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

                                                                                                                                                (G)

                                                                                                                                            2022
                                                                                                                                                                        TAX WITHHELD FOR                     OTHER NONRESIDENT

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

                                                                                                                                                (F)
                                                                                                                                                                                                                                                        COMPOSITE
                                                                                                                                                                                                             NONRESIDENT                                                                                                                                                                                                                                                                                                                                                                                                                       B54202209W
                                                                                                                                                                        TAX WITHHELD FOR                                                                                                                                                                                                                                                                                                                                                                                                                                           *B54202209W*

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

                                                                                                                                                (E)
                                                                                                                                                                                                             INCOME
                                                                                                                                                                        WV DISTRIBUTIVE 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                .00
                                                                                                                                                (D)

                                                                                                                                                                                                             OWNERSHIP 
                                                                                                                                                                        PERCENTAGE OF                                         to the sixth decimal place
                                                                                                                                                                   NRW-4 or 
                                                                                                                                                                   TAX EXEMPT
                                                                                                                                                                   NONRESIDENT
                                                                                                                                                                                                                                                                                                                                                                                                                   fi le their PTE-100 return electronically.
                                                                                                                                                                   NONRESIDENT 
                                                                                                                                                                   COMPOSITE
                                                                                                             AND COMPUTATION OF WITHHOLDING                                                                                                                                                                                                                                                                        must 
                                                                                                                                                (C) CHECK ONLY ONE 1234 WV RESIDENT

                                               SUMMARY OF K-1 SHAREHOLDERS/PARTNERS OWNERSHIP                                                   (B)                                                                                                                                                                                                                                                                                                                                                                                                                                                              Total WV Income
                                                                                                                                                                        SSN/FEIN

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              line 7 (Withholding column) of PTE-100                                       line 8 (Withholding column) of PTE-100
                                                                                                                                                                                                                                                                                                                                                                                                                                                                           to                                                         to 

                                                                                                                                                                                                                                                                                                                                                                                                          SP Totals
                                                                                                 W                                                                                                                                                                                                                                                                                                                                                                        Column F                                                   Column G
                                                                                                                                                (A)

                                                                                              SP                                                                        SHAREHOLDER/             PARTNER NAME
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 FEIN
         Schedule                                                                                                                                                                                                                                                 MARK IF A SINGLE                         SHAREHOLDER/PARTNER HAS               100% OWNERSHIP
                                                                                                 Form PTE-100
                                                                                                                                                                                                                                                                                                                                                               1   2   3   4   5   6   7   8   9   10                                                                     • Transfer Total of                                        • Transfer Total of 
                                                                                                                                                                                                                                                                                                                                                                                                                   Taxpayers reporting more than 10 shareholders/partners