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      WV
     4868
(F    IT-140) W      Application for  Extension of Time to File                                                                                                         2020
File this form to request a six-month extension of time to file your 2020 West Virginia Personal Income Tax Return 
Your return must be filed no later than October 15, 2021. 

This form is NOT an extension of time to PAY personal income taxes due. 

                                                TAXPAYER INFORMATION
SOCIAL SECURITY                                                *SPOUSE’S SOCIAL 
NUMBER                                                      SECURITY NUMBER
                                                                                YOUR 
LAST NAME                                                      SUFFIX           FIRST                                                                                           MI
                                                                                NAME
                                                                                SPOUSE’S 
SPOUSE’S                                                       SUFFIX           FIRST                                                                                           MI
LAST NAME                                                                       NAME
FIRST LINE OF                                                  SECOND LINE OF 
ADDRESS                                                         ADDRESS

     CITY                                                      STATE            ZIP CODE

TELEPHONE                             EMAIL                                           EXTENDED DUE DATE
NUMBER                                                                                                                                                      MM/DD/YYYY

                                                     CALCULATION

a. Total income tax liability.............................................................................................................................. a.                    .00

b. Total payments (West Virginia withholding and/or credit for estimated payments)...................................                                       b.                    .00

c. Amount of West Virginia personal income tax due (subtract line b from line a)........................................                                    c.                    .00

                                                        NOTE

This form and payment must be fi led on or before the due date of the return (April 15, 2021). A penalty is imposed forfi                                                           late  ling/
late payment of tax unless reasonable cause can be shown. If you receive an extension of time for federal income purposes 
and expect to owe no West Virginia income tax, you are not requiredfito  le this form. To receive the same extension for state 
tax purposes, you need only note on your West Virginia Personal Income Tax Return that a federal extension was granted. 

                                                   Mail this return to:
                                       West Virginia State Tax Department
                                      Tax Account Administration Division
                                                     P.O. Box 2585
                                            Charleston, WV 25329-2585

                            This form must be complete and submitted in full.

                                   DO NOT CUT OR RESIZE THIS FORM.

                                                                                *P40202012W*
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