K-1            FROM SP       Schedule of WV Partner/Shareholder/Member/Bene fi                                                               ciary 
REV10-22                            Income, Loss, Modi fication, Credits, and Withholding                                                          2022
                                            TAXABLE YEAR OF ORGANIZATION

BEGINNING                                               ENDING
                          MM        DD            YYYY                                                                                   MM DD       YYYY
ORGANIZATION NAME (please type or print)                NAME OF PARTNER/SHAREHOLDER/MEMBER/BENEFICIARY

STREET or POST OFFICE BOX                               STREET or POST OFFICE BOX

CITY                                STATE   ZIP         CITY                                                                                STATE ZIP

WV IDENTIFICATION NUMBER            FEIN                FEIN/SSN                                                                            WV IDENTIFICATION NUMBER

CHECK ONE:                          WITHHOLDING
                                    1. Income subject to withholding for nonresident as reported on 
      S Corporation                       organization’s S Corporation, Partnership or Fiduciary Return                                     $                       .00

                                    2.  Amount of West Virginia tax withheld (see instructions)
      Limited Liability Company                                                                                                             $                       .00

                                                        PERCENTAGE OF OWNERSHIP
      Partnership         Fiduciary                                                                                                                                 %

DISTRIBUTIVE SHARE
INCOME
1. Distributive pro rata share of income allocable to West Virginia...........................................                        1                             .00
ADDITIONS
2. Interest or dividend income on federal obligations which is exempt from federal tax but 
subject to state tax............................................................................................................      2                             .00
3. Interest or dividend income on state and local bonds other than bonds from West Virginia 
sources.............................................................................................................................. 3                             .00
4. Interest on money borrowed to purchase bonds earning income exempt from West 
Virginia tax......................................................................................................................... 4                             .00
5. Any amount not included in federal income that was an eligible contribution for the 
Neighborhood Investment Program Tax Credit .................................................................                          5                             .00

6. Other Income deducted from federal adjusted gross income but subject to state tax......                                            6                             .00
SUBTRACTIONS
7. Interest or dividends received on United State or West Virginia obligations included in 
federal adjusted gross income but exempt from state tax.................................................                              7                             .00

8. Refunds of state and local income taxes received and reported as income to the IRS....                                             8                             .00
9. Other income included into federal adjusted gross income but excluded from state 
income tax.........................................................................................................................   9                             .00

10. Allowance for governmental obligations secured by residential property ........................                                   10                            .00

     *B54022201W*
      B54022201W

    NAME                                                                                                                        FEIN

CREDITS ALLOCABLE TO PARTNER/SHAREHOLDER/MEMBER

11. Left Intentionally blank. WV Tax Division use only. Do not write on line 11.                                             11

12. Economic Opportunity Tax Credit ...............................................................................          12             .00

13. High Technology Manufacturing Business ..................................................................                13             .00

14. Environmental Agricultural Equipment Tax Credit .......................................................                  14             .00

15. WV Neighborhood Investment Program Credit ..........................................................                     15             .00

16. Apprentice Training Tax Credit ...................................................................................       16             .00

17. Alternative Fuel Tax Credit .........................................................................................    17             .00

18. Historic Rehabilitated Buildings Tax Credit ................................................................             18             .00

19. West Virginia Military Incentive Tax Credit ................................................................             19             .00

20. Farm to Food Bank Tax Credit ...................................................................................         20             .00

21. Post-Coal Mine Site Business Credit ........................................................................             21             .00

22. Downstream Natural Gas Manufacturing Investment Tax Credit ..............................                                22             .00

23. Natural Gas Liquids .................................................................................................... 23             .00

24. Donation or Sale of Vehicle to Charitable Organizations ...........................................                      24             .00

25. Small Arms And Ammunition Manufacturers Credit ...................................................                       25             .00

26. WV Jumpstart Savings Program Credit for Employer contribution .............................                              26             .00

27. Capital Investment in Child-Care Property Tax Credit .................................................                   27             .00

28. Operating Costs of Child Care Property Tax Credit ....................................................                   28             .00

29. Industrial Advancement Act Tax Credit  .......................................................................           29             .00
ADDITIONAL INFORMATION
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                                                                                                                                *B54022202W*
                                                                                                                                B54022202W

                          WEST VIRGINIA SCHEDULE K-1

GENERAL

The partners, members, or shareholders of any pass-through entity are liable for tax on their share of the income, whether 
or not distributed, and must include their share on the individual income tax return.

West Virginia Schedule K-1 provides a reporting mechanism for a Pass-through entity to report the distributive share of 
gains, losses, modifications and credits of owners (i.e. partners, shareholders, members, etc.) Additionally, it is the reporting 
mechanism for any withholding required to be performed on nonresident owners.

This form should be used for any owner that is not a “C” Corporation. The Schedule K-1C should be used for any owner 
that is a “C” Corporation.

WITHHOLDING

This section includes information concerning the entity reporting the information (including the name, address, identification 
number and type), information concerning the owner to which this information statement relates (including the name, 
address, and identification number) and a withholding statement.

Line 1 of this section should include the distributive share of income for a nonresident owner.

Line 2 of this section should include the amount withheld for the nonresident owner.

DISTRIBUTIVE SHARE

This section includes the owner’s distributive share of items of gain, loss, modification and credit applicable to the owner.

Line 1 of this section should include the distributive share of income for an owner regardless of source. 

Lines 2 through 10 reflect the distributive share of modifications available to the owner reported on the entity’s Schedule B.

Line 11 is left intentionally blank. Do not mark on this line. 

Lines 12 through 29 reflect the distributive share of tax credits available to the owner reported on the entity’s Schedule 
PTE-100TC.

Report by Owners – The WV Schedule K-1 should be provided to all owners that are not “C” Corporations. All such owners 
must file a WV tax return that includes all WV Schedule K-1’s provided to the owner. Include your share of the partnership’s 
income or (loss), credits, deductions, etc., as shown by your Schedule K-1 on your West Virginia income tax return for the 
year in which the tax year of the entity ends.

SPECIAL RULE FOR PASS-THROUGH ENTITIES:

Pass-through entity owners of Pass-through entities should allocate income received from a pass-through entity unless 
such entities are engaged in a unitary business. If a unitary relationship exists, a pass-through entity owner of a Pass-
through entity may reapportion its WV income, including the appropriate factors of the subsidiary.

“FROM SP” CHECKED - INFORMATION ONLY K-1

When the entity listed in “Organization Name” submits the K-1 for information purposes, the entity must check the “From SP” 
box and include the “PARTNER/SHAREHOLDER/MEMBER/BENEFICIARY” on Schedule SP.