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Get West Virginia Tax Form

FY, under penalties provided by law, that the number of exemptions claimed in this certificate is not in excess of those to which I am entitled. Date Signature NONRESIDENTS - SEE REVERSE SIDE WV/IT-104 Rev. 1/07 WEST VIRGINIA CERTIFICATE OF NONRESIDENCE To be completed by employees who reside in Kentucky, Maryland, Ohio, Pennsylvania or Virginia. If you are a resident of Kentucky, Maryland, Ohio, Pennsylvania or Virginia and your only source of income from West Virginia is wages or salaries.

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