regarding that
situation.
By signing this Request for Statement of Good Standing, I certify under penalty of perjury that I am the taxpayer or the
taxpayer’s authorized representative and am entitled to receive the result of this request.
If you are a CPA or Attorney completing this Request for Statement of Good Standing for a business of which you are not a
principle, a principle of the business must ALSO sign this request as the taxpayer.
If you are authorizing release of information for someone who is not a CPA or Attorney, this form must be notarized.
Taxpayer Signature
Title
Date
Print Name
Phone
E-mail
CPA/Attorney Signature
Title
Date
Print Name
Phone
E-mail
Signature of person other than taxpayer, CPA, or
Title
Date
attorney (Form must be notarized).
Print Name
Phone
E-mail
State of West Virginia
-- Select --
County of __________________________, to-wit,
This day appeared before me, the undersigned notary public ________________________________________, who
acknowledge under oath the signature above.
_________________________________________ Notary public
____________________________
Date
My commission expires: ___________________________
If you would like the response faxed to you, enter the fax number including area code (
) _______________________
Name of person fax is to be addressed to: ___________________________________________
send this request to:
phone numbers:
West Virginia State Tax Department
(304) 558-0678
ATTN: TPS – Administrative Support
(304) 558-8695
PO Box 885
(304) 558-1114
Charleston, WV 25323-0885
(304) 558-0659
Fax # (304) 558-8643
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial