STATE OF WEST VIRGINIA
                                                                                                      
State Tax Department, Tax Account Administration Div
                                                                                                      
                                                                                                      P.O. Box 425 
                                                                                                      Charleston, WV 25322-0425
                                                                                                      
                                                                                                      _____________________________________________________________
                                                                                                      TESTName CUSTOMER                                                                    Letter Id:     L1469374464
                                                                                                      1001_____________________________________________________________           LEE ST E Issued:          10/09/2020
                                                                                                      AddressCHARLESTON WV  25301-1725                                                     Account #:       2276-2396
                                                                                                      _____________________________________________________________                        Period:          12/31/2020
City                                                                      State                        Zip
                                                                                                      
SEV-401C                        ANNUAL COAL SEVERANCE RETURN
rtL351V.1

ACCOUNT                                   PERIOD                         DUE                                                                                                                       EXTENSION
NUMBER                                    ENDING                         DATE                                                                                                                         DATE
                                          MMDDYYYY                       MMDDYYYY                                                                                                                  MMDDYYYY
CHOOSE                                                                                                                                                                                                DATE
ONE:             CONSOLIDATED             SEPARATE           AMENDED                                                                                               ISOPACH MAP SENT                   SENT
                                                                                                                                                                                                   MMDDYYYY

                                                            SECTION A:  TAX COMPUTATIONS  
1   TOTAL TAX DUE (SECTION B, LINE 33)
                                                                                                                                                                                                                      .
2   TOTAL CREDITS (SECTION TC, LINE 12)
                                                                                                                                                                                                                      .
3   NET SEVERANCE TAX PAYABLE (LINE 1 MINUS LINE 2)
                                                                                                                                                                                                                      .
4   TOTAL PAYMENTS MADE FOR PERIODS
                                                                                                                                                                                                                      .
5   TOTAL TAX DUE
                                                                                                                                                                                                                      .
6   OVERPAYMENT AMOUNT
                                                                                                                                                                                                                      .
7   AMOUNT TO BE CREDITED TO NEXT YEARS TAX
                                                                                                                                                                                                                      .
8   AMOUNT TO BE REFUNDED
                                                                                                                                                                                                                      .

                                                            SECTION TC:  TAX CREDITS
                                                                                                                                                                                           12TH MONTH       FULL YEAR
9   ANNUAL CREDIT - $500 PER YEAR OR $41.67 PER MONTH FOR EACH MONTH ENGAGED IN BUSINESS IN WV
                                                                                                                                                                                                      .               .
10  INVESTMENT CREDITS
                                                                                                                                                                                                      .               .
11  CREDIT FOR COAL LOADING FACILITIES (ATTACH SCHEDULE CL)
                                                                                                                                                                                                      .               .
12  TOTAL CREDIT (ADD LINES 9 THROUGH 11 FULL YEAR) AND REPORT ON LINE 2 OF SCHEDULE A
                                                                                                                                                                                                                      .

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  
                                                                                                                                                                                           B     2     7     2     0     2     0     0     1     W

    ACCOUNT #

                                              SECTION B:  TAX COMPUTATIONS  
                                                                                                                                                                                                                                       COLUMN C
LOCAL TAX (ALL COAL MINED, PROCESSED OR SOLD)                                                                                                                                                                                          TOTAL TAX
                                                                                                                                                                                                                                        
13  GROSS VALUE ...............................................................................................................................................................                                                  .

14  RATE ....................................................................................................................................................................................................................... 0.0035
15  TOTAL LOCAL TAX (LINE 13 X LINE 14) ...............................................................................................................................................................................           $     .
                                              SOLD TO ELECTRIC POWER PRODUCERS
REGULAR COAL                      JULY 1, 2020 TO JUNE 30, 2021 JULY 1, 2019 TO JUNE 30, 2020                                                                                     SOLD TO OTHERS
16  TONS MINED

17  TONS PROCESSED

18  TOTAL TONS

19  GROSS VALUE                               .                               .                                                                                                                                                  .
20  RATE                                      0.03              0.0395                                                                                                                                                           0.0465
                                              35
21  NET STATE SEVERANCE TAX                   .                               .                                                                                                                                                  .
(LINE 20 X LINE 19)
22  MINIMUM TAX  (LINE 16 X 0.75)             .                               .                                                                                                                                                  .

23  GREATER OF LINE 21 OR LINE 22             .                               .                                                                                                                                                  .

24  TOTAL REGULAR SEVERANCE  (Add columns on line 23) ............................................................................................................................................                                $     .
THIN SEAM 37" TO 45"

25  TONS MINED ..................................................................................................................................................................

26  GROSS VALUE ...............................................................................................................................................................                                                  .

27  RATE .......................................................................................................................................................................................................                 0.0165
28  TOTAL TAX  (LINE 26 X LINE 27) ...................................................................................................................................................................................            $     .
THIN SEAM UNDER 37"

29  TONS MINED ...................................................................................................................................................................

30  GROSS VALUE ................................................................................................................................................................                                                 .

31  RATE ............................................................................................................................................................................................................            0.0065
32  TOTAL TAX  (LINE 30 X LINE 31)...................................................................................................................................................................................             $     .

33  TOTAL TAX DUE  (Sum Column C) (Enter on line 1, Section A) .....................................................................................................................                                              $     .

                                                                                                                                                                                  B     2     7     2     0     2     0     0     2     W

   ACCOUNT #

                                  SECTION C:  SEVERANCE TAX COMPUTATION 12TH MONTH PERIOD  
                                                               COLUMN 1              COLUMN 2                                                                                COLUMN 3
                                                   12TH MONTH TAXABLE AMOUNT           RATE                                                                                  TAX DUE (COLUMN 1 X COLUMN 2)

34 GROSS VALUE OF SEVERED COAL                                          .            0.05
   (NON THIN SEAM)                                                                                                                                                                       .

                                                                                                                                                                                         .
35 VALUE ADDED FROM PROCESSED COAL                                      .            0.05

                                                                                                                                                                                         .
36 COAL SOLD TO ELECTRIC POWER PRODUCERS                                .            0.037

                                                                                                                                                                                         .
37 QUALIFIED THIN SEAM 37" TO 45"                                       .            0.02

                                                                                                                                                                                         .
38 QUALIFIED THIN SEAM LESS THAN 37"                                    .            0.01
39 GROSS VALUE TO BE TAXED
   (SUM OF COLUMN 1)
                                                                        .

40 TOTAL TAX DUE  (Sum of Column 3) ....................................................................................................................................                 .
                                  SECTION E:  REPORT OF COAL PRODUCTION FOR TAXABLE YEAR
   MINING PERMIT                  NAME OF COUNTY               COUNTY   TONS PRODUCED IN 12TH MONTH                                                                          TOTAL TONS PRODUCED ANNUALLY
                                                               FIPS CODE
41
                                                                                                                                                                         .00                              .00
42
                                                                                                                                                                         .00                              .00
43
                                                                                                                                                                         .00                              .00
44
                                                                                                                                                                         .00                              .00
45
                                                                                                                                                                         .00                              .00
46
                                                                                                                                                                         .00                              .00
47
                                                                                                                                                                         .00                              .00
48
                                                                                                                                                                         .00                              .00
49
                                                                                                                                                                         .00                              .00
50
                                                                                                                                                                         .00                              .00
IF REPORTING MORE THAN TEN (10) ENTRIES, UPLOAD SPREADSHEET AT MYTAXES.WVTAX.GOV
KEY TO COUNTY FIPS CODES
001 Barbour         015 Clay         029 Hancock   043 Lincoln          057 Mineral    071 Pendleton                                                                         085 Ritchie 099 Wayne
003 Berkeley        017 Doddridge    031 Hardy     045 Logan            059 Mingo      073 Pleasants                                                                         087 Roane   101 Webster
005 Boone           019 Fayette      033 Harrison  047 McDowell         061 Monongalia 075 Pocahontas                                                                        089 Summers 103 Wetzel
007 Braxton         021 Gilmer       035 Jackson   049 Marion           063 Monroe     077 Preston                                                                           091 Taylor  105 Wirt
009 Brooke          023 Grant        037 Jefferson 051 Marshall         065 Morgan     079 Putnam                                                                            093 Tucker  107 Wood
011 Cabell          025 Greenbrier   039 Kanawha   053 Mason            067 Nicholas   081 Raleigh                                                                           095 Tyler   109 Wyoming
013 Calhoun         027 Hampshire    041 Lewis     055 Mercer           069 Ohio       083 Randolph                                                                          097 Upshur

                                                                                       B     2     7     2     0     2     0     0     3     W