Form K-130 - Kansas Privilege Tax - 2004 Page 3
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4PART I - ADDITIONAL INFORMATION
1. Did the corporation file a Kansas privilege tax return under
6. If this is a final return for Kansas, please state the reason. If
the corporation was liquidated or dissolved, state the IRC
the same name for the preceding year?
section under which the corporation was liquidated.
_____ Yes _____ No. If no, enter previous name and EIN.
2. Enter the address of the corporation’s principal location in
Kansas.
Telephone
7. If your federal taxable income has been redetermined for any
prior years that have not previously been reported to Kansas,
3. The corporation’s books are in care of:
please check the applicable box or boxes below and state
Name
the calendar, fiscal, or short period year ending date. You are
required to submit the federal Forms 1139, 1120X or
Address
Revenue Agent’s Report along with the Kansas Form K-139
or K-130X under separate cover.
Other State’s Adjustment
Revenue Agent’s Report
Telephone
Amended Return
4. List each estimated tax payment and credit forward amount
claimed on this return.
Net Operating Loss
Amount
Date
Years ended
8. If you are registered with the Kansas Department of Revenue
under any other Kansas tax act, enter all registration or
license numbers on the applicable line:
a. Sales Tax
b. Compensating Use Tax
c. Withholding Tax
TOTAL (Enter on line 25,
Form K-130) . . . . . . . . . . . .
d. Other (specify)
5. Has your corporation been involved in any reorganization
during the period covered by this return?
____ Yes ____ No. If yes, enclose a detailed explanation.
PART II - AFFILIATED FINANCIAL INSTITUTIONS OR CORPORATIONS DOING BUSINESS IN KANSAS
Name of Corporation or Financial Institution
Employer Identification Number
(Enclose separate sheet for additional corporations)
PART III - SCHEDULE OF NONREFUNDABLE CREDITS (See Instructions)
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1. Business and job development credit (Enclose Schedule K-34)...............................................................................................
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2. Historic preservation credit (Enclose Schedule K-35)...............................................................................................................
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3. Disabled access credit (Enclose Schedule K-37) ....................................................................................................................
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4. Agricultural loan interest reduction credit (Enclose Schedule K-51 and K-52) .........................................................................
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5. Venture capital credit (Enclose Schedule K-55).......................................................................................................................
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6. High performance incentive program credit (Enclose Schedule K-59).....................................................................................
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7. Community service contribution credit (Enclose Schedule K-60) .............................................................................................
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8. Total nonrefundable credits (Enter on line 23, page 2) .............................................................................................................
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