PDF document
- 1 -

Enlarge image
                                                                                                                                                                                                                                                                                                                                             .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00  .00 .00        .00

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      W
                                                                                                                                         (G)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          9

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      0
                                                                                                                                    2020                     TAX WITHHELD FOR                     OTHER NONRESIDENT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   0
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      2
                                                                                                                                                                                                                                                                                                                                             .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00  .00 .00        .00                                                                                                                                                                                                                                                                                          0
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      2
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      4
                                                                                                                                         (F)
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      5
                                                                                                                                                                                                                    COMPOSITE
                                                                                                                                                                                                  NONRESIDENT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         B
                                                                                                                                                             TAX WITHHELD FOR                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              *B54202009W*

                                                                                                                                                                                                                                                                                                                                             .00 .00 .00 .00 .00 .00 .00 .00 .00 .00 .00  .00 .00        .00

                                                                                                                                         (E)
                                                                                                                                                                                                  INCOME
                                                                                                                                                             WV DISTRIBUTIVE 

                                                                                                                                         (D)

                                                                                                                                                             PERCENTAGE                           OF OWNERSHIP      to the sixth decimal place                                                                                               0.  0.  0.  0.  0.  0.  0.  0.  0.  0.  0.   0.
                                                                                                                                                           4 NRW-4 or 
                                                                                                                                                           TAX EXEMPT
                                                                                                                                                           3 NONRESIDENT
                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                           2 NONRESIDENT 
                                                                                                                                                           COMPOSITE
                                                                                                                                         (C)CHECK ONLY ONE 1 WV RESIDENT

                                                                                                 AND COMPUTATION OF WITHHOLDING TAX      (B)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Total WV Income
                                                                                                                                                             SSN/FEIN
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        line 7 (Withholding column) of PTE-100                                       line 8 (Withholding column) of PTE-100
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     to                                                         to 

                                               SUMMARY OF K-1 SHAREHOLDERS/PARTNERS OWNERSHIP 
                                                                                                                                                                                                                                                                                                                                                                                              Page totals
                                                                                                 W                                                                                                                                                                                                                                                                                                                                                                                                                                  Column F                                                   Column G
                                                                                                                                         (A)
                                                                                                                                                                                                                                                                                                                                                                                                         SP Schedule Grand Total

                                                                                              SP                                                             SHAREHOLDER/             PARTNER NAME
                                                                                                 PTE-100                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               FEIN
SCHEDULE                                                                                                                                                                                                                                        MARK IF A SINGLE                         SHAREHOLDER/PARTNER HAS               100% OWNERSHIP

                                                                                                                                                                                                                                                                                                                                             1   2   3   4   5   6   7   8   9   10  11  12                                                                                                                                         • Transfer Total of                                        • Transfer Total of 
                                                                                                                                                                                                                                                                                                                                                                                                                                Taxpayers reporting more than 12 shareholders/partners must  le their PTE-100 return electronically.
                                                                                                                                                                                                                                                                                                                                                                     -9-






PDF file checksum: 1788187283

(Plugin #1/8.13/12.0)