Form K-40 - Kansas Individual Income Tax And/or Food Sales Tax Refund - 2004 Page 5
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5114404
PART B - NONRESIDENT ALLOCATION (See instructions, page 24)
-
If amount is negative, shade the minus (-) in box. Example:
INCOME:
Total From Federal Return:
Amount From Kansas Sources:
,
,
.
1 5 0 0 0
60,000
00
B1. Wages, salaries, tips, etc. . . . . . . . . . . . . . . . . . . . .
,
,
.
100
00
B2. Interest and dividend income. . . . . . . . . . . . . . . . . .
,
,
80
.
8 0
00
B3. Refunds of state and local income taxes. . . . . . . . .
,
,
.
.
00
B4. Alimony received . . . . . . . . . . . . . . . . . . . . . . . . . . .
-
,
,
.
00
B5. Business income or loss . . . . . . . . . . . . . . . . . . . . .
-
,
,
.
00
B6. Farm income or loss. . . . . . . . . . . . . . . . . . . . . . . . .
-
,
,
.
00
B7. Capital gain or loss. . . . . . . . . . . . . . . . . . . . . . . . . .
-
-
,
,
.
.
00
B8. Other gains or losses. . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
B9. Pensions, IRA distributions, and annuities. . . . . . . .
-
,
,
.
B10. Rental real estate, royalties, partnerships,
00
S corporations, estates, trusts, etc. . . . . . . . . . . . . .
,
,
.
6 2 0
B11. Unemployment compensation, taxable Social
620
00
Security benefits, and other income. . . . . . . . . . . . .
-
,
,
.
1 5 7 0 0
00
B12. Total income from Kansas sources (Add lines B1 through B11). . . . . . . . . . . . . . . . . . . . .
ADJUSTMENTS AND MODIFICATIONS TO KANSAS SOURCE INCOME:
Total From Federal Return:
Amount From Kansas Sources:
,
,
.
00
B13. IRA Retirement Deductions . . . . . . . . . . . . . . . . . . .
,
,
.
00
B14. Penalty on early withdrawal of savings. . . . . . . . . . .
,
,
.
00
B15. Alimony paid. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
B16. Moving expenses . . . . . . . . . . . . . . . . . . . . . . . . . . .
,
,
.
00
B17. Other federal adjustments. . . . . . . . . . . . . . . . . . . . .
,
,
.
00
B18. Total federal adjustments to Kansas source income (Add lines B13 through B17). . . . . . .
-
,
,
.
1 5 7 0 0
00
B19. Kansas source income after federal adjustments (Subtract line B18 from line B12). . . . . .
-
,
,
.
4 2 0
00
B20. Net modifications applicable to Kansas source income (See instructions) . . . . . . . . . . . . .
,
,
.
1 6 1 2 0
00
B21. Modified Kansas source income (Line B19 plus or minus line B20) . . . . . . . . . . . . . . . . . .
-
,
,
.
1 6 2 2 0
00
B22. Kansas adjusted gross income (From line 3, Form K-40). . . . . . . . . . . . . . . . . . . . . . . . . .
1 0 0
%
B23. Nonresident allocation percentage (Divide line B21 by line B22 and round to nearest whole
percent, enter on line 9, Form K-40) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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