STATE OF WEST VIRGINIA 
   State Tax Department, Tax Account Administration Div
   P.O. Box 1826
   Charleston, WV 25327-1826

   Name

   Address                                                                                                   Account #:

   City                                                            State                 Zip

WV/CST-200CU
rtL325V.1-Web                    WEST VIRGINIA SALES AND USE TAX RETURN

   Period Ending:                                          Due Date:                                                               Amended
                                 (A)                                                        (B)              (C)       (D)                   (E)
                                 Gross Amount                                               Deductions Taxable Amount  Tax                   Tax Due
                            (Taxable & Exempt Transactions) (Schedule D Required)                      (A minus B)     Rate                  (C times D Ln 1 & 2)
1. Sales to WV Customers*                                                                                              0.06
2. Purchases for Use in WV                                                                                             0.06
3. Municipal Sales Tax Due* (Schedule M required)                                                      (Enter amount from Line 31, Column E)
4. Municipal Use Tax Due*   (Schedule M required)                                                      (Enter amount from Line 31, Column H)
5. Excess Tax Collected   
6. Interest
7. Additions to Tax
8. Total Due or Credit*                                                                                      (Sum of lines 1 through 7)
9. Less Prior Payment   (Accelerated payment, credit carried forward, original payment when amending)   
10. Less State Use Tax Credits   (May not exceed Line 2, Column E)                                     (Enter amount from Schedule D, Part 3)
11. Less Tourism Development Tax Credit (May not exceed Line 1, Column E)   (Enter amount from Schedule D, Part 4)
12. Amount Due or Credit  (Schedules S, U or BD required for Credit Due on return*)                    (Line 8 minus lines 9, 10, & 11)
*Negative tax amounts are permitted on lines indicated only and will initiate a request for refund or credit.
If credit for overpayment indicated on Line 12, specify the amount(s) to be refunded and/or carried forward to next tax period:   
13.Refund Amount                                                                                       Carry Forward Amount   
This section must be completed by sellers of specific goods/services for proper distribution of the above reported tax due: 
14. Taxable Sales of Wine/Liquor to Private Clubs                                                      Wine/Liquor Account #

   Schedule S Attached                                                                          Schedule U Attached 
   Schedule BD Attached                                                                         State Oasis Transfer Sheet Attached
Please attach all schedules and supporting documentation as indicated.   
If required to file Schedules S, U, BD, or to print instructions visit www.tax.wv.gov.

This return is not considered complete unless it is signed.
   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)

Signature of Preparer   (Name of Preparer - Type or Print) (Phone)                          (Date)                  G     1     5     2     0     1     6     0     1      W

Schedule D - State Deductions, Exemptions, and Credits                                                         Account #: ______________
Part 1 - Sales Tax Deductions   
1.  Sales for which an exemption certificate was received at the time of sale   
2.  Sales for which a direct pay permit was received at the time of sale   
3.  Sales for which a credit memo or adjustment was completed after the sale          (Schedule S required)
4.  Sales that were returned by the purchaser   
5.  Uncollected bad debt transactions                                                 (Schedule BD required)
6. Sales of exempt food and food ingredients   
7. Sales of capital improvement contracting   
8.  Sales of exempt drugs, mobility enhancing equipment, and prosthetics (if not reported on Line 2)   
9.  Sales of prescription drugs to consumers   
10. Sales of personal services   
11. Sales of professional services   
12. Sales of public services controlled by the PSC   
13. Sales of transportation services   
14. Sales of other per se exemptions      Please specify:  
15. Total deductions of sales to WV customers                (Enter this amount on Page 1, Line 1, Column B, Deductions)
Part 2 - Use Tax Deductions   
1.  Purchases directly used in manufacturing   
2.  Purchases directly used in natural resource production   
3.  Purchases directly used in transportation   
4.  Purchases directly used in transmission   
5.  Purchases directly used in communications   
6. Purchases directly used in public utilities   
7. Purchases directly used in research and development   
8.  Purchases directly used in a high-technology business   
9.  Purchases of drugs, mobility enhancing equipment, and prosthetics by a health care provider   
10. Purchases by a non-profit organization   
11. Other exempt purchases     Please specify:   
12. Total deductions to purchases for WV use     (Enter this amount on Page 1, Line 2, Column B, Deductions)   

Part 3 - Use Tax Credit for Tax Paid on Out of State Purchases that have been Reported on Page 1, Line 2
    Two Digit State Abbreviation of State(s) where Purchased                    Total Purchase Amount                   Out of State Tax Paid

State Use Tax Credit to be applied to this return                   (Enter this amount on Page1, Line 10)

Part 4 - Sales Tax Credit for Tourism Development (Approved Applicants Only)      
Annual Credit Remaining Monthly Base Tax              Sales Tax Due Credit Allowed    Credit Taken this Month           Balance of Annual
from Previous Month     Amount                        this Month           this Month (Enter on Page 1, Line 11)        Credit Remaining

Taxpayers reporting more than one approved tourism development project tax credit are required to file electronically at www.MyTaxes.WVtax.gov   

    MAIL TO:  WEST VIRGINIA STATE TAX DEPARTMENT
                        Tax Account Administration Div
    P.O. Box 1826, Charleston, WV  25327-1826
    FOR ASSISTANCE CALL (304) 558-3333  TOLL FREE (800) 982-8297
    For more information visit our web site at: www.tax.wv.gov
                    File online at https://mytaxes.wvtax.gov                          G     1     5     2     0     1     6     0     2      W

Schedule M - Municipal Sales and Use Tax                                             Account #: ______________

   A             B        C                                    D     E             F                        G    H
   FIPS   Municipality    Taxable Sales                        Tax   Municipal     Taxable Purchases        Tax  Municipal
   Code        Name       (Required if tax due)                Rate  Sales Tax Due (Required if tax due)    Rate Use Tax Due
                                                                     (C times D)                                 (F times G)
1  05332 Beckley                                               0.010                                        0.010
2  08932 Bolivar                                               0.010                                        0.010
3  10180 Bridgeport                                            0.010                                        0.010
4  14600 Charleston                                            0.010                                        0.010
5  14610 Charles Town                                          0.010                                        0.010
6  15628 Clarksburg                                            0.010                                        0.010
7  22564 Dunbar                                                0.010                                        0.010
8  26452 Fairmont                                              0.010                                        0.010
9  32716 Grafton                                               0.010                                        0.010
10 35284 Harpers Ferry                                         0.010                                        0.010
11 35428 Harrisville                                           0.010                                        0.010
12 39460 Huntington                                            0.010                                        0.010
13 52060 Martinsburg                                           0.010                                        0.010
14 54484 Milton                                                0.010                                        0.010
15 55588 Moorefield                                            0.005                                        0.005
16 59068 Nitro                                                 0.010                                        0.010
17 62140 Parkersburg                                           0.010                                        0.010
18 62764 Pennsboro                                             0.010                                        0.010
19 66412 Quinwood                                              0.010                                        0.010
20 66988 Ranson                                                0.010                                        0.010
21 70084 Romney                                                0.010                                        0.010
22 70828 Rupert                                                0.010                                        0.010
23 75292 South Charleston                                      0.010                                        0.010
24 80020 Thomas                                                0.010                                        0.010
25 83500 Vienna                                                0.010                                        0.010
26 85156 Weirton                                               0.010                                        0.010
27 86452 Wheeling                                              0.010                                        0.010
28 87556 Williamstown                                          0.010                                        0.010
29        
30        
                          Total Muni Sales Tax Due                                 Total Muni Use Tax Due
31
                          (Enter on Page 1, Line 3)                                (Enter on Page 1, Line 4)

          MAIL TO:  WEST VIRGINIA STATE TAX DEPARTMENT
                       Tax Account Administration Div
                     P.O. Box 1826, Charleston, WV  25327-1826
         FOR ASSISTANCE CALL (304) 558-3333  TOLL FREE (800) 982-8297
          For more information visit our web site at: www.tax.wv.gov               G     1     5     2     0     1     6     0     3      W
                       File online at https://mytaxes.wvtax.gov