West Virginia 
CST-250                           WEST VIRGINIA CONSUMER SALES AND USE TAX                                           State Tax 
REV 02/2022
                      APPLICATION FOR DIRECT PAY PERMIT                                                           Department

                                                BUSINESS IDENTIFICATION 
WEST VIRGINIA ACCOUNT                                    LEGAL BUSINESS OR CORPORATE NAME
IDENTIFICATION NUMBER

LEGAL NAME OF OWNER IF SOLE OWNER -  FIRST NAME                            LAST NAME

STREET ADDRESS LINE 1

STREET ADDRESS LINE 2                                                      UNIT                           UNIT
(OPTIONAL)                                                                 TYPE                           NUMBER
CITY                                                                       STATE                          ZIP

        TO BE COMPLETED BY OWNER, PARTNER OR OFFICER OF CORPORATION
I, THE UNDERSIGNED, HEREBY CERTIFY THAT THE ABOVE BUSINESS HAS A VALID 
BUSINESS REGISTRATION CERTIFICATE (PROVIDE BUSINESS REGISTRATION NUMBER) 
I, THE UNDERSIGNED, HEREBY CERTIFY THAT THE ABOVE BUSINESS IS NOT DELINQUENT ON THE PAYMENT OF ANY TAXES IMPOSED BY CHAPTER 11 OF THE WEST 
VIRGINIA CODE; AND THIS BUSINESS SATISFIES ONE OR MORE OF THE FOLLOWING CONDITIONS (CHECK ALL THAT APPLY):

ENGAGED IN THE BUSINESS OF MANUFACTURING                                   ENGAGED IN THE BUSINESS OF GAS STORAGE

ENGAGED IN THE BUSINESS OF PRODUCING NATURAL RESOURCES                      ENGAGED IN THE BUSINESS OF TRANSPORTATION

 ENGAGED IN THE BUSINESS OF COMMUNICATION                                  ENGAGED IN THE BUSINESS OF TRANSMISSION

ENGAGED IN THE OPERATING OF A PUBLIC UTILITY BUSINESS                      ENGAGED IN THE BUSINESS OF RESEARCH AND DEVELOPMENT

 A NATIONALLY CHARTERED FRATERNAL OR SOCIAL ORGANIZATION                   A BONA FIDE CHARITABLE ORGANIZATION THAT MAKES NO CHARGE 
                                                                           WHATSOEVER FOR SERVICE RENDERED
ENGAGED IN THE BUSINESS OF GENERATION, PRODUCTION, OR SELLING OF           A HEALTH CARE PROVIDER PURCHASING DRUGS, DURABLE MEDICAL 
ELECTRIC POWER                                                             GOODS, MOBILITY ENHANCING EQUIPMENT AND PROSTHETIC DEVICES 
                                                                           THAT ARE TO BE DISPENSED UPON PRESCRIPTION
 A VOLUNTEER FIRE DEPARTMENT ORGANIZED AND INCORPORATED UNDER THE 
LAWS OF WEST VIRGINIA

GIVE A DETAILED DESCRIPTION OF YOUR BUSINESS ACTIVITY WITHIN WEST VIRGINIA:

                                                         SIGNATURE
ON BEHALF OF THE ABOVE BUSINESS, I AM HEREBY APPLYING FOR A DIRECT PAY PERMIT. UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE EXAMINED THIS 
RETURN 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

CONTACT                                                                             TELEPHONE NUMBER

                                         CST-250 

                West Virginia Direct Pay Permit Instructions and Information 

  The  State  Tax  Commissioner  may,  in  his  discretion,  authorize  a  person  that  is  a  user,  consumer, 
  distributor  or  lessee  to  which  sales  or  leases  of  tangible  personal  property  are  made  or  services 
  provided,   to   pay   consumers   sales   and/or   use   tax   directly   to   the   West   Virginia   State   Tax 
  Department   thereby   waiving   the   collection   of   the   tax   by   that   person’s   vendor   (WV   Code 
  §11-15-9d).
  The  issuance  of  a  Direct  Pay  Permit  imposes  certain  requirements  on  the  holder  of  such  permit. 
  These requirements include: 
 1.  Notification  of  each  vendor  from  whom  tangible  personal  property  is  purchased  or  leased  or  from
 whom  services  are  purchased  of  his  Direct  Pay  Permit  number  and  that  any  tax  thereon  will  be
 paid  directly  to  the  Tax  Commissioner.  If  the  Direct  Pay  Permit  Number  is  changed  by  the  Tax
 Commissioner, all vendors must be renotified.
 2.  Filing   a   West  Virginia  Consumers  Sales  or  Use  Tax  Return  on  or  before  the  20th  day  of  the
 month  for  the  proceeding  month’s  or  quarter’s  transaction.  West  Virginia   Consumers  Sales  and
 Use  Tax  Returns  not  filed  by  the  due  date  will  be  subject  to  interest  and  penalties  and  the  permit
 may be canceled. This may be by mail or through MyTaxes.
 3.  Maintenance  of  books,  records  and  invoices  (including  vendor  lists)  for  inspection  by  the  West
 Virginia State Tax Department.
 4.  A Direct Pay Permit may not be used to purchase gasoline or special fuel.
 This application is  not  valid unless all entries are completed. 
 Upon  review  of  the  application,  the  West  Virginia  State  Tax  Department  will  determine  whether 
 you  are  entitled  to  receive  a  Direct  Pay  Permit.  Upon  approval  of  your  application,  a  numbered 
 Direct  Pay  Permit  will  be  mailed  to  you.  Should  your  application  be  rejected,  you  will  be  notified 
i  n writing. 
 West   Virginia   Sales   and   Use   Tax   Returns   will   be   forwarded   to   you   by   the   Department   for 
 remitting   tax   or  notice  will  be  sent  through  MyTaxes i f  you  are  an  electronic  filer..  If  you  do  not 
 receive  a  West  Virginia   Consumers  Sales  and  Use  Tax  Return  within  sixty  (60)  days  after  you 
 receive your Direct Pay Permit, you must notify the West Virginia State Tax Department. 
 A  Direct  Pay  Permit  will  continue  to  be  valid  until i t i s  surrendered  by  you  or  canceled.  You  will 
 be notified by the State Tax Department of any change in your Direct Pay Permit number. 
 Upon   surrender   or   cancellation   of   the   Direct   Pay   Permit,   the   holder   must   promptly   notify, i n 
 writing,   the   specified   vendors  from  whom  tangible  personal  property i s  purchased  or l eased  or 
 by whom services are rendered of such surrender or cancellation. 
                                Please sign this report and mail to : 
                                West Virginia State Tax Department 
                                Tax Account Administration Division 
                                         PO Box 1826 
                                Charleston, WV 25322-1826 

  Note:   For   the   return   to   be   considered   timely   filed,   all   information   in   the   schedules   must   be 
  completed and filed with the return. 

 If   you   have   any   questions   about   these   reporting   procedures,   please   contact   the   West   Virginia   State  
Tax  Department,  Tax  Account  Administration  Division,  1001  Lee  Street  East,  Charleston  WV  25301,  or  
call (304) 558-3333. You can also visit our website: www.wvtax.gov