Form Mf-400 - Kansas Qualified Agricultural Ethyl Alcohol Producer Incentive Fund - Kansas Department Of Revenue Page 2

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INSTRUCTIONS FOR COMPLETING APPLICATION FOR KANSAS QUALIFIED
AGRICULTURAL ETHYL ALCOHOL PRODUCER INCENTIVE FUND
1. Complete this application and return to the Kansas Department of Revenue, Motor Fuel Tax, 915 S.W.
Harrison Street, Topeka, Kansas 66612-1588.
2. Each question must be answered fully. Incomplete applications will be returned for completion.
3. WHO MAY SIGN APPLICATION – Only the individual owner, one of the partners listed on application,
one of the executive officers listed, if applicant is a corporation; or a person who has been duly
authorized as attorney-in-fact by proper Power of Attorney which has been filed in this office, may sign
the application.
4. Applications must be properly notarized.
5. Upon acceptance, you will automatically be notified and will receive ethyl alcohol producer’s Reports
from the Department of Revenue on a quarterly basis

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