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4                                                                                                                                                                                                       4
5                                                                                                                                                                                                       5
                    WEST VIRGINIA FIDUCIARY INCOME TAX RETURN
6                                                                                                                                                                                                       6
   REVIT-14107/2023                                  (for resident and non-resident estates and trusts)                                                                             2023
7                                                                                                                                                                                                       7
   Trust Name
8  Estate or                                                                                                                        FEIN                                                                8
9  Trustee Executor                                                                                                                                                                                     9
10 Name                                                                                                                                                                                                 10
11 FIRST LINE OF                                                                SECOND LINE OF                                                                                                          11
12 ADDRESS                                                                          ADDRESS                                                                                                             12
13                                                                                                                                                                                                      13
14 CITY                                                                         STATE                                               ZIP                                                                 14
15 FILING PERIOD                       EXTENDED                                 FISCAL YEAR FILER                                   CHECK ONE:                           CHECK IF APPLICABLE:           15
16 ENDED                               DUE DATE                                                                                                                                                         16
   MM DD YYYY                          MM DD YYYY                                                                                   Resident          Non-Resident                  Final Amended
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                                                                                                                                                                                                      32
   5.    West Virginia tax (check one)  Rate Schedule               Schedule NR     ...................................................                            5                                .00
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 Beneficiaries, column F) ...............................................                          8                                .00 38
39                                                                                                                                                                                                      39
40 9.    West Virginia income tax paid for non-resident beneficiaries (total of Withholding for Beneficiaries, Column H)                                           9                                .00 40
41                                                                                                                                                                                                      41
42 10.  Combined tax due (sum of lines 7 and 9) ..............................................................................................................     10                               .00 42
43                                                                                                                                                                                                      43
   11.  West Virginia fiduciary income tax withheld (See Instructions) 
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
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   67891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071 727374757677787980
4                                                                                                                                                     4
5                                                                                                                                                     5
       Schedule         WITHHOLDING FOR BENEFICIARIES AND  
6      SB                                                                                                                                             6
7      Form IT-141      NON-RESIDENT TAX PAID FOR WITHHOLDING                            2023                                                         7
8                  ATTACH ADDITIONAL COPIES OF WITHHOLDING FOR BENEFICIARIES AS NEEDED                                                                8
9                                                                                                                                                     9
                          NAME AND ADDRESS OF EACH BENEFICIARY
10                 NAME         STREET OR MAILING ADDRESS           CITY                 STATE ZIP CODE                                               10
11                                                                                                                                                    11
12 1                                                                                                                                                  12
13                                                                                                                                                    13
14 2                                                                                                                                                  14
15                                                                                                                                                    15
16 3                                                                                                                                                  16
17                                                                                                                                                    17
18 4                                                                                                                                                  18
19                                                                                                                                                    19
20 5                                                                                                                                                  20
21                                                                                                                                                    21
22 6                                                                                                                                                  22
23                                                                                                                                                    23
24 7                                                                                                                                                  24
25                                                                                                                                                    25
26 8                                                                                                                                                  26
27                                                                                                                                                    27
28 9                                                                                                                                                  28
29                                                                                                                                                    29
30 10                                                                                                                                                 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                                                                                     6.5%                                                         35
36                                                                                                                                                    36
37 2                                                                                     6.5%                                                         37
38                                                                                                                                                    38
39 3                                                                                     6.5%                                                         39
40                                                                                                                                                    40
41 4                                                                                     6.5%                                                         41
42                                                                                                                                                    42
43 5                                                                                     6.5%                                                         43
44                                                                                                                                                    44
45 6                                                                                     6.5%                                                         45
46                                                                                                                                                    46
47 7                                                                                     6.5%                                                         47
48                                                                                                                                                    48
49 8                                                                                     6.5%                                                         49
50                                                                                                                                                    50
51 9                                                                                     6.5%                                                         51
52                                                                                                                                                    52
53 10                                                                                    6.5%                                                         53
54                                                                                                                                                    54
55 TOTALS                                                                                6.5%                                                         55
56                                                                                                                                                    56
57                                                                                                                                                    57
58                                                                                                                                                    58
59                                                                                                                                                    59
60                                                                                                                                                    60
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63                                                                  *P35202302W*                                                                      63
                                                                    P35202302W
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                                                      2

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4                                                                                                                                                                                                    4
5     SCHEDULE                                                                                                                                                                                       5
6       B                                                                                                                                                                                            6
7     Form IT-141     WEST VIRGINIA FIDUCIARY MODIFICATIONS                                                                                                  2023                                    7
8                                                                                                                                                            COLUMN II:AMOUNT ALLOCATED              8
9                                                                                                                                   COLUMN I:TOTAL           If this is a Simple Trust having        9
   ADDITIONS:                                                                                                                                                NO Taxable Income, OMIT Col. II
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 specifically 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 Officer 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
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60                                                                                                                                                                                                   60
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                                                                                                                                    *P35202303W*
63                                                                                                                                                    P35202303W                                     63
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