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                                                           STATE OF WEST VIRGINIA
                                                                                              
        State Tax Department, Tax Account Administration Div
                                                                                              
        P.O. Box 425 
                                                            Charleston, WV 25322-0425

                                                                                              _____________________________________________________________
                                                     NameTEST CORPORATION 1                                                                                                        Letter Id:          L1184948224
                                                                                              1001_____________________________________________________________           LEE ST E Issued:             10/07/2020
                                                                   AddressCHARLESTON WV  25301-1725                                                                                Account #:          2275-4088
                                                                                              _____________________________________________________________                        Period:             01/31/2021
        City                                                                      State                        Zip
                                                                                              
    SEV-400REV 05/2020                        WEST VIRGINIA SEVERANCE TAX ESTIMATE
                                                                                         FOR MONTHLY OR QUARTERLY REPORTING ONLY
                                 THIS FORM MUST BE COMPLETED AND RETURNED EVEN THOUGH NO BUSINESS MAY HAVE BEEN TRANSACTED. IF YOUR
                       BUSINESS WAS SOLD OR DISCONTINUED, PLEASE INDICATE THE EXACT DATE AND THE NEW OWNER ON THE BACK OF THIS FORM.
                       ACCOUNT                                                                     PERIOD                                                                          DUE
                       NUMBER                                                                      ENDING                                                                          DATE
                                                                                                   MMDDYYYY                                                 MMDDYYYY
                                                                                                   TAX CALCULATION  
                       RESOURCE                                                                             TAXABLE AMOUNT                                                             RATE            TAX DUE
1. NATURAL GAS (NOT MID VOLUME VERTICAL RATE)                                                                                                               .                      0.05                                                       .

2. OIL (NOT MID VOLUME VERTICAL RATE)                                                                                                                       .                      0.05                                                       .

3. NATURAL GAS - MID VOLUME VERTICAL  RATE
(Produces between 5 and 60 MCF per day)                                                                                                                     .                      0.025                                                      .
4. OIL - MID VOLUME VERTICAL RATE(Produces between1/2 to 10 Barrels per day)                                                                                .                      0.025                                                      .

5. COALBED METHANE                                                                                                                                          .                      0.05                                                       .

6. SAND, GRAVEL, OR OTHER MINERAL PRODUCT                                                                                                                   .                      0.05                                                       .

7. OTHER NATURAL RESOURCES - NATURAL GAS LIQUIDS                                                                                                            .                      0.05                                                       .
(INCLUDES ETHANE, BUTANE, PROPANE, CONDENSATE, ETC.)

8. INVESTMENT CREDITS                                                                                                                                                                                                                         .

9. $41.67 PER MONTH OR $125 PER QUARTER ANNUAL CREDIT                                                                                                                                                                                         .

10. TOTAL TAX DUE   (SUM OF LINES 1 THROUGH 7 MINUS THE SUM OF LINES 8 AND 9)                                                                                                                                                                 .

                                                                                                   SIGNATURE
UNDER PENALTIES 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

CONTACT                                                                                                                                                                                TELEPHONE NUMBER

SIGNATURE OF PREPARER OTHER THAN TAXPAYER                                    ADDRESS                                                                                                                   DATE

    MAIL TO: WEST VIRGINIA STATE TAX DEPARTMENT  
             Tax Account Administration Div  
             P.O. Box 425   
             Charleston, WV 25322-0425  
    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  
                                                                                                                                                                                       G     1     1     2     0     2     0     0     1     W



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                                     INSTRUCTIONS FOR FILING WV/SEV-400

All producers of natural resources must file a severance tax return to report the gross value or gross income from natural resources
severed and/or processed within West Virginia. Producers and processers of coal must file WV/SEV-4OOC, producers of timber must
file WV/SEV-400T. All other producers file WV/SEV400. It is extremely important that you separate the gross income value of each
type of natural resource you produce under the proper class code on the front of the return. Natural Gas Liquids, ethane, butane,
propane, condensate, etc. is reported on line 6 as "Other Natural Resources".

This return is for reporting monthly or quarterly estimates. If your net tax is $1,000 or more per month you are required to file 11
monthly estimate returns. If your net tax is less than $1,000per month, but more than $50 per month, you are required to file 3
quarterly estimate returns. The annual return you file at the end of your taxable year will include the last month's or quarter's tax due.
If your net tax liability is less than $600 per year, you are not required to file estimate returns; your entire amount of tax due will be
included on your annual return.

You may claim credit for any investment credits for which you qualify on line eight (8) of the return. An annual exemption of $41.67
per month may be claimed on line ten (10), up to the adjusted tax. If you qualify for any other exemptions from the tax, you may
exclude the exempt amount from the gross taxable amount on the estimated monthly or quarterly return and provide detail on the
annual return.

1. If you purchased this business during the last twelve (12) months, give the name and last known address of the previous
   owner. A successor in business could become liable for outstanding taxes owed by a previous owner.

2. If you quit business during the last twelve (12) months, write “yes” in the space provided and give the exact date you quit.
   If you did not, write “no” in the space. If you sold your business during the last twelve (12) months, write “yes” in the
   space provided, give the date of the sale, and provide the full name and address of the new owner. If you did not sell this
   business, write “no” in the space.
   a. Quit Business?           Sell or otherwise dispose of your business?   Exact date
   b. If business was sold, give exact name and address of new owner






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