West Virginia 
WV/NRER                 APPLICATION FOR EARLY REFUND OF WITHHOLDING ON                                                                                                     State Tax 
REV. 03/2021                     SALES OF REAL PROPERTY BY NONRESIDENTS                                                                                                    Department
Mail completed form to: WV State Tax Department, Tax Account Administration Division, PO Box 784, Charleston, WV 25323-0784
                        Tax Year                                                          Tax Year 
                    Beginning          MM         DD                            YYYY          Ending         MM                                           DD      YYYY
THIS FORM IS OPTIONAL AND IS NOT REQUIRED TO BE FILED.                               DO NOT  file this form unless your only source of WV income is the sale of real 
property and associated personal property in WV.DO NOT  file this form prior to 60 days or later than 120 days of the e ffective date of transfer or 
after the end of the tax year in which the property is sold. This form is not valid for property sold after November 1. 
NAME (if joint, include  first name and initial of both)                         LAST NAME                                                             YOUR SOCIAL SECURITY NUMBER

NAME (Corporation, Partnership, Trust or Estate)                                                                                                      SPOUSE’S SOCIAL SECURITY NUMBER

CORPORATE OFFICER, PARTNER, TRUSTEE, EXECUTOR, OR ADMINISTRATOR                                                                                       FEIN

ADDRESS (NUMBER AND STREET)

CITY, STATE AND ZIP CODE

                                   DESCRIPTION OF WV REAL PROPERTY TRANSACTION
CHECK ONE:                      INDIVIDUAL                                       BUSINESS ENTITY

A. Date of Transfer                                                             B. Property Account ID number
                          MM       DD             YYYY
C. Location and general description of property:

1. Enter amount withheld on Form WV/NRSR (attach photocopy of Copy C)..................................                                               1
2. Sales price................................................................ 2
3. Cost or other basis...................................................      3
4. Gain (line 2 less line 3).............................................      4
5. Complete whichever applies: 5a) 2.5% of total payment, or 5b) 6.5% of estimated capital gain                                                       5
6. REFUND. Line 1 less line 5 (this line MUST be completed).........................................................                                  6
                               SCHEDULE FOR COMPUTATION OF COST OR OTHER BASIS
a. Purchase price of property.............................................................................................................            a
b. Add:  Capital Improvements.....................................
             Selling expenses.............................................
             Other (list)............................................................................................................................ b
c. Less: Depreciation....................................................
             Other (list)............................................................................................................................ c
d. Adjusted basis of property (enter on line 3 above)........................................................................                         d
Under the penalties of 
perjury, I declare that I have 
examined this application, 
accompanying schedules 
or statements, and to the        Signature                                           Title (if applicable)                                                          Date
best of my knowledge and 
belief, it is true, correct 
and complete. If prepared 
by a person other than the       Signature (spouse, if applicable)                   Title (if applicable)                                                        Date
taxpayer, the declaration 
is based upon information 
of which the preparer has 
knowledge.                       Signature of preparer other than taxpayer      Address and telephone number of preparer      Prepare’s SSN or PTIN

                                                        WV/NRER
                  INSTRUCTIONS FOR APPLICATION FOR EARLY REFUND

           GENERAL INSTRUCTIONS                                        Line 1. Enter the amount of tax withheld and reported on Line 8i of 
THIS FORM IS OPTIONAL AND IS NOT REQUIRED TO BE FILED.                         the Form WV/NRSR. A photocopy of Copy B of the form 
                                                                               must be attached to this form. Retain the original Copy B 
                       P                                                       with your tax records.
The income tax withheld at closing and paid to the WV State            Line 2. Enter the contract sales price from the sale. Attach a copy 
Tax Department is claimed on the WV Income Tax return   ledfi     by            of the HUD-1 closing statement from the sale of this 
transferor for the tax year in which the transfer of the real property         property.
and associated tangible personal property in WV is sold. You may 
elect to receive a refund of excess income tax withheld prior to       Line 3. In general, the cost or adjusted basis is the cost of the 
fi ling the income tax return. Use form WV/NRER to apply for a                  property plus purchase commissions and improvements, 
refund of the amount of tax withheld on the sale or transfer of WV             minus depreciation (if applicable). Increase the cost or 
real property interest(s) by a nonresident individual or nonresident           other basis by any expense of sale, such as commissions 
entity which is in excess of the transferor/seller’s tax liability for         and state transfer taxes. Complete the Schedule for 
the transaction. Form WV/NRER may not be   ledfi       prior to 60              Computation of Cost or Other Bases on the bottom of Form 
days after the date the tax withheld is paid to the State Tax                  WV/NRER and enter the amount from Line d on Line 3. 
Department and may not be  filed more than 120 days after the                   Purchase price and improvement documentation is 
date of transfer of the real property.                                         required.
Form WV/NRER may not be  filed after the end of the tax year in         Line 4. Subtract the amount on Line 3 from the amount on Line 2. 
which the transfer of the real property occurs. Form WV/NRER                   However, if you are reporting a gain under the installment 
is not valid for property sold after November 1. You must  file                 method for federal income tax purposes, attach a separate 
the appropriate WV income tax return to obtain a refund.                       sheet that lists the payments received during the tax year 
                                                                               and the gross pro  tfipercentage. Multiply the amount of 
IMPORTANT: If Form WV/NRER is  filed, the transferor/seller must                the payments by the gross pro fit percentage and enter the 
still  file the appropriate WV Income Tax return after the end of the           result on Line 4.
tax year, report the entire income for the year (from all sources, 
including the transfer), and pay any additional tax due on the         Line 5. Complete whichever applies: 2.5% of total payment or 6.5% 
income or request an additional refund.                                        of estimated capital gain.
                                                                       Line 6. Subtract the amount on Line 5 from the amount on Line 
               W   M                     F   A                                 1. If an overpayment is shown on Line 6, the State Tax 
An individual,  fiduciary, or corporation transferor/seller may   le fi          Department will refund any amount of $2.00 or more.
Form WV/NRER. A pass-through entity transferor/seller may not 
fi le Form WV/NRER.                                                                             S          ( ):
                                                                       Form WV/NRER must be signed by an individual (both taxpayer 
           SPECIFIC INSTRUCTIONS                                       and spouse, if  filing a joint income tax return), or a responsible 
At the top of Form WV/NRER, enter the tax year of the transferor/      o  fficer of the company or corporation.
seller if other than a calendar year.                                  Your signature(s) signi  esfi  that your application, including all 
Enter the name, address and identi fication number (social security     attachments, is, to the best of your knowledge and belief, true, 
number or federal employer identi fication number) of the transferor/   correct and complete, under the penalties of perjury.
seller applying for a refund of the amount withheld. The name and      If a power of attorney is necessary, complete WV Form 2848 and 
identi fication number entered must be the same as the name and         attach to your applicaiton.
identi fication number entered for the transferor/seller on the Form 
WV/NRSR. If the identi fication number on this form is incorrect, 
enter the correct identi fication number and attach an explanation to                           W           T  F
                                                                       File the completed WV/NRER with the:
the form. If the transferor/seller was issued an individual taxpayer 
                                                                       West Virginia State Tax Department
identi fication number (ITIN) by the IRS, enter the ITIN.
                                                                       Tax Account Administration Division/Withholding Unit
Line A. Enter the date of the transfer.                                PO BOX 784
Line B. Enter the location and general description of the property,    Charleston WV 25323-0784
           including the WV property account ID number assigned by 
                                                                                      A                     I
           the County Assessor.                                        For additional information, please call:
Check the box applicable to the type of taxpayer.                      1-800-982-8297 or
Line C. Enter the information describing the WV real property          TDD (hearing impaired) 1-800-282-9833
           transaction.