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IT-141                WEST VIRGINIA FIDUCIARY INCOME TAX RETURN
REV 03/2022                                        (for resident and non-resident estates and trusts)
                                                                                                                                                                                 2022
Estate or                                                                                        FEIN
Trust Name
Trustee Executor 
      Name
FIRST LINE OF                                                                 SECOND LINE OF 
ADDRESS                                                                       ADDRESS

      CITY                                                                   STATE                ZIP
FILING PERIOD                           EXTENDED                              FISCAL YEAR FILER  CHECK ONE:                                                          CHECK IF APPLICABLE:
ENDED                                    DUE DATE
MM DD YYYY                              MM DD YYYY                                                   Resident Non-Resident                                                       Final Amended
TYPE OF ENTITY
SIMPLE           COMPLEX          DECEDENT’S         CH7         CH11     QUALIFIED              POOLED                                                         ESBT                   GRANTOR 
TRUST            TRUST            ESTATE                                  DISABILITY TRUST       INCOME FUND                                                    (S portion only)       TYPE TRUST
                                                      Bankruptcy estate
DECEDENT         Date of Death                                         SSN                                                                                      Final Individual Return 
      INFO       MM/DD/YYYY                                                                                                                                     Filed for Decedent

1.    Federal taxable income (enter line 23, Federal Form 1041 or line 11, 1041-QFT) .............................................                              1                                .00

2.    West Virginia  duciary additions (Schedule B, line 6) ........................................................................................           2                                .00

3.    West Virginia  duciary subtractions (Schedule B, line 11) ..................................................................................             3                                .00

4.    West Virginia taxable income (sum of lines 1 and 2 minus line 3) ......................................................................                   4                                .00
                               IF THIS IS A SIMPLE TRUST HAVING NO TAXABLE INCOME, OMIT LINES 5-7

5.    West Virginia tax (check one)      Rate Schedule            Schedule NR ...................................................                               5                                .00

6.    Credits from Tax Credit Recap Schedule (see schedule page 6) ........................................................................                     6                                .00

7.    Adjusted tax due (line 5 minus line 6) .................................................................................................................. 7                                .00

8.    Non-resident income subject to tax (total of income for Bene ciaries, column F) ...............................................                          8                                .00

9.    West Virginia income tax paid for non-resident bene ciaries (total of Withholding for Bene ciaries, Column H)                                           9                                .00

10.  Combined tax due (sum of lines 7 and 9) ..............................................................................................................     10                               .00
11.  West Virginia  duciary income tax withheld (See Instructions) 
        CHECK HERE IF WITHHOLDING IS FROM NRSR (NON RESIDENT SALE OF REAL ESTATE) ...................................................                           11                               .00
12.  Estimated payments/payments with extension of time .........................................................................................               12                               .00

13.  Paid with original return (amended return only) ....................................................................................................       13                               .00

14.  Overpayment previously refunded or credited (amended return only) .................................................................                        14                               .00

15.  Total payments (sum of lines 11, 12, and 13 minus line 14) ..................................................................................              15                               .00

16.  Balance of tax due (line 10 minus line 15) ............................................................................................................    16                               .00

17.  Overpayment (if line 15 is larger than line 10, enter amount) ................................................................................             17                               .00

18.  Amount of line 17 to be credited to next year’s tax                                                                                                        18                               .00

                                                              19.  Amount to be refunded (line 17 minus line 18) ....                                           19                               .00

      *P35202201W*
          P35202201W
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