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                                                                                                                                                                West Virginia 
                               RetuRN of iNcome tax WithholdiNg foR                                                                                             State Tax 
WV/NRSR                                                                                                                                                         Department
Rev. 09-12                                    NoNReSideNt Sale of Real pRopeRty

1. Property account ID Number:                                               2. Date of transfer

Address and Description
                                                                                MM                                                   DD YYYY
                                                                             3. Check if the transferor/seller is reporting gain 
                                                                                under the installment method.                

4.  Transferor/Seller’s Identification number CheCk one  5. Spouse’s SSN Number                                                         7. Transferor/Seller is:
                                                    SSn                                                                                  a. Individual
                                                    FeIn
                                                                                                                                         b. Corporation
                                                    ITIn
                                                                                                                                         c. Trust or Estate
6.  Transferor/Seller’s name (Enter only one name, unless husband and wife are filing a joint return. If more                            d. Business Trust
than one transferor/seller, use separate forms for each.)
                                                                                                                                         e. Partnership

Street Address including City, State and Zip Code                                                                                        f. S Corporation
                                                                                                                                         g. Limited Liability Company
                                                                                                                                         h. Limited Liability Partnership

8. Computation of total payment and tax to be withheld (see instructions)
a. Total sales price paid to transferor..................................................................................          a                                               ●

b. Less selling expenses.....................................................................................................      b                                               ●

c. Less debts secured by mortgages or other liens on the property...................................                               c                                               ●

d. Net proceeds................................................................................................................... d                                               ●

e. Total payments (net proceeds paid to transferor)............................................................                    e                                               ●

f. Transferor/seller’s ownership percentage........................................................................                f                                               %

g. Transferor/seller’s share of total payment (multiply line e by line f)................................                          g                                               ●
h. Enter applicable rate:
1) 2.5% of total payments, or
2) 6.5% of estimated capital gain $__________________........................................                                      h                                               %
i. WV Income Tax withheld (multiply line g or amount of estimated capital gain by line h) 
(If partial exemption granted, enter amount stated on Form WV/NRCE)...........................                                     i                                               ●
Under the penalties of perjury, I declare that I have examined this return and to the best of my knowledge and belief, it is true, correct and complete. 
If prepared by a person other than the transferor/seller, the declaration is based on all information to which the preparer has any knowledge.

Signature                                                                Date

Make check or Money order payable to and Mail to:
West Virginia state tax departMent
tax account adMinistration diVision
po box 784
charleston, WV 25323-0784

copy a – File With the West Virginia state tax departMent
                                                                                *b56040801a*



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                                                        WV/NRSR
      InstructIons for return of Income tax wIthholdIng 
                               for nonresIdent sale of real property

There are three copies of From WV/NRSR                                         SpecIfIc INStRuctIoNS foR
      GeNeRal INStRuctIoNS                                                      completING the foRm:
                    Purpose of form:                                    lIne 1 enter the street address for the property as listed with the 
                                                                        county assessor. If the property does not have a street address, 
This form is designed to assure the regular and timely collection       provide  such descriptive  information  as  is used by the  county 
of wV income tax due from nonresident sellers of real property          assessor to identify the property.  also include the property 
located within the state. This form is used to determine the amount     account Id number for the parcel being transferred. If the property 
of income tax withholding due on the sale of property and provide       is made up of more than one parcel and has more than one account 
for its collection at the time of the sale or transfer.                 number, include all applicable account numbers.
                    Who must file:                                      lINe 2 enter the date of transfer. The date of transfer is the effective 
If the transferor/seller is a nonresident individual or nonresident     date of the deed. The effective date is the later of: (1) the date of the 
entity, and is transferring an interest in real property located within last acknowledgement; or (2) the date stated in the deed.
the state of wV, unless the transaction is otherwise exempt from        lINe 3 check the box if the transferor/seller is reporting the gain 
the income tax withholding requirement, the person responsible  under the installment method.
for closing must file  form  wV/nrsr with the  wV  state  tax 
                                                                        lINeS 4, 5, and 6 unless transferors/sellers are husband and wife 
department. If there are multiple transferors/sellers, a separate 
                                                                        and filing a joint wV income tax return, a separate form wV/
form must be completed for each nonresident individual or 
                                                                        nrsr must be completed for each transferor/seller that is entitiled 
nonresident entity subject to the withholding requirements. The 
                                                                        to receive any part of the proceeds of the transfer. enter the tax 
separate form requirement does not apply to a husband and wife 
                                                                        identification number or social security number for the nonresident 
filing a joint wV income tax return.
                                                                        transferor/seller and the social security number for the spouse, if 
a “nonresident entity” is defined to mean an entity that: (1)  applicable. do not enter the street address of the property being 
is not formed under the laws of wV, and (2) is not qualified by  transferred.
or registered with the wV state tax department to do business 
                                                                        lINe 7 check the appropriate box for the transferor/seller.
in wV.
                                                                        lINe 8 If a certificate of partial exemption is issued by the wV 
                    When to file:                                       state  tax  commissioner,  do  not  complete  lines  8a  through  8h. 
unless the transaction is otherwise exempt from the income tax  Instead, enter the amount stated on form wV/nrce.
withholding requirement, the person responsible for closing must        complete this section to determine the total payment allocable to 
complete form wV/nrsr for each nonresident transferor/seller            the transferor/seller that is subject to the income tax withholding 
at closing of sale.                                                     requirements and the amount of tax required to be withheld. The 
a nonresident individual or nonresident entity that sells real  total payment is computed by deducting from the total sales price 
or personal property located in wV must file a wV income tax  including the fair market value of any property or other non-
return. The appropriate income tax return must be filed for the year  monetary consideration paid to or otherwise transferred to the 
in which the transfer of the real property occurred. The due date  transferor/seller the amount of any mortgages or other liens, the 
for each income tax return type can be found in the instructions to  commission payable on account of the sale, and any other expenses 
the specific income tax return.                                         due from the seller in connection with the sale.
                    What to file:                                       lINe 8f If there are multiple owners, enter the percentage of 
                                                                        ownership of the transferor/seller for whom this form is being filed.
copy a of form wV/nrsr must be submitted to the wV state tax 
department with check or money order in the aggregate amount of         lINe 8g multiply line 8e by line 8f to determine the transferor/
tax due for each nonresident transferor/seller with regard to a sale    seller’s share of the total payment.
or transfer of real property within thirty (30) days of the date the    lINe 8h enter the applicable rate for the transferor/seller used for 
amounts were withheld.                                                  computing the withholding tax. If withholding tax is computed on 
copy B of form wV/nrsr is to be provided to the transferor/seller       6.5%, enter the amount of the estimated capital gain on line h2.
at closing.  nonresident individuals or nonresident entities must       lINe 8i enter the amount of tax withheld.
file the appropriate wV income tax return for the year in which 
                                                                        payment of tax: make check or money order payable to the wV 
the transfer of the property occurred. see the specific instructions 
                                                                        state tax department.
for the tax return being filed.
                                                                        signature: copy a of this return must be verified and signed by 
copy c of form wV/nrsr is to be retained by the taxpayer.
                                                                        the individual transferor/seller, an authorized person or officer of a 
                                                                        business entity, or the person responsible for closing.



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SpecIfIc INStRuctIoNS foR                                           The income tax withheld and reported on line 8 of form wV/nrsr 
                                                                    must be claimed as a withholding income tax payment.
tRaNSfeRoR/SelleR (copy B)
                                                                    S corporations, Partnerships and Limited 
How to claim the tax withheld
                                                                    Liability Companies and Business Trusts
a copy of form wV/nrsr (copy B) must be submitted with the 
appropriate wV Income tax return. failure to do so will result in   s corporation, partnerships and limited liability companies and 
                                                                    business trusts that elect to be treated as pass-through entities must 
the disallowance of the credit claimed.
                                                                    file a wV Income/Business franchise tax return for s corporation 
The manner in which the income tax withheld is claimed by the  and partnership return (wV/spf-100). The income tax withheld 
nonresident individual or nonresident entity depends on the  and reported of line 8 of form wV/nrsr must be claimed as a 
type of wV income tax return you are required to file. follow the  withholding income tax payment.
specific instructions below. claiming the income tax withheld on 
                                                                    This tax, and any other tax paid with form wV/nrsr must be 
a line other than as described below may result in the withholding 
                                                                    allocated to the nonresident shareholders, partners or members 
being denied.
                                                                    and reported on a modified federal schedule K-1 or wV statement. 
Individuals and Revocable Living Trusts                             all tax allocated to a nonresident shareholder, partner or member 
                                                                    must be claimed as a nonresident tax paid by s corporations, or 
nonresident  individuals are  required to  file  a  nonresident  wV 
                                                                    other unincorporated business entities.
Income tax return (form wV/It-140). The income tax withheld 
and reported on line 8 of form wV/nrsr must be claimed as a         Trusts and Estates
withholding Income tax payment.
                                                                    trustees of trusts and personal representatives of estates are 
             C corporations                                         required to file a wV fiduciary Income tax return (form It-141). 
                                                                    The  income  tax  withheld  and  reported  on  line  8  of  the  from 
c corporations are required to file a wV combined corporation 
                                                                    wV/nrsr must be claimed as a withholding tax payment.
net Income/Business franchise tax return (form wV/cnf120). 



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                                                                                                                                                                West Virginia 
                               RetuRN of iNcome tax WithholdiNg foR                                                                                             State Tax 
WV/NRSR                                                                                                                                                         Department
Rev. 09-12                                    NoNReSideNt Sale of Real pRopeRty

1. Property account ID Number:                                           2. Date of transfer

Address and Description
                                                                                MM                                                   DD YYYY
                                                                         3. Check if the transferor/seller is reporting gain 
                                                                                under the installment method.                

4.  Transferor/Seller’s Identification number CheCk one  5. Spouse’s SSN Number                                                         7. Transferor/Seller is:
                                                    SSn                                                                                  a. Individual
                                                    FeIn
                                                                                                                                         b. Corporation
                                                    ITIn
                                                                                                                                         c. Trust or Estate
6.  Transferor/Seller’s name (Enter only one name, unless husband and wife are filing a joint return. If more                            d. Business Trust
than one transferor/seller, use separate forms for each.)
                                                                                                                                         e. Partnership

Street Address including City, State and Zip Code                                                                                        f. S Corporation
                                                                                                                                         g. Limited Liability Company
                                                                                                                                         h. Limited Liability Partnership

8. Computation of total payment and tax to be withheld (see instructions)
a. Total sales price paid to transferor..................................................................................          a                                               ●

b. Less selling expenses.....................................................................................................      b                                               ●

c. Less debts secured by mortgages or other liens on the property...................................                               c                                               ●

d. Net proceeds................................................................................................................... d                                               ●

e. Total payments (net proceeds paid to transferor)............................................................                    e                                               ●

f. Transferor/seller’s ownership percentage........................................................................                f                                               %

g. Transferor/seller’s share of total payment (multiply line e by line f)................................                          g                                               ●
h. Enter applicable rate:
1) 2.5% of total payments, or
2) 6.5% of estimated capital gain $__________________........................................                                      h                                               %
i. WV Income Tax withheld (multiply line g or amount of estimated capital gain by line h) 
(If partial exemption granted, enter amount stated on Form WV/NRCE)...........................                                     i                                               ●

copy b – For transFeror/seller(records copy)



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                                                                                                                                                                West Virginia 
                               RetuRN of iNcome tax WithholdiNg foR                                                                                             State Tax 
WV/NRSR                                                                                                                                                         Department
Rev. 09-12                                    NoNReSideNt Sale of Real pRopeRty

1. Property account ID Number:                                           2. Date of transfer

Address and Description
                                                                                MM                                                   DD YYYY
                                                                         3. Check if the transferor/seller is reporting gain 
                                                                                under the installment method.                

4.  Transferor/Seller’s Identification number CheCk one  5. Spouse’s SSN Number                                                         7. Transferor/Seller is:
                                                    SSn                                                                                  a. Individual
                                                    FeIn
                                                                                                                                         b. Corporation
                                                    ITIn
                                                                                                                                         c. Trust or Estate
6.  Transferor/Seller’s name (Enter only one name, unless husband and wife are filing a joint return. If more                            d. Business Trust
than one transferor/seller, use separate forms for each.)
                                                                                                                                         e. Partnership

Street Address including City, State and Zip Code                                                                                        f. S Corporation
                                                                                                                                         g. Limited Liability Company
                                                                                                                                         h. Limited Liability Partnership

8. Computation of total payment and tax to be withheld (see instructions)
a. Total sales price paid to transferor..................................................................................          a                                               ●

b. Less selling expenses.....................................................................................................      b                                               ●

c. Less debts secured by mortgages or other liens on the property...................................                               c                                               ●

d. Net proceeds................................................................................................................... d                                               ●

e. Total payments (net proceeds paid to transferor)............................................................                    e                                               ●

f. Transferor/seller’s ownership percentage........................................................................                f                                               %

g. Transferor/seller’s share of total payment (multiply line e by line f)................................                          g                                               ●
h. Enter applicable rate:
1) 2.5% of total payments, or
2) 6.5% of estimated capital gain $__________________........................................                                      h                                               %
i. WV Income Tax withheld (multiply line g or amount of estimated capital gain by line h) 
(If partial exemption granted, enter amount stated on Form WV/NRCE)...........................                                     i                                               ●

copy c – For issuer






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