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4                                                                                                                                                                           4
5      Schedule                NONRESIDENTS/PART-YEAR RESIDENTS                                                                                                             5
       A
6                                                                                                                                                                           6
       Form IT-140 B                                      SCHEDULE OF INCOME                                                                           2023
7                                                                                                                                                                           7
8  NONRESIDENT                PART-YEAR RESIDENTS                                                    FROM                                           TO                      8
                              (Enter period of West Virginia residency MM/DD/YYYY)
9  (To Be Completed By Nonresidents and Part-Year Residents Only)                          COLUMN A:                         COLUMN B:                 COLUMN C:            9
10                   INCOME                                                             AMOUNT FROM  FEDERAL RETURN  ALL INCOME DURING PERIOD       WV SOURCE INCOME DURING 10
                                                                                                                     OF WV RESIDENCY                NONRESIDENT PERIOD
11                                                                                                                                                                          11
12 1  Wages, salaries, tips (withholding documents)                          1                        .00                            .00              .00        12
13                                                                                                                                                                          13
14 2  Interest  2                        .00                            .00              .00        14
15                                                                                                                                                                          15
16 3  Dividends     3                        .00                            .00              .00        16
17                                                                                                                                                                          17
18 4  IRAs, pensions and annuities                4                        .00                            .00              .00        18
19 5  Total taxable Social Security and Railroad Retirement                                                                                                                19
20     benefits (see line 32 and 38 of Schedule M) ................                     5                        .00                            .00                         20
21                                                                                                                                                                          21
   6  Refunds of state and local income tax 
22     (see line 36 of Schedule M)              6                        .00                            .00                         22
23                                                                                                                                                                          23
24 7  Alimony received          7                        .00                            .00                         24
25                                                                                                                                                                          25
26 8  Business profit (or loss) ..............................................         8                        .00                            .00              .00        26
27                                                                                                                                                                          27
28 9  Capital gains (or losses)            9                        .00                            .00              .00        28
29                                                                                                                                                                          29
30 10 Supplemental gains (or losses)  10                                      .00                            .00              .00        30
31                                                                                                                                                                          31
32 11 Farm income (or loss)  11                                 .00                            .00              .00        32
33                                                                                                                                                                          33
34 12 Unemployment compensation insurance                            12                       .00                            .00              .00        34
35                                                                                                                                                                          35
   13 Other income from federal return (identify source) 
36                                                                                      13                       .00                            .00              .00        36
37                                                                                                                                                                          37
38 14 Total income (add lines 1 through 13)  14                                         .00                            .00              .00        38
39                                                                                                                                                                          39
   ADJUSTMENTS
40                                                                                                                                                                          40
41 15 Educator expenses             15                       .00                            .00              .00        41
42                                                                                                                                                                          42
43 16 IRA deduction        16                       .00                            .00              .00        43
44                                                                                                                                                                          44
45 17 Self-employment tax deduction                   17                       .00                            .00              .00        45
46                                                                                                                                                                          46
47 18 Self Employed SEP, SIMPLE and qualified plans ......                             18                       .00                            .00              .00        47
48                                                                                                                                                                          48
49 19 Self-employment health insurance deduction  19                                                .00                            .00              .00        49
50                                                                                                                                                                          50
51 20 Penalty for early withdrawal of savings  20                                         .00                            .00              .00        51
52                                                                                                                                                                          52
53 21 Other adjustments (See instructions page 32)                          21                       .00                            .00              .00        53
54                                                                                                                                                                          54
55 22 Total adjustments (add lines 15 through 21)  22                                             .00                            .00              .00        55
56                                                                                                                                                                          56
   23 Adjusted gross income  
57     (subtract line 22 from line 14 in each column)  23                                            .00                            .00              .00        57
58                                                                                                                                                                          58
                                                                                        24 West Virginia income 
59                                                                                         (line 23, Column B plus column C)                    24               .00        59
60                                                                                                                                                                          60
                                                                                        25 Income subject to West Virginia Tax but exempt 
61                                                                                         from federal tax 25               .00        61
62                                                                                                                                                                          62
       *P40202307A* 26 Total West Virginia income (line 24 plus line 25)  
63     P40202307A                                                                          Enter here and on line 2 on the next page            26               .00        63
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                                                                                           –7–

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4                                                                                                                                                                                         4
5    Schedule                          NONRESIDENTS/PART-YEAR RESIDENTS                                                                                                                   5
     A
6                                                                                                                                                                                         6
     Form IT-140 B                             SCHEDULE OF INCOME                                                                                                2023
7                                              SCHEDULE A (CONTINUED)                                                                                                                     7
8                                                                                                                                                                                         8
9  PART I: NONRESIDENT/PART-YEAR RESIDENT TAX CALCULATION                                                                                                                                 9
10                                                                                                                                                                                        10
11 1  Tentative Tax (apply the appropriate tax rate schedule on page 35 to the amount shown on line 7, Form IT-140)                                      1        .00               11
12                                                                                                                                                                                        12
13 2  West Virginia Income (line 26, Schedule A) 2        .00               13
14                                                                                                                                                                                        14
15 3  Federal Adjusted Gross Income (line 1, Form IT-140)       3        .00               15
16 4  Tax (divide line 2 by line 3, round to 4 decimal places and multiply the result by line 1)                                                                                        16
17 Enter here and on line 8, Form IT-140      4        .00               17
18                                                                                                                                                                                        18
   PART II: SPECIAL NONRESIDENT INCOME FOR RESIDENTS OF RECIPROCAL STATES 
19                                                                                                                                                                                        19
     AND CERTAIN ACTIVE MILITARY MEMBERS
20                                                                                                                                                                                        20
21 ELIGIBILITY:  Complete this section ONLY if ALL THREE of the following statements were true for 2023                                                                                  21
22 • You were EITHER a resident of Kentucky, Maryland, Ohio, Pennsylvania or Virginia                                                                                                     22
     OR a member of the military assigned to active duty in West Virginia whose domicile is outside West Virginia
23 • Your only West Virginia source income was from wages and salaries                                                                                                                   23
24 • West Virginia income tax was withheld from such wages and salaries by your employer(s)                                                                                              24
25 If you were a non-military, domiciliary resident of Pennsylvania or Virginia and spent more than 183 days in West Virginia, you are also considered a                                  25
26 resident of West Virginia and must file Form IT-140 as a resident of West Virginia.                                                                                                    26
27 NOTE: If you were a resident of any state other than Kentucky, Ohio, Maryland, Pennsylvania, or Virginia, you are ineligible to complete Part                                          27
28 II. You must check the box Filing as Nonresident or Filing as a Part-Year Resident and Complete Schedule A and Part I to report any income                                             28
29 from West Virginia sources.                                                                                                                                                            29
30 I declare that I was not a resident of West Virginia at any time during 2023, I was a resident of the state shown OR was in West Virginia                                              30
31 pursuant to active duty military orders, my only income from sources within West Virginia was from wages and salaries, and such wages                                                  31
32 and salaries were subject to income taxation by my state of residence.                                                                                                                 32
33                                             YOUR STATE OF RESIDENCE (Check one):                                                                                                       33
34                                                                                                                                                                                        34
      1 Commonwealth of Kentucky        4 Commonwealth of Pennsylvania    Number of days spent in West Virginia
35                                                                                                                                                                                        35
36                                                                                                                                                                                        36
      2 State of Maryland               5 Commonwealth of Virginia        Number of days spent in West Virginia
37                                                                                                                                                                                        37
38                                                                                                                                                                                        38
      3  State of Ohio                  6 Active Military, stationed in West Virginia but not domiciled here (Must enclose military order and DD2058)
39                                                                                                                                                                                        39
40                                                                                                               (A)                                             (B)                      40
                                                                                                                 Primary Taxpayer's Social                       Spouse's Social Security 
41                                                                                                               Security Number                                 Number                   41
42                                                                                                                                                                                        42
43                                                                                                                                                                                        43
44                                                                                                                                                                                        44
45 5  Enter your total West Virginia Income from wages and salaries in the appropriate column                 5                 .00                                    .00               45
46 6  Enter total amount of West Virginia  Income Tax withheld  from your wages and                                                                                                      46
47 salaries paid by your employer in 2023  6                 .00                                    .00               47
48                                                                                                                                                                                        48
49 7  Line 6, column A plus line 6 column B Report this amount on line 15 of Form IT-140                            7        .00               49
50                                                                                                                                                                                        50
51                                                                                                                                                                                        51
52                                                                                                                                                                                        52
53                                                                                                                                                                                        53
54                                                                                                                                                                                        54
55                                                                                                                                                                                        55
56                                                                                                                                                                                        56
57                                                                                                                                                                                        57
58                                                                                                                                                                                        58
59                                                                                                                                                                                        59
60                                                                                                                                                                                        60
61                                                                                                                                                                                        61
62                                                                                                                                                                                        62
                                                                                                                 *P40202308A*
63                                                                                                               P40202308A                                                               63
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                                                                   –8–