PVA-1                                        BUILD WEST VIRGINIA                                                                                        West Virginia  
                                                                                                                                                        Tax Division
REV07/2023            PROPERTY VALUE ADJUSTMENT TAX CREDIT

                                 IDENTIFICATION OF TAXPAYER CLAIMING CREDIT
  SSN/FEIN

  FIRST NAME                                                                    LAST NAME

BUSINESS NAME
                                                                  TAX PERIOD
  BEGINNING                                                                     ENDING
                      MM         DD                  YYYY                                MM DD                                                  YYYY
          BUSINESS IDENTIFICATION (Business/Entity that earned the credit if different from taxpayer)
  FIRST NAME                                                                    LAST NAME

BUSINESS NAME

  ADDRESS                                                                       CITY                                                            ZIP

       PROJECT INFORMATION (As certified by the West Virginia Department of Economic Development)
             You must include a copy of your certificate issued by the West Virginia Department of Economic Development 

                      PROJECT COMPLETION DATE

                           CERTIFIED COSTS

                  REFUNDABLE CREDIT LIMITATION AMOUNT

                                            CALCULATION OF AVAILABLE CREDIT
1 CERTIFIED COSTS

2 MULTIPLY COSTS BY 60 PERCENT

3 AVERAGE STATEWIDE CLASS III PROPERTY TAX RATE FOR THE YEAR THE PROJECT 
  WAS COMPLETED (PER DOLLAR RATE)

4 MULTIPLY LINE 2 BY LINE 3

5 TOTAL PROPERTY VALUE ADJUSTMENT CREDIT (LINE 4 MULTIPLIED BY 10)

6 CREDIT AVAILABLE  FOR  USE  PER  TAX  YEAR (FOR 10  CONSECUTIVE  TAX  YEARS)  
  LINE 5 DIVIDED BY 10
                                                     TAXPAYER SIGNATURE
Under penalty of perjury, I declare that I have examined this form and to the best of my knowledge and belief, it is true, correct and complete.

          Credit Schedule for reference 
SIGNATURE OF TAXPAYER                       NAME OF TAXPAYER (PRINT OR TYPE)                TITLE                                                   DATE

PERSON TO CONTACT CONCERNINGDoTHIS SCHEDULE Not Send forPHONE NUMBER                                                                                forms testing 

SIGNATURE OF PREPARER OTHER THAN TAXPAYER   PREPARER ADDRESS                                                                                        DATE

   SCHEDULE PVA-1 (continued) 

                                        CORPORATION NET INCOME TAXPAYERS 
   Beginning with the year in which construction of the property is completed, one tenth of the approved credit may be claimed.  
                                                     Credit may NOT be carried back or carried forward.  
   Property Value Adjustment Credit allocated to this period in excess of credit applied to tax liability and refundable credit claimed is forfeited.
7  WV APPORTIONED INCOME OF ENTITY WHICH EARNED THE CREDIT

8  WV TAX LIABILITY OF ENTITY WHICH EARNED THE CREDIT

9  AMOUNT OF OTHER TAX CREDITS APPLIED

10 TAX LIABILITY AFTER OTHER CREDITS APPLIED
11 PRO-RATED PROPERTY VALUE ADJUSTMENT CREDIT APPLIED TO TAX LIABILITY 
   (smaller of Line 6 or Line 10) Enter on CIT-120TC or EPT-100TC
12 REMAINING TAX CREDIT 
   (If Line 11 is smaller than Line 6, Line 6 minus Line 11. Otherwise, 0)
13 REFUNDABLE CREDIT LIMITATION AMOUNT

14 REFUNDABLE CREDIT USED IN PRIOR YEARS
15 AVAILABLE REFUNDABLE CREDIT 
   (Line 13 - Line 14)
16 REFUNDABLE CREDIT CLAIMED 
   (Lessor of Line 12 or 15) Enter on CIT-120 Line 13

   Credit Schedule for reference 

                      Do Not Send for forms testing