West Virginia Code of State Rules
Agency 110 - Tax
Title 110 - LEGISLATIVE RULE STATE TAX DEPARTMENT
Series 110-13FF - Tax Credit For Providing Vehicles To low-Income Workers
Section 110-13FF-7 - Claiming the credit

7.1. Any taxpayer or dealer in new or used vehicles claiming a credit under this rule shall file the following form with the return for the tax against which the credit is being claimed.

7.2. The form shall be completed and the information contained therein verified by the qualified charitable organization at the time the vehicle is donated or sold.

7.3. The following form shall be used:

[name of qualified charitable organization] hereby certifies that the taxpayer named herein is eligible for the credit allowed under W. Va. Code § 11-13FF-1, et seq., in an amount not to exceed $___________________ for the sale or donation of the vehicle identified below.

Address of qualified charitable organization:

_____________________________________________________

Taxpayer Identification Number of qualified charitable organization:

_________________________

Vehicle make, model, and year:

______________________________________________________

Vehicle Identification Number (VIN):

______________________________________________________

Name of Taxpayer or Seller:

______________________________________________________

Physical address of Taxpayer or Seller:

______________________________________________________

Taxpayer identification number:

______________________________________________________

Program value of vehicle:

$_____________________________________________________

Maximum amount of credit authorized:

$_____________________________________________________

Donor's Certification:

By signing below, I certify that I have donated the above-referenced vehicle to the qualified charitable organization identified herein for no consideration.

Seller's Certification

By signing below, the seller of the above vehicle certifies that, having made a diligent search, it finds that the vehicle:

* Has passed a West Virginia safety inspection;

* Has not been reported as stolen and not recovered;

* Has informed the program participant whether the vehicle is subject to any unperformed safety recalls;

* Has not been reported as a total loss as the result of an accident;

* Has not been flood-damaged;

* Has not been junked or salvaged;

and that the vehicle is suitable to provide safe and reliable transport for commuting to employment.

Certification of qualified charitable organization:

By signing below, the authorized representative of the qualified charitable organization named above certifies that the organization has given no consideration in exchange for the donated vehicle, or, in the case of a sold vehicle, that the organization has not received any consideration from the seller of the vehicle. The date of donation is ________________.

Signature of donor or seller:

_________________________________________________________

Date of signature:

_________________________________________________________

Authorized signature of certifying Qualified Charitable Organization:

_________________________________________________________

Date of signature:

_________________________________________________________

7.4. Dealer Warranty. -- The fair market value of the vehicle and not the sales price shall be used to determine the applicability of § 46A-6-107a(a)(3)(A) to any vehicle the sale of which qualifies for a tax credit as provided by this rule.