Form K-40 - Kansas Individual Income Tax And/or Food Sales Tax Refund - 2009 Page 2
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TAX: Enter the income tax amount from line 12 ___________________
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13. Credit for taxes paid to other states (See instructions. Enclose return(s) from other states.). . . . . .
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14. Credit for child & dependent care expenses (See instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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15. Other credits (Enclose all appropriate credit schedules). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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16. Total tax credits (Add lines 13, 14 and 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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17. Income tax balance after credits (Subtract line 16 from line 12; cannot be less than zero) . . . . .
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18. Use tax due (See instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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19. Total Tax Balance (Add lines 17 and 18). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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20. Kansas income tax withheld from W-2, 1099, or K-19 (Enclose K-19; see instructions) . . . . . . .
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21. Estimated tax paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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22. Amount paid with Kansas extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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23. Earned income credit (See instructions). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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24. Refundable portion of tax credits (Enclose all appropriate credit schedules). . . . . . . . . . . . . . . . .
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25. FOOD SALES TAX REFUND (You must meet ALL the qualifications; see instructions). . . . . . . . . . . . . . . . . . . . .
For an ORIGINAL return, skip to line 28. For an AMENDED return, complete lines 26 and/or 27 before continuing to line 28.
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26. Payments remitted with original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
-
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27. Overpayment from original return (This figure is a subtraction; see instructions) . . . . . . . . . . . . .
-
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28. Total refundable credits (Add lines 20 through 26 and subtract line 27) . . . . . . . . . . . . . . .
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29. UNDERPAYMENT (If line 19 is greater than line 28, enter the difference here) . . . . . . . . . . . .
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30. Interest (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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31. Penalty (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Check here if you were engaged in
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32. Estimated Tax Penalty (See instructions) . . . . . . . . . . . .
commercial farming or fishing in 2009.
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33. AMOUNT YOU OWE (Add lines 29 through 32. Include amounts from lines 36 through 39, if
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applicable.) See instructions for payment options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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34. OVERPAYMENT (If line 19 is less than line 28, enter the difference here) . . . . . . . . . . . . . . . . .
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(Enter the amount of line 34 you wish to be applied to your 2010 estimated tax)
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35. CREDIT FORWARD
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If you wish to donate to any of the following contribution programs, enter your donation amount(s) on the appropriate
line(s). These donations will reduce your refund or increase the amount you owe.
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36. CHICKADEE CHECKOFF (Kansas Nongame Wildlife Improvement Program). . . . . . . . . . . . . .
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37. SENIOR CITIZENS MEALS ON WHEELS CONTRIBUTION PROGRAM . . . . . . . . . . . . . . . . .
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38. BREAST CANCER RESEARCH FUND. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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39. MILITARY EMERGENCY RELIEF FUND. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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40. REFUND (Subtract lines 35 through 39 from line 34. SIGN your return below.) . . . . . . . . . . .
I authorize the Director of Taxation or the Director's designee to discuss my return and enclosures with my preparer.
I declare under the penalties of perjury that to the best of my knowledge and belief this is a true, correct, and complete return.
Date
Signature of taxpayer
Signature of preparer other than taxpayer
Phone number of preparer
Tax preparer's EIN (Employer
Identification Number) OR
If joint return, BOTH taxpayer and spouse must sign even if only one had income
SSN (Social Security Number)
MAIL TO:
KANSAS INCOME TAX
ENCLOSE any necessary documents
KANSAS DEPARTMENT OF REVENUE
with this form. DO NOT STAPLE.
915 SW HARRISON ST
TOPEKA, KS 66699-1000
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