Enlarge image | 67891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071 727374757677787980 4 4 5 Schedule SCHEDULE OF 5 DP 6 Form IT-140 B ADDITIONAL DEPENDENTS 2023 6 7 7 8Use this schedule to continue listing dependents If space is needed for more than 25 dependents, a copy of this form 8 9 may be obtained from the West Virginia Tax Division’s website: taxwvgov 9 10 10 First Name Last Name Social Security Number Date of Birth 11 MM DD YYYY 11 12 12 13 13 14 14 15 15 16 16 17 17 18 18 19 19 20 20 21 21 22 22 23 23 24 24 25 25 26 26 27 27 28 28 29 29 30 30 31 31 32 32 33 33 34 34 35 35 36 36 37 37 38 38 39 39 40 40 41 41 42 42 43 43 44 44 45 45 46 46 47 47 48 48 49 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 *P40202311A* 62 63 P40202311A 63 67891011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859606162636465666768697071 727374757677787980 –49– |