West Virginia 
                                              INFORMATION REPORT                                                        State Tax 
NRW-3
REV 7-21                            OF 761 NONPARTNERSHIP VENTURES                                                 Department
                                                  Read Instructions
ORGANIZATION NAME AND MAILING ADDRESS                                 NONRESIDENT’S NAME AND MAILING ADDRESS
NAME (PLEASE TYPE OR PRINT)                                           NAME (PLEASE TYPE OR PRINT)

STREET OR POST OFFICE BOX                                             STREET OR POST OFFICE BOX

CITY                                    STATE ZIP                     CITY                                   STATE ZIP

WEST VIRGINIA IDENTIFICATION NUMBER     FEDERAL IDENTIFICATION NUMBER WEST VIRGINIA IDENTIFICATION NUMBER    SOCIAL SECURITY NUMBER

AMOUNT OF FIXED OR DETERMINABLE GAINS,                                AMOUNT OF FIXED OR DETERMINABLE GAINS, 
PROFITS, AND INCOME OF THE ORGANIZATION $                             PROFITS, OR INCOME RECEIVED            $
                                                                      CHECK ONE 
                                                                                RESIDENT                     NONRESIDENT

                                                  Taxable Year of Organization
Beginning                                                             Ending
                MM                        DD      YYYY                          MM                        DD            YYYY

                INFORMATION REPORT OF 761 NONPARTNERSHIP VENTURES
                                                  INSTRUCTIONS

Who Must File: An unincorporated organization which has elected, under I.R.C. § 761, to not be treated as a 
partnership for federal  income tax purposes must   lefiWV/NRW-3, Information Report of 761 Nonpartnership 
Ventures, and report the following information:
     (1) The amount of  fixed or determinable gains, pro fi             ts, and income of the unincorporated organization, and
     (2) The name, address and taxpayer identi  cationfi               number of persons receiving   xedfi      or determinable
     gains, pro fits or income  from such nonpartnership venture.

When and Where to File:  Form WV/NRW-3 must be  fi                     led on or before February 28, of the preceding year with: 
     West Virginia State Tax Department
     Tax Account Administration Division
     PO Box 1202
     Charleston, WV 25324-1202
A duplicate copy of this statement must be furnished by the organization to each member of the organization to 
be attached to the individual’s West Virginia Personal income Tax Return