Form K-150 - Kansas Franchise Tax - 2004

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 KANSAS
K-150
680104
(10/04)
FRANCHISE TAX
DO NOT STAPLE
For the taxable year beginning ____ ___ / ___ ___/___ ___ ___ ___ ; ending ____ ___ / ___ ___/___ ___ ___ ___
Name
Employer ID Numbers (EINs)
Business Activity Code (NAICS):
(Enter both if applicable)
___ ___ ___ ___ ___ ___
Number and Street of Principal Office
Date Business Began in KS (mm/dd/yyyy):
EIN this entity:
___ ___ / ___ ___/___ ___ ___ ___
___ ___ ___ ___ ___ ___ ___ ___ ___
City
State
Zip Code
Date Business Discontinued in KS (mm/dd/yyyy):
___ ___ / ___ ___/___ ___ ___ ___
EIN Federal Consolidated Parent:
If your name or address has changed since last year, mark an "X" in
___ ___ ___ ___ ___ ___ ___ ___ ___
___ ___
State of Commercial Domicile:
this box.
Federal Form Type Used:
Corporate (1120)
Corporate Short Form (1120A)
Business Trust (1120)
Other:
Co-op (1120)
Small Business (1120S)
Partnership (1065)
NOTE: This form must be accompanied by a balance sheet
PERCENT TO
listing all assets and liabilities as of the end of the tax year.
TOTAL IN KANSAS
TOTAL EVERYWHERE
KANSAS
1. Average value of real and tangible personal
1
$
=
%
$
property owned or rented during the taxable year . .
divided by
2
%
$
=
$
2. Total payroll . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
divided by
3
%
$
=
$
3. Sales . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
divided by
4
%
4. Average percent to Kansas (Add percentages on lines 1 through 3 and divide by the number of factors used) . . . . . . . . . . .
5
.
5. Net worth (Total shareholders equity) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.
6
___ ___ ___
___ ___ ___ ___
6. Average percent (Enter percentage from Line 4). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
.
7. Kansas net worth (Multiply line 5 by line 6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8
.
8. Total Kansas franchise tax (Multiply line 7 by .00125; cannot be more than $20,000) . . . . . . . . . . . . . .
9
.
9. Amount paid with extension. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
10
.
10. Refund (If line 9 exceeds line 8) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
.
11. Tax due (If line 8 exceeds line 9). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12
.
12. Interest (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
13
.
13. Penalty (See instructions) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14
.
14. Total tax, interest and penalty due (Add lines 11, 12 and 13) (Complete Form K-150V) . . . . . . . . . . .
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 this is a true, correct, and complete return.
sign
Signature of officer
Title
Date
here
Date
Individual or firm signature of preparer
Address and Phone Number
Mail to:
Kansas Franchise Tax
Kansas Department of Revenue
915 SW Harrison Street
Topeka, KS 66699-5000

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