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*P40202102F*

Clear All Values Check Your Return for Required Information Print Your Return IT-140. REV 9-21. F. WEST VIRGINIA PERSONAL INCOME TAX RETURN 2021. SOCIAL Deceased *SPOUSE'S Deceased SECURITY SOCIAL SECURITY. NUMBER Date of Death: NUMBER Date of Death: YOUR. LAST NAME SUFFIX FIRST MI. NAME. SPOUSE'S. SPOUSE'S. SUFFIX FIRST MI. LAST NAME. NAME. FIRST LINE OF SECOND LINE. ADDRESS OF ADDRESS. CITY STATE WV ZIP CODE. TELEPHONE EXTENDED DUE DATE. EMAIL. NUMBER MM/DD/YYYY. Amended Check before 4/18/22 if you wish to stop the original debit Nonresident Nonresident/ Form WV-8379 filed as return (amended return only) Special Part-Year Resident an injured spouse Yourself (a) 0. FILING Exemptions (If someone can claim you as a dependent, leave box (a) blank.)

P40202102F *P40202102F* –2– PRIMARY LAST NAME SHOWN ON FORM IT-140 SOCIAL SECURITY NUMBER 8.Total Taxes Due (line 8 from previous page) 8.00 9. Credits from Tax Credit Recap Schedule (see schedule on page 5 ) (now includes the Family Tax Credit) 9.00 10.

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