STATE OF WEST VIRGINIA
   State Tax Department, Tax Account Administration Division
   P.O. Box 3943
   Charleston, WV 25339-3943 

          Name

          Address

          City                                         State            Zip

WV/IT-101A     WEST VIRGINIA EMPLOYER’S ANNUAL RETURN OF INCOME TAX WITHHELD 

Account #:                                  Tax Year Ending:               Due Date:
                                                                                                          Amended
Part 1: Complete Lines 1-6
1.Number of employees who received wages, tips and other compensation for the tax year
          (Include withhholding tax statements, W-2s/1099) 
2.Wages, tips and other compensation for the tax year                                                                 .

3.Total WV income tax withheld from wages, tips and other compensation for the tax year                               .

4.Total payments for the tax year                                                                                     .

5.Balance due (If line 3 is greater than line 4, write difference here)                                                .

6.Overpayment (If line 4 is greater than line 3, write difference here)                                                .
Refund

Part 2: Tell us about your business. If not applicable to your business, leave blank.

If your business has stopped paying wages check here and enter the final date you paid wages
                                                                                                       MM   DD    YYY
Part 3: Sign your return.
Under penalty of perjury, I declare that I have examined this return (including accompanying schedules and statements) and to the best of my knowledge and 
belief it is true and complete.

(Signature of taxpayer)             (Name of taxpayer - type or print)               (Title)                (Date)

(Person to contact concerning this return)    (Telephone number)                     (E-mail address)

(Signature of preparer other than taxpayer)   (Address)                                                     (Date)

           MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT
                        Tax Account Administration Div
                  P.O. Box 1667 , Charleston, WV 25326-1667
FOR ASSISTANCE CALL (304) 558-3333 TOLL FREE (800) 982-8297 
              For more information visit our web site at: www.tax.wv.gov
                       File online at https://mytaxes.wvtax.gov                      *P44201801W*
                                                                                        P 4  4       2 0  1 8  0  1  W

     West Virginia Employer’s Annual Return of                         CREDITS AND/OR REFUNDS MAY BE CAPTURED AND 
                   Income Tax Withheld                                    APPLIED TO OUTSTANDING TAX LIABILITIES.
Effective January 1, 2019, Annual  lersfi  will no longer  le afi         Part 2:  Tell us about your business.  If not applicable to  your 
separate WV/IT-103 Year End Reconciliation.                            business, leave it  blank.
Employers are required to furnish each employee a withholding          If your business has stopped paying wages, check the box 
tax statement (Form W-2 or approved substitute) on or before           provided and enter the date you last paid wages in the space 
January 31 of the following year.  A copy of each employee’s W-2       provided.   Complete this section only if you have no employees 
is to be submitted to the State Tax Department accompanied with        and do not expect to have employees in the future.  By completing 
this form no later than January 31 of the succeeding year.  There is   this section, you authorize the closing of your Withholding Tax 
no need to file separate returns.                                       account.
Annual filers   are employers who withhold less than $600 annually      Part 3:  Sign your return.
or who employ certain domestic and/or household employees.             An unsigned return is not a valid return!  Your return must be 
Payment:     Payments are submitted separately from returns.           signed by a company representative, designated preparer, owner 
Annual payments accompanied by     Form WV/IT-101V are due             or o fficer, partner or member.   Please include a telephone number 
by the 15th of January following the close of the calendar year.       should we need to contact you concerning your return.
Return:   The IT-101A return is due the 31st day of January            Underpayment:  Enclose a payment for the Balance Due (Line 5) 
following the close of the calendar year.  This return is now a        with this form.  Payments received after January 15th are LATE.  
combination reconciliation and annual return.  You will no longer      Interest and penalty will be assessed.
fi le a separate WV/IT-103 Year end Reconciliation.  You will           Online: You may view your tax accounts,  lefi   tax returns, and 
report the number of W-2s and send copies of the withholding tax       make payments online by registering at mytaxes.wvtax.gov for 
statements (W-2’s) along with this form.                               MyTaxes.  For additional information, please contact:
Changes:  If it becomes necessary to change your filing frequency                          Taxpayer Services Division
during the year, please notify the Tax Account Administration                                 (304) 558-3333
Division.  Your Withholding Tax account will be adjusted 
accordingly and, if necessary, additional forms will be issued.                                  Toll Free
                                                                                             1-800-WVA-TAXS
Amended:  To correct a previously filed return, please check the                               (800)982-8297
box for AMENDED. Please be sure that the period ending date is 
for the period that needs to be corrected.                                      For the hearing impaired TDD 1-800-282-9833
INSTRUCTIONS FOR COMPLETING FORM WV/IT-101A                                          Visit our web site www.wvtax.gov

Part 1: Complete Lines 1 through 6
Line 1  -  Enter number of employees who received wages for 
the calendar year.  If no employees, enter zero.  YOU MUST 
INCLUDE COPIES OF W-2’s WITH THIS FORM.
Line 2 -  Enter total amount of compensation paid to these 
employees for the calendar year.  If no compensation was paid 
during this period, enter zero.
Line 3 -  Enter total amount of West Virginia Income Tax withheld 
for the calendar year.  If no withholding during this period, enter 
zero.
Line 4 - Enter the total payments submitted to the WV State Tax 
Department for the calendar year.  If no payments were submitted, 
enter zero.
Line 5 - Compare line 4 to line 3, if line 3 is greater than line 
4, enter the di  erenceff here and follow the     Underpayment 
instructions.  If line 3 is less than line 4, go to Line 6.  If line 3 
equals line 4, go to Part 2.
Line 6 - Compare line 4 to line 3, if line 4 is greater than line 3, 
enter the di fference here.  The overpayment credit will be applied 
to the next period.  Or, to request a refund, please check the box.