Free West Virginia Gsr 01 Template

Free West Virginia Gsr 01 Template

The West Virginia GSR-01 form is a request for a Statement of Good Standing issued by the West Virginia State Tax Department. This form is essential for businesses to confirm their compliance with state tax obligations. Completing this form ensures that your business is recognized as being in good standing, which is crucial for various business transactions.

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The West Virginia GSR-01 form, officially known as the Request for Statement of Good Standing, serves a crucial role for businesses operating within the state. This form is essential for obtaining confirmation that a business is in good standing with the West Virginia State Tax Department. It requires basic information, such as the taxpayer identification number, complete business name, and business location. The form also includes a section where the type of business—whether a partnership, sole ownership, corporation, or LLC—must be specified. By submitting this request, the applicant acknowledges that if the business is not in good standing, they will receive written notification detailing any outstanding tax returns or payments. Furthermore, the form mandates a signature from the taxpayer or their authorized representative, certifying the request under penalty of perjury. If a CPA or attorney is completing the form on behalf of the business, their signature is also required, along with that of a principal of the business. For those authorizing information release without professional representation, notarization is necessary. Additionally, the form provides options for receiving responses via fax, ensuring that communication remains efficient. Understanding the GSR-01 form is vital for business owners to maintain compliance and avoid potential issues with state tax obligations.

West Virginia Gsr 01 Example

GSR-01

West Virginia

Request for Statement of Good Standing

Rev. 10/14

West Virginia

State Tax

Department

Taxpayer Identiication Number _____________________________

Complete Business Name ___________________________________________________________________________

Business Location __________________________________________________________________________________

Mailing Address ____________________________ _______________________

_____________

________________

Street

City

State

Zip

Type of business (check one):

Partnership

Sole Ownership

Corporation/LLC

Other

______________________

I understand that in the event that this business is not in good standing with the Tax Department I will be notiied in writing as to what tax returns or tax payments are considered not iled or paid and who to contact with any questions regarding that

situation.

By signing this Request for Statement of Good Standing, I certify under penalty of perjury that I am the taxpayer or the taxpayer’s authorized representative and am entitled to receive the result of this request.

If you are a CPA or Attorney completing this Request for Statement of Good Standing for a business of which you are not a principle, a principle of the business must ALSO sign this request as the taxpayer.

If you are authorizing release of information for someone who is not a CPA or Attorney, this form must be notarized.

Taxpayer Signature

Title

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Print Name

Phone

 

E-mail

 

 

 

 

 

 

 

 

CPA/Attorney Signature

 

Title

 

Date

 

 

 

 

 

 

 

 

Print Name

Phone

 

E-mail

 

 

 

 

 

 

 

 

Signature of person other than taxpayer, CPA, or

Title

 

Date

attorney (Form must be notarized).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Print Name

Phone

 

E-mail

State of West Virginia

County of __________________________, to-wit,

This day appeared before me, the undersigned notary public ________________________________________, who

acknowledge under oath the signature above.

_________________________________________ Notary public

____________________________ Date

My commission expires: ___________________________

If you would like the response faxed to you, enter the fax number including area code (

)

______________________

_

 

Name of person fax is to be addressed to:

___________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

send this request to:

 

phone numbers:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

West Virginia State Tax Department

(304)

558-0678

 

 

 

 

 

 

Excise & Support Tax Unit – 1st Floor

(304)

558-8695

 

 

 

 

 

 

PO Box 885

(304)

558-1114

 

 

 

 

 

 

Charleston, WV 25323-0885

(304)

558-0659

 

 

 

 

 

 

Fax # (304) 558-8643

 

 

 

 

 

 

 

Document Specs

Fact Name Details
Form Title GSR-01 West Virginia Request for Statement of Good Standing
Revision Date Rev. 10/14
Governing Law West Virginia Code § 11-10-1 et seq.
Purpose This form is used to request a statement confirming a business's good standing with the West Virginia State Tax Department.
Signature Requirement The taxpayer or their authorized representative must sign the form under penalty of perjury.
Notarization If completed by someone other than the taxpayer, the form must be notarized.
Contact Information Responses can be faxed to the requester; a fax number must be provided on the form.
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