Form K-40 - Kansas Individual Income Tax And/or Food Sales Tax Refund - 2001 Page 2
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2114201
TAX: Enter the tax amount from line 12 ___________________
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13. Credit for taxes paid to other states (See instructions, page 16) . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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14. Credit for child & dependent care expenses (See instructions, page 17). . . . . . . . . . . . . . . . . . . . . . .
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15. Other credits (Enclose all appropriate schedules) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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16. Total tax credits (Add lines 13, 14 and 15) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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17. Balance (Subtract line 16 from line 12; cannot be less than zero) . . . . . . . . . . . . . . . . . . . . . . . .
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18. Kansas income tax withheld (Enclose Kansas copies, Form W-2 and/or 1099R) . . . . . . . . . . . .
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19. Estimated tax paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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20. Amount paid with Kansas extension . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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21. Earned income credit (See instructions, page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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22. Refundable portion of tax credits (Enclose all appropriate schedules) . . . . . . . . . . . . . . . . . . . . . . . . .
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23. Food Sales Tax Refund (See instructions, page 18). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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If this is your ORIGINAL Kansas Income Tax return, skip lines 24 and 25 and continue to line 26.
If this is your AMENDED Kansas Income Tax return, complete lines 24 and/or 25 before continuing to line 26.
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24. Cash remitted on original return . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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25. Overpayment from original return (This figure is a subtraction; see instructions, page 18). . . . . .
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26. Total refundable credits (Add lines 18 through 24 and subtract line 25) . . . . . . . . . . . . . . . . . . .
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27. UNDERPAYMENT (If line 17 is greater than line 26) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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28. Interest (See instructions, page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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29. Penalty (See instructions, page 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Check here if you were engaged in
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30. Estimated Tax Penalty (See instructions, page 18) . . . . .
commercial farming or fishing in 2001.
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31. AMOUNT YOU OWE (Add lines 27, 28, 29 and 30. Include amounts from lines 34 and 35 if
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applicable.) See payment options on page 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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32. OVERPAYMENT (If line 17 is less than line 26). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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33. CREDIT FORWARD
(Enter the amount of line 32 you wish to be applied to your 2002 estimated tax) . . .
If you wish to donate to either the Chickadee Checkoff or the World War II Memorial Fund, enter the amount of your
donation on the appropriate line. This donation will reduce your refund or increase the amount you owe.
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34. CHICKADEE CHECKOFF (Kansas Nongame Wildlife Improvement Program). . . . . . . . . . . . . .
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35. WORLD WAR II MEMORIAL FUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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36. REFUND (Subtract lines 33, 34 and 35 from line 32). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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.
Signature of taxpayer
Signature of preparer other than taxpayer
Date
If joint return, BOTH taxpayer and spouse must sign even if only one had income
Address of preparer other than taxpayer
Phone number of preparer
other than taxpayer
ENCLOSE any necessary documents
MAIL TO:
KANSAS INCOME TAX
KANSAS DEPARTMENT OF REVENUE
with this form. DO NOT STAPLE.
915 SW HARRISON ST
TOPEKA, KS 66699-1000
Page 8
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