67891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071 727374757677787980
4                                                                                                                                                                                                       4
5  IT-141                WEST VIRGINIA FIDUCIARY INCOME TAX RETURN                                                                                                                                      5
6  REV 07/2023                                        (for resident and non-resident estates and trusts)                                                                                                6
                                                                                                                                                                                    2023
7                                                                                                                                                                                                       7
   Estate or                                                                                                                        FEIN
8  Trust Name                                                                                                                                                                                           8
9  Trustee Executor                                                                                                                                                                                     9
10       Name                                                                                                                                                                                           10
11 FIRST LINE OF                                                                SECOND LINE OF                                                                                                          11
12 ADDRESS                                                                       ADDRESS                                                                                                                12
13                                                                                                                                                                                                      13
         CITY                                                                   STATE                                               ZIP
14                                                                                                                                                                                                      14
15 FILING PERIOD                           EXTENDED                             FISCAL YEAR FILER                                   CHECK ONE:                          CHECK IF APPLICABLE:            15
   ENDED                                    DUE DATE
16 MM DD YYYY                              MM DD YYYY                                                                                  Resident       Non-Resident                  Final Amended       16
17 TYPE OF ENTITY                                                                                                                                                                                       17
18 SIMPLE           COMPLEX          DECEDENT’S         CH7         CH11     QUALIFIED                                              POOLED                         ESBT                   GRANTOR       18
   TRUST            TRUST            ESTATE                                  DISABILITY TRUST                                       INCOME FUND                    (S portion only)       TYPE TRUST
19                                                       Bankruptcy estate                                                                                                                              19
20 DECEDENT         Date of Death                                          SSN                                                                                     Final Individual Return              20
21       INFO       MM/DD/YYYY                                                                                                                                     Filed for Decedent                   21
22                                                                                                                                                                                                      22
23 1.    Federal taxable income (enter line 23, Federal Form 1041 or line 11, 1041-QFT) .............................................                              1                                .00 23
24                                                                                                                                                                                                      24
25 2.    West Virginia  fiduciary additions (Schedule B, line 6) ........................................................................................           2                                .00 25
26                                                                                                                                                                                                      26
27 3.    West Virginia  fiduciary subtractions (Schedule B, line 11) ..................................................................................             3                                .00 27
28                                                                                                                                                                                                      28
29 4.    West Virginia taxable income (sum of lines 1 and 2 minus line 3) ......................................................................                   4                                .00 29
30                                IF THIS IS A SIMPLE TRUST HAVING NO TAXABLE INCOME, OMIT LINES 5-7                                                                                                    30
31                                                                                                                                                                                                      31
32 5.    West Virginia tax (check one)      Rate Schedule            Schedule NR ...................................................                               5                                .00 32
33                                                                                                                                                                                                      33
34 6.    Credits from Tax Credit Recap Schedule (see schedule page 6) ........................................................................                     6                                .00 34
35                                                                                                                                                                                                      35
36 7.    Adjusted tax due (line 5 minus line 6) .................................................................................................................. 7                                .00 36
37                                                                                                                                                                                                      37
38 8.    Non-resident income subject to tax (total of income for Bene ficiaries, column F) ...............................................                          8                                .00 38
39                                                                                                                                                                                                      39
40 9.    West Virginia income tax paid for non-resident bene ficiaries (total of Withholding for Bene ficiaries, Column H)                                           9                                .00 40
41                                                                                                                                                                                                      41
42 10.  Combined tax due (sum of lines 7 and 9) ..............................................................................................................     10                               .00 42
43 11.  West Virginia  fiduciary income tax withheld (See Instructions)                                                                                                                                  43
44                                                                                                                                                                                                      44
           CHECK HERE IF WITHHOLDING IS FROM NRSR (NON RESIDENT SALE OF REAL ESTATE) ...................................................                           11                               .00
45                                                                                                                                                                                                      45
46 12.  Refundable Credit (Build WV) ............................................................................................................................  12                                   46
47                                                                                                                                                                                                      47
48 13.  Estimated payments/payments with extension of time .........................................................................................               13                               .00 48
49                                                                                                                                                                                                      49
50 14.  Paid with original return (amended return only) ....................................................................................................       14                               .00 50
51                                                                                                                                                                                                      51
52 15.  Overpayment previously refunded or credited (amended return only) .................................................................                        15                               .00 52
53                                                                                                                                                                                                      53
54 16.  Total payments (sum of lines 11, 12, 13, and 14 minus line 15) ............................................................................                16                               .00 54
55                                                                                                                                                                                                      55
56 17.  Balance of tax due (line 10 minus line 16) ............................................................................................................    17                               .00 56
57                                                               18.  Overpayment (if line 16 is larger than line 10,                                                                                   57
58                                                               enter amount) .............................................................                       18                               .00 58
59                                                                                                                                                                                                      59
60                                                               19.  Amount of line 18 to be credited to next year’s tax                                          19                               .00 60
61                                                                                                                                                                                                      61
62       *P35202301W*                                            20.  Amount to be refunded (line 18 minus line 19) ....                                           20                               .00 62
63        P35202301W                                                                                                                                                                                    63
   678910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970711727374757677787980

   67891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071 727374757677787980
4                                                                                                                                                                                   4
5      Schedule         WITHHOLDING FOR BENEFICIARIES AND                                                                                                                           5
6        SB                                                                                                                                                                         6
       Form IT-141      NON-RESIDENT TAX PAID FOR WITHHOLDING 
7                                                                                                                                                               2023                7
8                  ATTACH ADDITIONAL COPIES OF WITHHOLDING FOR BENEFICIARIES AS NEEDED                                                                                              8
9                         NAME AND ADDRESS OF EACH BENEFICIARY                                                                                                                      9
10                 NAME         STREET OR MAILING ADDRESS                                                                                             CITY      STATE ZIP CODE      10
11                                                                                                                                                                                  11
   1  
12                                                                                                                                                                                  12
13                                                                                                                                                                                  13
   2  
14                                                                                                                                                                                  14
15                                                                                                                                                                                  15
   3  
16                                                                                                                                                                                  16
17                                                                                                                                                                                  17
   4  
18                                                                                                                                                                                  18
19                                                                                                                                                                                  19
   5  
20                                                                                                                                                                                  20
21                                                                                                                                                                                  21
   6  
22                                                                                                                                                                                  22
23                                                                                                                                                                                  23
   7  
24                                                                                                                                                                                  24
25                                                                                                                                                                                  25
   8  
26                                                                                                                                                                                  26
27                                                                                                                                                                                  27
   9  
28                                                                                                                                                                                  28
29                                                                                                                                                                                  29
   10  
30                                                                                                                                                                                  30
31        (A)                                              (E)                                                                                        (F)       (G)   (H)           31
                                                                                                                                    BENEFICIARY SHARE OF        RATE  TAX PAID FOR 
32 SOCIAL SECURITY       WEST VIRGINIA FILING METHOD     IF NRW-4                                                                                   WV INCOME       BENEFICIARIES 32
33        #        (B) RESIDENT (C) COMPOSITE (D) NONRES PREVIOUSLY                                                                                                   WITHHOLDING   33
                                                         FILED
34                                                                                                                                                                                  34
35 1                                                                                                                                                            5.12%               35
36                                                                                                                                                                                  36
   2                                                                                                                                                            5.12%
37                                                                                                                                                                                  37
38                                                                                                                                                                                  38
39 3                                                                                                                                                            5.12%               39
40                                                                                                                                                                                  40
41 4                                                                                                                                                            5.12%               41
42                                                                                                                                                                                  42
   5                                                                                                                                                            5.12%
43                                                                                                                                                                                  43
44                                                                                                                                                                                  44
45 6                                                                                                                                                            5.12%               45
46                                                                                                                                                                                  46
47 7                                                                                                                                                            5.12%               47
48                                                                                                                                                                                  48
   8                                                                                                                                                            5.12%
49                                                                                                                                                                                  49
50                                                                                                                                                                                  50
   9                                                                                                                                                            5.12%
51                                                                                                                                                                                  51
52                                                                                                                                                                                  52
   10                                                                                                                                                           5.12%
53                                                                                                                                                                                  53
54                                                                                                                                                                                  54
   TOTALS                                                                                                                                                       5.12%
55                                                                                                                                                                                  55
56                                                                                                                                                                                  56
57                                                                                                                                                                                  57
58                                                                                                                                                                                  58
59                                                                                                                                                                                  59
60                                                                                                                                                                                  60
61                                                                                                                                                                                  61
62                                                                                                                                                                                  62
                                                                                                                                    *P35202302W*
63                                                                                                                                                    P35202302W                    63
   678910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970712727374757677787980

   67891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071 727374757677787980
4                                                                                                                                                                                                    4
5      SCHEDULE                                                                                                                                                                                      5
6              B                                                                                                                                                                                     6
       F    IT-141           WEST VIRGINIA FIDUCIARY MODIFICATIONS 
7                                                                                                                                                            2023                                    7
8                                                                                                                                                            COLUMN II:AMOUNT ALLOCATED              8
                                                                                                                                    COLUMN I:TOTAL           If this is a Simple Trust having 
9  ADDITIONS:                                                                                                                                                NO Taxable Income, OMIT Col. II         9
10                                                                                                                                                                                                   10
11 1.  Interest income on state and municipal bonds, other than West Virginia .........                                                                                                              11
12                                                                                                                                                                                                   12
13 2.  Lump sum distribution (Federal Form 4972) .....................................................                                                                                               13
14                                                                                                                                                                                                   14
15 3.  Federal exemption (Form 1041, line 21) ...........................................................                                                                                            15
16                                                                                                                                                                                                   16
17 4.  Other additions – state nature and source ___________________________....                                                                                                                     17
18                                                                                                                                                                                                   18
19 5.  Electing small business trust additions ..............................................................                                                                                        19
20 6. TOTAL ADDITIONS                                                                                                                                                                                20
21     (Add Lines 1 through 5, Col. II and enter here and on Page 1, Line 2)..............                                                                                                           21
22 SUBTRACTIONS:                                                                                                                    COLUMN I:TOTAL           COLUMN II:AMOUNT ALLOCATED              22
23                                                                                                                                                                                                   23
24 7.  Interest income on US obligations speci fically exempt from state tax ...............                                                                                                          24
25 8.  West Virginia exemption ....................................................................................                                   600.00                                  600.00 25
26                                                                                                                                                                                                   26
27 9.  Other subtractions – state nature and source ________________________ ...                                                                                                                     27
28                                                                                                                                                                                                   28
29 10. Electing small business trusts subtractions .......................................................                                                                                           29
30 11. TOTAL SUBTRACTIONS                                                                                                                                                                            30
31     (Add Lines 7 through 10, Col. II and enter here and on Page 1, Line 3) .........                                                                                                              31
32 NET FIDUCIARY MODIFICATIONS                                                                                                      COLUMN I:TOTAL           COLUMN II:AMOUNT ALLOCATED              32
33                                                                                                                                                                                                   33
34 12. NET FIDUCIARY MODIFICATIONS (Line 6 minus Line 11)                                                                                                                                            34
35                                                                                                                                                                                                   35
36                                                                                                                                                                                                   36
   Direct Deposit            
37                                                                                                                                                                                                   37
38 of Refund                 CHECKING                 SAVINGS                            ROUTING NUMBER                                                      ACCOUNT NUMBER                          38
39     PLEASE REVIEW YOUR ACCOUNT INFORMATION FOR ACCURACY. INCORRECT ACCOUNT INFORMATION MAY RESULT IN A $15.00 RETURNED PAYMENT CHARGE.                                                            39
40 I authorize the State Tax Division to discuss my return with my preparer    YES    NO                                                                                                             40
41                                                                                                                                                                                                   41
   Under penalty of perjury, I declare that I have examined this return, accompanying schedules, and statements, and to the best of my knowledge and belief, it is true, correct and complete.
42                                                                                                                                                                                                   42
43                                                                                                                                                                                                   43
44 _________________________________________________________________________________________________________________________ 44
  (Signature of Fiduciary or O  fficer Representing Fiduciary)                                             (Date)                 (Email)
45                                                                                                                                                                                                   45
46                                                                                                                                                                                                   46
47                                                                                                                                                                                                   47
48 Paid          (Signature of Preparer)                                                                                                                                        (Date)               48
49 Preparer’s                                                                                                                                                                                        49
50 Use Only                                                                                                                                                                                          50
51               (Preparer’s EIN)                                                 (Printed Name)                                                                 (Telephone Number)                  51
52                                                                                                                                                                                                   52
53                                                                                                                                                                                                   53
54                                                                                                                                                                                                   54
55                                                                                                                                                                                                   55
56                                                                                                                                                                                                   56
57                                                                                                                                                                                                   57
58                                                                                                                                                                                                   58
59                                                                                                                                                                                                   59
60                                                                                                                                                                                                   60
61                                                                                                                                                                                                   61
62                                                                                                                                                                                                   62
                                                                                                                                    *P35202303W*
63                                                                                                                                                    P35202303W                                     63
   678910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970713727374757677787980