BACKUP WITHHOLDING TAX PAYMENT

                          MAIL TO:  WEST VIRGINIA STATE TAX DEPARTMENT
                          Tax Account Administration Div
                          P. O. Box 1667, Charleston, WV  25326-1667
           FOR ASSISTANCE CALL (304) 558-3333  TOLL FREE (800) 982-8297
                          For more information visit our web site at: www.wvtax.gov
                          File online at https://mytaxes.wvtax.gov

                          Please cut off and return with payment

  WV-945-V                BACKUP WITHHOLDING PAYMENT VOUCHER

                                                                    Tax Period

B                                                                                  Due Date
7 Business name (individual name if sole proprietor)
1
2 Address
0
1 City, State and Zip Code
1
0
1 Account ID:                                       Amount Enclosed:                       .
W

                                                                                            rtL053 v.2-web