Form Wv/sev-400w - Waste Coal - West Virginia Severance Tax Estimate
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1
2STATE OF WEST VIRGINIA
State Tax Department, Tax Account Administration Div
P.O. Box 425
Charleston, WV 25322-0425
Name
Address
Account #:
City
State
Zip
WASTE COAL
WV/SEV-400W
rtL055 v 7-Web
WEST VIRGINIA SEVERANCE TAX ESTIMATE
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.
SCHEDULE E - REPORT OF WASTE COAL PRODUCTION
County
Waste coal produced
KEY TO COUNTY FIPS CODES
Name of County of Production
FIPS Code
Round to nearest whole ton
001 Barbour
023 Grant
045 Logan
067 Nicholas
089 Summers
003 Berkeley
025 Greenbrier
047 McDowell
069 Ohio
091 Taylor
00
.
005 Boone
027 Hampshire
049 Marion
071 Pendleton
093 Tucker
007 Braxton
029 Hancock
051 Marshall
073 Pleasants
095 Tyler
00
.
009 Brooke
031 Hardy
053 Mason
075 Pocahontas
097 Upshur
011 Cabell
033 Harrison
055 Mercer
077 Preston
099 Wayne
00
013 Calhoun
035 Jackson
057 Mineral
079 Putnam
101 Webster
.
015 Clay
037 Jefferson
059 Mingo
081 Raleigh
103 Wetzel
017 Doddridge
039 Kanawha
061 Monongalia
083 Randolph
105 Wirt
00
.
019 Fayette
041 Lewis
063 Monroe
085 Ritchie
107 Wood
021 Gilmer
043 Lincoln
065 Morgan
087 Roane
109 Wyoming
00
.
SCHEDULE A - TAX COMPUTATIONS
1.
Total Gross Value of Recovered and Processed Waste Coal
.
2.
Rate
0.025
3.
Tax Due Before Credits (Multiply Line 1 by Line 2)
.
Investment Credits
4.
.
5.
$41.67 Per Month Annual Exemption *
.
6.
Total Tax Due (Line 3 minus Lines 4 & 5)
.
* Only one annual exemption may be claimed for each business entity
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)
(Signature of preparer other than taxpayer)
(Address)
(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
0
5
2
0
0
8
0
1
W
File online at https://mytaxes.wvtax.gov
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