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

                                                                                              _____________________________________________________________
                                                                         BAILEYName #2 / COLEMAN #3 GROUP                                                                               Letter Id:      L1743411744
                                                                                              270_____________________________________________________________           SARVIS FORK RD Issued:         06/28/2021
                                                                 AddressSANDYVILLE WV  25275-9718                                                                                       Account #:      2213-7083
                                                                                              _____________________________________________________________                             Period:         12/31/2021
        City                                                                      State                        Zip
                                                                                              
SEV-401REV 05/2020    WEST VIRGINIA SEVERANCE TAX ANNUAL RETURN

ACCOUNT                                   PERIOD                                                                DUE                                                                                EXTENSION
NUMBER                                    ENDING                                                         DATE                                                                                      DATE
                                          MMDDYYYY                                                       MMDDYYYY                                                                                  MMDDYYYY

        FINAL                                  AMENDED                                                          SEPARATE                                                                           CONSOLIDATED

         BEFORE YOU COMPLETE THIS PAGE, YOU MUST COMPLETE THE SUPPORTING SCHEDULES.
                                                                                                 TAX CALCULATION  
1. TOTAL TAX (PAGE 2, SEVERANCE TAX COMPUTATION SCHEDULE, LINE 8)                                                                                                                                                                              .

2. TOTAL CREDITS (PAGE 2, SCHEDULE TC, LINE 3)                                                                                                                                                                                                 .

3. ADJUSTED TAX (LINE 1 MINUS LINE 2) IF LINE 2 IS GREATER THAN LINE 1, ENTER 0                                                                                                                                                                .

4. TOTAL PAYMENTS MADE FOR THE PERIOD COVERED BY THIS RETURN AND ANY CREDIT FROM PRIOR YEARS OVERPAYMENT                                                                                                                                       .

5. BALANCE OF TAX DUE (LINE 3 MINUS LINE 4)
IF LINE 4 IS GREATER THAN LINE 3 ENTER 0, AND ENTER AMOUNT OVERPAID ON LINE 6.                                                                                                                                                                 .

6. OVERPAYMENT AMOUNT (LINE 4 MINUS LINE 3) IF LINE 3 IS GREATER THAN LINE 4, ENTER 0                                                                                                                                                          .

7. AMOUNT OF LINE 6 TO BE CREDITED TO NEXT YEAR’S TAX                                                                                                                                                                                          .

8. AMOUNT OF LINE 6 TO BE REFUNDED (LINE 6 MINUS LINE 7)                                                                                                                                                                                       .

                                                                                                         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  
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     SEV-401 continued

                                                                                      SEVERANCE TAX COMPUTATION SCHEDULE   
1.   NATURAL GAS
     (Schedule A MUST be completed. Enter total tax due from Schedule A, Total Line.)                                                                                       .
2.   OIL
     (Schedule B MUST be completed. Enter total tax due from Schedule B, Total Line.)                                                                                       .
3.   NATURAL GAS AT MID VOLUME VERTICAL WELL RATE
     (Schedule C MUST be completed. Enter total tax due from Schedule C, Total Line.)                                                                                       .

4.   OIL(ScheduleATDMID VOLUMEMUSTbe completed.VERTICALEnterWELLtotal taxRATEdue from Schedule D, Total Line.)                                                              .
5.   COALBED METHANE
     (Schedule E MUST be completed. Enter total tax due from this commodity from Schedule E, Column F, line 1.)                                                             .
6.   SAND, GRAVEL, OR OTHER MINERAL PRODUCT NOT QUARRIED OR MINED
     (Schedule E MUST be completed. Enter total tax due from this commodity  from Schedule E, Column F, line 2.)                                                            .
7.   OTHER NATURAL RESOURCE PRODUCTS (NATURAL GAS LIQUIDS, ETHANE, BUTANE, PROPANE, CONDENSATE, ETC.)                                                                       .
     (Schedule E MUST be completed. Enter total tax due from these commodities from Schedule E, Column F, line 3.)   
8.   TOTAL TAX –   ENTER HERE AND ON LINE 1 ON PAGE 1
                                                                                                                                                                            .

                                                                                      SCHEDULE TC - TAX CREDITS
1.  ANNUAL CREDIT-$500 PER YEAR OR $41.67 PER MONTH FOR EACH MONTH ENGAGED IN BUSINESS IN WEST VIRGINIA.   
     ONLY ONE ANNUAL CREDIT MAY BE CLAIMED BY EACH BUSINESS ENTITY, NOT TO EXCEED $500.00.                                                                                  .

2.  MANUFACTURING INVESTMENT TAX CREDIT (MUST ATTACH DOCUMENTATION)                                                                                                         .

3.  TOTAL CREDIT - ADD LINES 1 AND 2, ENTER TOTAL HERE AND LINE 2 ON PAGE 1.                                                                                                .

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